The National Asthma Council has released a new health professional resource in time for World Sleep Day (15 March) outlining the key steps to treat patients who present with poor asthma control and sleep disturbance.
Associate Professor Greg Katsoulotos, Australian Asthma Handbook Committee member and respiratory medicine and sleep disorders physician, said it is a valuable new resource for health professionals when patients with asthma report persistent night time cough.
“Asthma symptoms during sleep or on waking indicate suboptimal asthma control and frequent nocturnal symptoms indicate increased risk of acute asthma exacerbations and should not be accepted as normal.
The resource recommends that health professionals should consider stepping up asthma treatment with anti-inflammatory therapy in a patient with sleep disturbance due to asthma symptoms,” he said.
Associate Professor Katsoulotos said nocturnal cough can occur with or without wheeze and can be a sign of poor asthma control that needs to be addressed with the patient who may instead think that their cough is due to an infection.
“Airway inflammation occurs in asthma, so treatment of airway inflammation is just as important as treatment of airway infection. If one or two courses of antibiotics do not help, consider that there may be unstable asthma or an alternative diagnosis.
“Inhaled anti-inflammatory therapy is the cornerstone of asthma treatment, not antibiotics or SABA alone,” he said.
The new sleep resource also highlights key asthma practice points and encourages the use of an asthma symptom tool such as the Australian Asthma Handbook Asthma Control Test.
Associate Professor Katsoulotos said the resource also aims to increase awareness of other causes of cough for people with asthma that may attract inappropriate use of oral steroids and multiple courses of antibiotics from misdiagnosis.
“Several conditions may contribute to both sleep disturbance and poorer asthma control, such as allergic rhinitis, obstructive sleep apnoea, gastro-oesophageal reflux disease and obesity and these should be investigated and managed simultaneously,” he said.
