Why do respiratory conditions worsen at night??
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Respiratory medicine
Why do respiratory conditions worsen at night??
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I have a question for all the respiratory bods out there... It is well know that asthma worsens at night - infact some patients only have noctural symptoms. When we have asthmatics or children with vi
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Cat:OpenClinicalForum:8114d353-b41b-4a03-b052-dc009589d5cf
Cat:OpenClinicalForum:8114d353-b41b-4a03-b052-dc009589d5cfDiscussion:5afb6ec9-2dee-49fc-a779-10530b6cb35b
Forums » Open clinical » Respiratory medicine » Why do respiratory conditions worsen at night??
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Why do respiratory conditions worsen at night??
posted at 8/9/2011 8:43 PM BST
on bmj.com
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Posts: 1348
First: 25/1/2009 Last: 20/5/2013 |
I have a question for all the respiratory bods out there... It is well know that asthma worsens at night - infact some patients only have noctural symptoms. When we have asthmatics or children with viral wheeze on the wards we know that they tend to worsen at night - those who were managing on 3-4hrs between inhalers, and in air during the day will often require more freqent nebulisers and oxygen at night. Children with croup rarely present in the day - its is usually the early hours of the morning. I've heard several theories on this but am not truely convinced by any of them...
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Re: Why do respiratory conditions worsen at night??
posted at 8/9/2011 9:41 PM BST
on bmj.com
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Posts: 1785
First: 7/3/2009 Last: 22/5/2013 |
Here is another: symathetic drive is lower at night. And still another- supine position is worse for people suffering from respiratory disorders. You seat patients up to allow for more volume of air to enter. Plus night brings more anxiety than daylight.That is also a contributing factor.
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Re: Why do respiratory conditions worsen at night??
posted at 9/9/2011 8:54 AM BST
on bmj.com
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Posts: 643
First: 2/2/2011 Last: 21/5/2013 |
A line ---------night brings more anxiety than daylight -------from Dr Yoram chaiter----post is a very logical explanation. the logic also applies to other diseases., like heart diseases and mental disorders.i am always hearing from the caretakers of my patients that the symptoms of diseases of their near and dear exacerbated at night. |
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Re: Why do respiratory conditions worsen at night??
posted at 9/9/2011 11:28 AM BST
on bmj.com
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Posts: 1178
First: 19/4/2010 Last: 21/5/2013 |
I think all the points here are valid, and combine to give the answer. I think the most important factors are: 1) Supine/prone positioning: V/Q matching is far better when sat upright, rather than lying flat to sleep. 2) Reduced respiratory drive during sleep: we all hypoventilate when asleep, so any respiratory illness which we can cope with during the day, becomes more significant during periods of hypoventilation 3) Allergens: I don't think it's feather pilllows, indeed the evidence is against that, but HDM is problaby implicated, and the cat that sleep on the bed certainly is... Great question, thanks!
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Re: Why do respiratory conditions worsen at night??
posted at 21/9/2011 6:19 AM BST
on bmj.com
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Posts: 1593
First: 24/12/2008 Last: 14/5/2013 |
This is an excellent discussion. I just wanted to emphasize about lower sympathetic drive and hypoventilation during sleep. That's definitely something an important player especially when it might get associated with significant desaturation. Then with respiratory tract (especially Upper) infection, it might be more collapsible. In anyway, during supine position sleep, and upper airway collapse has been around in the pathogenesis of obstructive sleep apnea. With infection and iflammation of upper airway, it could get worse. Relaxation of genioglossus muscles is there and falling of tongue backwards are as always there.
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Forums » Open clinical » Respiratory medicine » Why do respiratory conditions worsen at night??
