How Do Allergies and Asthma Affect Sleep?

Allergic diseases can worsen at night and may interfere with your sleep, resulting in problems such as daytime fatigue and trouble concentrating. Conditions like allergic rhinitis, asthma, and atopic dermatitis have several features in common that make them worse at night, but they also have unique characteristics that can impact sleep quality as well.

If you have an allergic condition, it's important that you consider how it affects you at different times of the day and night. Talk to your healthcare provider if your symptoms are interfering with your sleep. You may benefit from lifestyle adjustments or medical therapy to help you rest easier.

Allergens That May Worsen Symptoms at Nighttime

Brianna Gilmartin / Verywell

Allergies and Sleep

The symptoms of allergic disease can worsen at night for various reasons.

Aside from being exposed to certain home allergens, your body's natural hormone and immune cycles can change in the evening and encourage symptoms as well.

Exposure to Allergens

All allergies—whether they manifest with a rash, breathing problems, or a stuffy nose—can be worsened with allergens. Allergens are harmless substances that induce an excessive immune reaction.

Depending on which allergens tend to trigger your symptoms, you might have more exposure at night. These include:

  • Dust mites
  • Fabrics
  • Detergents, which can linger even after items are washed
  • Lotions
  • Pets
  • Medications

If you notice that your allergy symptoms are worse in the evening or when you're in bed (or if they follow any other pattern), talk to your healthcare provider to try to identify the reason why.

Daily Physical Changes

There are a number of changes that your body experiences in a typical day. Normal patterns that your hormones and immune cells cycle through in 24 hours can affect inflammatory responses that trigger or worsen certain allergic symptoms.

Cortisol and adrenaline are anti-inflammatory hormones that are at their lowest points when you are sleeping. And inflammatory proteins like cytokines, histamine, and interleukin, which worsen symptoms of allergic diseases, increase when you are tired.

Many people who have disruptions in sleep associated with allergic conditions don't realize it.

Children who have allergic diseases can experience altered breathing and an increased tendency to wet the bed. Parents often don't realize that allergies can be associated with bed-wetting accidents.

Asthma and Sleep

Asthma-related sleep problems can cause daytime sleepiness and fatigue. Experts suggest that people who have unexplained sleep problems should be screened for respiratory diseases such as asthma.

Related issues can include:

  • Trouble falling asleep
  • Disturbed sleep
  • Waking up during sleep
  • Not feeling refreshed in the morning

In general, asthma that is not well controlled is associated with more severe sleeping problems.

There are several factors that can make asthma symptoms worse at night. The same immune changes and potential exposure to allergens that affect everyone at night can trigger your asthma symptoms if you have the condition.

Additionally, lower nighttime cortisol levels can make the lungs more susceptible to asthma-associated bronchospasm, which causes wheezing, chest tightness, and shortness of breath.

These issues can be more than just bothersome for people with asthma—they can cause dangerous breathing impairment. 

Asthma controllers, which are maintenance medications used to prevent asthma symptoms, may improve your sleep quality if you have asthma.

Allergic Rhinitis and Sleep

Allergic rhinitis commonly affects a person’s quality of sleep due to nasal congestion, sneezing, runny nose, and itchy nose and eyes. Research shows that approximately 65% of people with nasal allergies feel that their symptoms interfere with sleeping.

Treatment of nasal congestion, such as intranasal corticosteroid nasal sprays, may reduce symptoms of allergic rhinitis to help you get a good night's sleep.

Allergic rhinitis is also associated with asthma. Having both conditions results in a more significant sleep disturbance than having only one.

Obstructive Sleep Apnea

In addition to the nighttime symptoms that can occur with allergic rhinitis, the condition is also associated with obstructive sleep apnea (OSA). Generally, OSA interferes with sleep because obstruction in the upper airways causes breathing to pause intermittently throughout the night.

With OSA, airflow is decreased during sleep, potentially leading to low oxygen levels in the bloodstream and strain on the heart.

Atopic Dermatitis and Sleep

Atopic dermatitis is associated with itching of the skin, which can be severe and may also be worse when you are trying to sleep.

As you are drifting off, your parasympathetic nervous system kicks in, which helps you relax but also increases your perception of subtle sensory cues like itching.

Sleep disorders can also worsen the symptoms of atopic dermatitis due to disturbances in sleep-related hormones and their effect on the immune system.

Itching, scratching, and other symptoms of atopic dermatitis can, obviously, make it hard to get comfortable. Experts suggest that sleep disturbances are a reflection of the severity of atopic dermatitis.

Treatments for atopic dermatitis that reduce itching such as topical corticosteroids may help improve the quality of sleep.

A Word From Verywell

Allergic conditions can prevent you from getting a good night's sleep. You might notice this if your allergies tend to have a seasonal pattern. And, many people who have one allergic condition also have others, only compounding the effect on sleep.

If you think that you could be having trouble with your sleep and/or problems with allergies, be sure to talk to your healthcare provider so you can get to the bottom of your health concerns and get the right treatment for the relief of your symptoms.

7 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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By Daniel More, MD
Daniel More, MD, is a board-certified allergist and clinical immunologist. He is an assistant clinical professor at the University of California, San Francisco School of Medicine and currently practices at Central Coast Allergy and Asthma in Salinas, California.