IN THE lead up to World Sleep Day (15 Mar), the National Asthma Council has released a new health professional resource today, outlining how to treat patients who present with poor asthma control and sleep disturbance issues.
According to Australian Asthma Handbook Committee member A/Prof Greg Katsoulotos, the resource is particularly valuable for treating patients with persistent coughing at night-time.
"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.
Katsoulotos said nocturnal coughing can occur with or without wheezing and can be a sign of poor asthma control that needs to be addressed with patients who may mistake their cough for a virus or 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 [Short-Acting Beta Agonists] alone," he explained.
The sleep resource also highlighted key asthma practice points and encourages the use of an asthma symptom tool such as the Australian Asthma Handbook's Asthma Control Test.
Katsoulotos said the resource also aims to increase awareness of other causes of coughing for people with asthma that may attract inappropriate use of oral steroids and multiple courses of antibiotics from misdiagnosis.
"Several medical 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 in patients," Katsoulotos concluded. JG
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