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    It turns out that asthma worsens at night, finds new study

    By Emily Hagan | Published on Oct 18, 2023

    Asthma, a respiratory condition that affects millions worldwide, has long been known to worsen at night. While sleep and physical activities were thought to contribute to this phenomenon, a recent study has uncovered the significant role of the body’s internal circadian clock in the severity of asthma symptoms. Published in The Proceedings of the National Academy of Sciences, this groundbreaking research sheds light on the mechanisms that influence asthma and could potentially revolutionize its treatment.

    Decoding the Findings

    Researchers from Brigham and Women’s Hospital and Oregon Health & Science University embarked on an exploration to determine how much the circadian system affects asthma severity. By utilizing two circadian protocols, they successfully isolated the influence of the biological clock from other behavioral and environmental factors. The results were eye-opening.

    The study revealed that individuals who experienced the most severe asthma symptoms also suffered the greatest drops in pulmonary function at night, induced by both circadian rhythms and behaviors such as sleep. Intriguingly, the data indicated that symptom-driven bronchodilator inhaler use was up to four times more frequent during the circadian night than during the day. This finding holds clinical significance and emphasizes the importance of understanding and managing asthma symptoms at night.

    The Burden of Nighttime Asthma

    Nighttime asthma remains a prevalent issue, with approximately 75% of asthma patients in the United States reporting worsened symptoms during the evening hours. Factors like exercise, air temperature, posture, and sleep environment have long been recognized as contributors to asthma severity. However, this study aimed to unravel the role of the internal circadian system in this nocturnal aggravation.

    Unveiling the Circadian System

    The circadian system, consisting of a central pacemaker in the brain known as the suprachiasmatic nucleus, plays a crucial role in synchronizing bodily functions with the daily environmental and behavioral demands. By separating the influence of the circadian system from sleep and other factors, the researchers enrolled 17 participants with asthma in two laboratory protocols.

    In the “constant routine” protocol, participants spent 38 hours awake, maintaining a constant posture and exposed to dim light conditions while consuming identical snacks every two hours. The “forced desynchrony” protocol involved placing participants on a recurring 28-hour sleep/wake cycle for a week, with all behaviors scheduled evenly across the cycle.

    Implications for Asthma Management

    Understanding the complex interplay between the circadian system and asthma severity carries significant implications for those diagnosed with the condition. By recognizing the nighttime exacerbation of symptoms as a consequence of circadian rhythms, healthcare professionals can tailor treatment plans more effectively. Asthma patients may find it beneficial to monitor their symptoms closely during the night and adjust their medication accordingly.

    With ongoing research in the field of asthma and circadian rhythms, the hope is to develop innovative treatment strategies that improve the quality of life for millions affected by this chronic respiratory condition.

    Image courtesy: Shutterstock

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