Thursday, March 19, 2009

Breathless in the middle of the night

'Western' med: Breathless in the middle of the night
Thu, Mar 19, 2009
AsiaOne

Qn: Maybe it's the drier air but in the middle of the night my nose gets blocked and there's a back dripping into my throat. This causes dewy phlegm to form and I can't breathe, accompanied by a wheezing sound. Is this bronchitis?

To combat this I take a puff of ventolin and experience extreme dryness in the throat but the phlegm seems to clear up and I can breathe better.

During the day I am totally all right except for the lack of sleep due to sudden breathlessness. Apparently this is happening to some of my friends who has allergy-induced asthmatic conditions.

Why does this happen and what can I do to heal the condition and not treat the symptom?

J


Ans: This is not really bronchitis; there is probably some hypersensitivity of the airway. Hence when it is more dusty or cold, mucus formation is encouraged, leading to the back dripping into the back of the throat.

Taking a ventolin puff helps as it will open up the airway and clear the congestion. Taking an anti-allergy pill will also help.

This hypersensitivity occurs when one is exposed to allergens and the best way to manage the situation is to avoid the aggravating factor. Another way is to undergo a short course of inhaled steroids.

Answer contributed by:
Dr Swee Yong Peng, CEO, ParkWayHealth Primary Care Network

The information provided here is intended for educational purposes only. Please consult a doctor if you are not feeling well. AsiaOne disclaims any and all liability for injury or other damages that could result from use of the information obtained from this article.

TCM: Breathless in the middle of the night
Mon, Mar 16, 2009
AsiaOne

Qn: Maybe it's the drier air but in the middle of the night my nose gets blocked and there's a back dripping into my throat. This causes dewy phlegm to form and I can't breathe, accompanied by a wheezing sound. Is this bronchitis?

To combat this I take a puff of ventolin and experience extreme dryness in the throat but the phlegm seems to clear up and I can breathe better.

During the day I am totally all right except for the lack of sleep due to sudden breathlessness. Apparently this is happening to some of my friends who has allergy-induced asthmatic conditions.

Why does this happen and what can I do to heal the condition and not treat the symptom?

J


Ans: After reading your enquiry, I understand that your main symptoms consist of blocked nose, back dripping of mucus into your throat, lots of phlegm and difficulty in breathing. Just by looking at the symptoms described, it may be too premature to determine that you have bronchitis. Instead, your condition may be related to an allergy, more specifically bronchial asthma.

Bronchitis

Bronchitis occurs when the windpipe, airways, mucous membrane and surrounding tissues become inflamed. The main clinical manifestations of chronic bronchitis are cough, phlegm cough, shortness of breath and repeated respiratory tract infection with the cough being long-term.

Conditions of patients with mild chronic bronchitis are usually more prominent in the early mornings and they tend to cough less during the day, while those with more severe chronic bronchitis tend to cough throughout the day with the same intensity. Patients will experience more phlegm in the early mornings (in the form of white, mucus froth), which is often difficult to expel due to its thickness.

When combined with respiratory tract infection, symptoms of asthma will emerge and this condition often persists.

Bronchial asthma

Symptoms of bronchial asthma include cough, wheezing, shortness of breath, chest tightness and phlegm. The wheezing occurs upon expiration, usually during a recurrence of an asthma attack when the patient suffers shortness of breath or difficult breathing. Other symptoms include dry cough or respiratory secretion of large amounts of white, frothy phlegm.

The onset of an asthma attack may be sudden, occurring in just a few minutes and is treatable using bronchodilator or there may be spontaneous remission.

The pathogenic characteristics of asthma are:

  • Attacks usually happen in the presence of inducing factors
  • Attacks often occur or worsen either at night or in the early hours of the morning
  • Anti-asthmatic medication is able to relieve/ease the symptoms
  • Often, the patient has no history of chronic cough or phlegm cough. It is usually characterised by a sudden or recurrent attack of asthma. Despite this, the patient may show few or even no signs of the condition between attacks.
  • There may also be an individual or family medical history of allergy, with a lot of patients suffering from perennial allergic rhinitis or sinusitis.

Below are some of the common causes of bronchial asthma:

  • Allergens such as dust, mites, pollen, fungus, pet dander and chemical gas
  • Repeated respiratory tract infections
  • Foods that may trigger allergic reaction like fish, prawn, crab, egg and milk
  • Environmental stimulants such as large differences between indoor and outdoor temperatures
  • Emotional factors such as nervousness and agitation
  • Engaging in strenuous or rigorous exercises
  • Certain medications may trigger asthma attacks such as heart disease medication and aspirin

With regards to your condition, in order to treat the root of the problem, it will be best to consult a doctor or physician for a more in-depth diagnosis. Only then will the doctor or physician be able to prescribe the appropriate medication to control and eliminate the discomfort as well as symptoms.

Should your condition be triggered by allergy, below are some suggestions on lifestyle habits that you may want to consider:

  • Exercise regularly to build up the body’s immunity
  • Avoid contact with possible allergens such as dust and mites, and aggravators like high/low temperatures
  • Reduce emotional stress and maintain a healthy, light diet

Answer contributed by:

Physician Wu Min, who practices at Eu Yan Sang TCM Clinic at Sembawang.

Each individual has differing conditions and body constitutions that require individualised treatment and prescription. It is therefore advisable that one always consults a physician when one is not feeling well. In no circumstances should one self-administer any of the above-mentioned herbs.

AsiaOne disclaims any and all liability for injury or other damages that could result from use of the information obtained from this article.

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