A sudden onset of shortness of breath in a sleeping child is a clear sign of asthma, a lung disease in which the airways become temporarily constricted. According to the National Center for Health Statistics of the Centers for Disease Control and Prevention, 8.9 million American children were diagnosed with asthma in the year 2002. Asthma can be treated and controlled with a variety of medications that dilate the airways and decrease the symptoms.
Cause of Asthma
Atopic asthma is an allergic reaction in the lungs caused by inhaled foreign particles. A wide variety of potential genes have been identified in association with the disorder. Meanwhile, environmental factors, such as cigarette smoke and exposure to infections in childhood, are also thought to play a role. The allergy is caused by an abnormal reaction by the immune system. When a susceptible child is exposed to the irritant in question, mast cells are activated, releasing large amounts of the chemical called histamine. Histamine and other chemicals have a variety of effects. Most importantly, they cause constriction of the airways, which obstructs the flow of air in and out of the lung.
Symptoms of Asthma
According to "Nelson's Textbook of Pediatrics," 80 percent of children have their first symptoms before 6 years of age. The association between the irritant and the symptoms may not be immediately obvious, and many children with asthma experience worsening of symptoms during the night. Children are more prone to night symptoms when they have respiratory infections, and common symptoms are breathlessness and wheezing. While adults may complain of chest tightness, most children may simply describe their symptoms as "pain."
Immediate Treatment
A child who has an episode of nighttime breathlessness should be treated with an immediate-acting bronchodilator, which must be prescribed. The most commonly used drug is albuterol, given as an inhaler. The metered-dose inhaler is the standard treatment for older children and adults. Preschool-aged children may have difficulty using this technique; for them, a spacer with a mask is more appropriate. If a child has symptoms that persist for more than five to 10 minutes, take him to a doctor or emergency room.
Longterm Treatment
Children who have more than two nighttime episodes a month should be treated with additional medications to reduce the frequency and severity of asthma attacks. The most common form of medication prescribed are the inhaled corticosteroids. Drugs such as beclomethasone and fluticasone are used. These decrease the inflammatory reaction in the lung and thereby lower the allergic response. Additional drugs may be used in children who still have poor symptoms despite treatment.
References
- "Nelson Textbook of Pediatrics"; Dr. Robert M. Kliegman, et al.; 2008
- "Discovery Medicine"; The Genetics of Asthma and Allergic Disorders; Michael E. March, et al.; January 14th 2011
- KidsHealth.com: When to Go to the ER if Your Child has Asthma
