Pathophysiology of nocturnal asthma

Learning Objectives: This article will focus an the pathophysiologic change s underlying the nocturnal worsening of asthma and the therapeutic approach to this disorder. Data Sources: Selected articles appearing since 1985 dealing specifically w ith the underlying pathologic features and therapy of nocturnal asthma. Study Selection: Studies that aimed to elucidate the pathologic features, m echanisms, and therapeutic strategies for the treatment of nocturnal asthma are summerized. Results: Nocturnal asthma is associated with significant decline in pulmona ry function and increase of airway inflammation at night. The administratio n of medications must be designed to achieve the maximal effect during the night in nocturnal asthma. Conclusions: The further elucidation of the reasons underlying nocturnal as thma should lead to more specific therapeutic interventions with maximal ef fect at night.