A persistent, chronic, nighttime cough is one of the most common symptoms of mild asthma.
It also can be a symptom of several other pulmonary problems. If your child coughs often at night, how do you tell if it's asthma - or something else?
Without a medical evaluation, you really can't. Even doctors find it difficult to diagnose asthma when its only presenting symptom is nighttime coughing. In general, an asthma cough is a non-productive cough - one that doesn't bring up any mucus. It may sound as if something is rattling, or have a wheeze at the end of it. More often than not, there's a spasmodic quality to the cough - it may continue until the child is completely out of breath and gagging, or even until they actually vomit.
What if your child is coughing up mucus and sputum?
Well, say doctors, chances are that it's not an asthma cough if it's productive. In most cases, a productive cough accompanies a cold, or lingers for a week or two beyond it. It may also be a symptom of other seriously lung problems, though, so if a cough persists more than 5-7 days, be certain to contact your doctor.
Treatment of a night-time cough obviously depends on the underlying cause of the cough, but most doctors agree that if a cough is productive, treatment shouldn't suppress the cough, since the body needs to bring up all the 'junk' that's clogging the lungs and airways. In fact, if there's obvious congestion that isn't being brought up, an expectorant can help break it up and allow it to be coughed out.
Asthma coughs, on the other hand, are most often dry coughs caused by bronchial spasms.
Since there's nothing to bring up, there's no way for an asthma cough to be 'productive', though you may hear rattling or 'crinkling' sounds if you listen to the chest of a child when they cough. Most doctors now believe that the actual cause of an asthma cough is an irritant or allergen of some kind that sets off an excessive immune reaction. The airways swell as histamine is produced, and the muscles around the bronchial passages go into spasms to attempt to force the irritant up through them.
When dealing with an asthma cough, productive treatment should include regular use of a bronchodilator to help loosen up the muscles around the bronchial tubes. Those muscles put a stranglehold on the airways and make it almost impossible to force air in and out of them. Relaxing them can soothe the most evident symptom of childhood nighttime asthma. Productive treatment often also includes the use of an anti-inflammatory - most often inhaled steroids - to reduce chronic swelling of the bronchioles and make it easier for them to empty.
You can also try a few 'natural remedies' to help reduce episodes of night-time asthma coughing - as long as you keep using the treatment your doctor gave you.
Some herbalists suggest a cup of hot black or green tea with honey before bedtime - the theophyline and caffeine in the tea are both older treatments for asthma, and the honey can sooth a dry, irritated throat.
Add a banana or two to your daily diet, or make sure to eat plenty of magnesium-rich vegetables and meats - magnesium helps control muscle contraction, and many people with asthma have low magnesium levels.
Finally, avoid having irritants in your (or the child's) bedroom. No pets, no stuffed animals, nothing that might trap dust mites or dust - major causes of allergic reactions in childhood asthma.