Albuterol, Asthma, and an Inability to Sleep

I was diagnosed with asthma last fall, at age 36. It was a direct result of having the RSV virus, and permanent damage to my lungs. It was a shock, something I honestly never expected, and in many ways, it has been harder and scarier to manage than any of the other chronic conditions I live with.

It's also impacted them all, in one way or another.

One necessary evil

After initial diagnosis, my asthma was decently controlled for a few months. In February of this year, I began struggling with more persistent coughing, wheezing, tightness of chest, pain in my lungs, and an inability to catch my breath.

Using one routine inhaler twice a day stopped being sufficient to manage this, so all sorts of tests were run and all sorts of medications were tried - some which helped a little, others which didn't seem to make any difference.

One necessary evil: albuterol.

Albuterol's effects on me

Just like my forced on-again, off-again relationship with prednisone, using an albuterol inhaler and albuterol solution in my nebulizer has changed a lot of things for me.

The albuterol makes me a little shaky. Sometimes it increases my heart rate a lot, which felt scary at first. Now I know to expect it. But it also makes me more alert, it makes my brain run a little faster, I tend to think and talk faster, and overall, feel kind of "amped up" after use.

Now, there are times in my day that I can use those side effects to my advantage. But, there are times in my day in which they are a complete detriment.

The issue

Because I was waking up having such intense coughing fits from my asthma that I couldn't catch my breath, my pulmonologist recommended that I use my nebulizer just before bed.

Well, albuterol is one of 2 solutions that go into my nebulizer. The other, budesonide, is a steroid, very similar to prednisone. So, together, these 2 medications make me mentally ready to run a marathon, write a novel, or clean my house.

They don't, in fact, do anything to promote or allow sleep. The other night is a perfect example of how frustrating this has become.

Trying to settle down to sleep

After 2 days of decently controlled asthma and no need to nebulize at bedtime, I had a day filled with intense coughing, and I knew I needed to support my airways or could have a scary night ahead of me. I used my nebulizer with both albuterol and budesonide, and then instead of getting right into bed, I went back downstairs and did all the dishes. I threw in a load of laundry, and I washed all of my inhalers and the parts to my nebulizer.

About an hour later, thinking I had outsmarted the medication and my brain, I got into bed. I watched an episode of television, and then tried to settle into my bedtime routine around 11pm.

A double edged sword

At 3:30 am, I was still awake, staring at the clock, wondering what my next move should be. I had tossed and turned, tried to give it time, tried to listen to meditations, tried to doze off - nothing.

What a double edged sword. Have sleep continually disrupted by intense coughing fits, or have sleep unattainable by medically managing those coughing fits. What would you do?

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