Waking a child at night to give asthma meds?

Posted on: Wed, 12/15/2004 - 10:58am
yuck2nuts's picture
Joined: 02/28/2002 - 09:00

My 5-year old PA daughter with asthma is in the middle of a cold with coughing and wheezing.

My ped wants us to wake her in the middle of the night to administer Xopenex/Albuterol, but my allergist says that I should never wake a sleeping child to do this. The allergist said that if the child wakes up on her own with wheezing or coughing in the middle of the night, then I should administer the meds, but I should never wake her to do it. I guess the allergist feels that if she is sleeping soundly, she is fine. The ped feels that the meds should not "run out" over night and should be given every 4-6 hours around the clock.

Since I don't know anyone else with a kid this age with asthma, I just thought that someone in this group may have been given similar advice and could tell me what you have done and/or what has worked for you.

I really would prefer not to wake my child (and for ME to get a full night's sleep) if I can.


Posted on: Wed, 12/15/2004 - 11:07am
tcperrine's picture
Joined: 03/01/2002 - 09:00

Hmmm... I'm no expert. My DD ran into a bout of asthma last summer (2003) when she got sick 3 times in a 3 month period. They had me waking her for treatments too. Both the allergist & pediatrician concurred. If she wasn't bad off (coughing) in the middle of the night, I spaced them out further (like 6 hours apart). But I didn't eliminate them. DD can, and frequently does, sleep 12 hour stretches. Too long to go without meds if asthma is triggered.

Posted on: Wed, 12/15/2004 - 11:41am
jami's picture
Joined: 09/02/2004 - 09:00

Tis' the Season ... We were at the Pulmanary specialists yesterday, my 5 year old has been put on multiple new drugs,, and Xopanx (not new, but frequency new) every 4 hours. He did specifically state to not wake him up to give meds, but if he wakes up-- even to go to the bathroom, not just wheezing -- to go ahead and give the xopanex. But to tell you the truth-- with all the medication- steriods beigh what they are--- I'm not sure he actually sleeps for more than 4 hours until he is done with the heavy doses.

Posted on: Wed, 12/15/2004 - 12:36pm
Anonymous's picture
Anonymous (not verified)

yuck2nuts, again, no expert, but dealing with two children with asthma (one worse than the other). My children are now nine and seven. No one has ever told me NOT to wake my children to give them their asthma meds if they were required.
When my son's asthma flares up to the point where he needs Ventolin every four hours, I do wake up every four hours to give him the two puffs of Ventolin. I have certainly done the same with my daughter. Also, at the age of your child.
Right now, my daughter has "the croup" and she was coughing quite heavily in the middle of the night over the week-end and there I was up at 2:30 a.m. steaming her in the bathroom.
My son, with a virus right now, has needed his Ventolin, and one night last week also, up in the middle of the night to administer Ventolin.
It's just the way I've always done it and no one ever told me not to wake them. This way I figure they get their meds in them and I'm fortunate that they both quickly go back to sleep and I can kinda gauge better if they're getting into any difficulty at all (especially my son).
Not sure if this helps.
Best wishes! [img]http://uumor.pair.com/nutalle2/peanutallergy/smile.gif[/img]

Posted on: Wed, 12/15/2004 - 11:57pm
Carefulmom's picture
Joined: 01/03/2002 - 09:00

Our allergist also said don`t wake dd up to give asthma meds. He said if she needs them, she will wake up on her own. We really didn`t discuss what if she wakes up to go the bathroom. I really didn`t discuss it with the ped, since if she is having trouble with her asthma I call the allergist.

Posted on: Thu, 12/16/2004 - 12:38am
kelly01's picture
Joined: 03/19/2001 - 09:00

If my son was on the tail end (ie, getting better during the day) we might not give him the nebulizer during the night. However, if he was still wheezing/coughing at any point during the day/night we kept up w/the nebulizer every 4-6 hours. In our experience, if I did not keep up w/the meds he would "pay" for it by waking up wheezing, etc.
How is the albuterol administered? We usually use an inhaler w/a spacer, but during asthma attacks episodes, we use the nebulizer. If we didn't want to wake him, we would take the mask off the nebulizer and point the tube at his mouth/nose so he would just breath it in (they showed us this in the hospital). The noise would startle him at first, but he would usually drift back to sleep.
Most likely different children/cases of asthma react differently.
My sons Ped. did explain this to me. Let's say that on the breathing scale 100% is feeling fine, 95% is a slight asthma attack, and 90% is a full blown asthma attack (just to reiterate, these numbers are purely hypothetical). He told me that the more severe the asthma becomes (ie, lets say the attack is unmedicated and proceeds to 90%) the more difficult it is to bring that person back to 100%. So his feelings were that it is better to medicate them when they are at 95% (ie, might still be sleeping) than to wait. This is just his opinion though, and I am sure medical advice varies.
I would say to do what your "gut" tells you and go from there. If you don't want to wake your child, try it...see what happens, and if they are fine in the morning then you know it will work for you. If you feel that your child needs it during the night, by all means try that too and see which works better for you.

Posted on: Thu, 12/16/2004 - 1:04am
kkeene's picture
Joined: 10/20/2003 - 09:00

We go through this with our son too.
If his breathing so so bad that I can hear the trouble he is having you bet I wake him...
If he is sleeping & is over coming it, I keep a close eye on him...
If it is in ? I just get the neb ready & put it in front of his face & turn it on, He opens his eyes & I say it ok mommy with hold it go back to sleep & he does.

Posted on: Thu, 12/16/2004 - 1:16am
Cindia's picture
Joined: 06/05/2001 - 09:00

Our DS was hospitalized briefly when he was 11 months old for asthma. The pulmonary specialist came round the clock to nebulize him. If he was sleeping, he would not wake him to give him a treatment.
So, we would also nebulize our DS at home while he was sleeping, if needed. It almost never woke him up. Sometimes, it was mainly for our piece of mind to help us sleep.

Posted on: Thu, 12/16/2004 - 1:28am
margaret's picture
Joined: 11/01/2000 - 09:00

We do wake our child for treatments if she is sick. We use a nebulizer with mask and really as long as one of us holds her head up, she sleeps right through the whole thing.

Posted on: Thu, 12/16/2004 - 1:48am
katiee's picture
Joined: 05/09/2001 - 09:00

Im my own experience with asthma, I have never woken my son to administer drugs unless he appeared in distress. I would tend to go with what the specialist suggests as it is his/her area of expertise. Just my opinion.
Cindy, all that sounds like croup is not necessarily croup. Especially in a older child like your DD and Wade.In our case it is asthma. It took a visit to the pulmonologist to confirm what I have always known with Wade. She sat us down and went through his CHEO file and all his ER visits shaking her head over and over again at the so called diagnosis of "croup". Not many GP's or ER doctors are versed in the many ways that asthma can present. I would consider upping her asthma drugs and requesting an RX for steriods to get her over the hump so to speak. Discuss this with your doctor but it sure sounds like what we go through with Wade on a regular basis.
Take care,

Posted on: Thu, 12/16/2004 - 3:48am
Shuleran's picture
Joined: 07/25/2004 - 09:00

Hi everyone,
I am that Respiratory Therapist that comes into your child's hospital room at night to do his nebulizer treatments. I work in a large Children's Hospital in the Southeast US. We only wake children for treatments if they are pretty sick. If they are sleeping well and not wheezing profusely, we administer treatments while awake. If they do sound bad, we give nebulized treatments while the child sleeps. The patient needs to be fully awake and cooperative to get a good inhaled treatment with a metered dose inhaler and a mask and spacer. It doesn't do you any good to have a screaming/ half-awake child to try to get a good treatment in.


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