Nocturnal asthma, its pathogenesis and treatment.

Many chronobiologic and cyclic environmental factors are implicated in the pathophysiology of nocturnal asthma. A better understanding of these interrelating processes is essential for an optimization of medications for asthma. A reasonable therapeutic approach for the management of nocturnal asthma is the use of inhaled beta-agonists routinely, on a daily basis, and if symptoms persist, the use of an appropriate SR theophylline scheduled once-daily in the evening. Inhaled cromolyn sodium and corticosteroid therapy, properly timed to rhythms, may be warranted to control inflammation and stabilize the airways.