Learning objectives: This article will focus on the pathophysiologic changes underlying the nocturnal worsening of asthma and the therapeutic approach to this disorder.
Data sources: Selected articles appearing since 1985 dealing specifically with the underlying pathologic features and therapy of nocturnal asthma.
Study selection: Studies that aimed to elucidate the pathologic features, mechanisms, and therapeutic strategies for the treatment of nocturnal asthma are summarized.
Results: Nocturnal asthma is associated with significant decline in pulmonary function and increase of airway inflammation at night. The administration 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 asthma should lead to more specific therapeutic interventions with maximal effect at night.