The optimum time for asthma sufferers to take a puff on their inhaler has been revealed by scientists.
Experts say the findings, published in the journal Thorax, are the first to show the importance of using the inhaler with best effect for our body clock – also known as the circadian rhythm. Over eight million Brits have the condition with 5.5 million seeking NHS treatment for it. Manchester University researchers found that if sufferers take their brown inhaler mid afternoon had better nighttime breathing function.
Study lead Dr Hannah Durrington, also of Manchester University NHS Foundation Trust, said: “Up to three-quarters of patients experience worsening symptoms overnight and up to 80% of fatal asthma attacks occur at night.
“This study shows that aligning the timing of beclomethasone – ‘the brown inhaler’, a commonly taken asthma treatment – with the body clock could have significant impacts on treatment outcomes. And this occurred without any of the associated adverse effects or costs of taking higher doses of steroids.”
The trial included 21 patients with asthma who were asked to take their medication in a different way. Once they had completed a week of one treatment pattern they then switched to another until they had all completed each of the three treatment patterns.
These treatment patterns included the “usual” pattern of dosing in the UK which is half the dose between 8am and 9am and a second half dose between 8pm and 9pm. They also trialled a once-daily dose of 400mg between 8am and 9am and a once-daily dose between 3pm and 4pm.
While the research team found all regimes appeared to improve asthma control, the once-daily afternoon dose appeared to improve night-time lung function and those on this regime appeared to have better blood eosinophil counts – a key biomarker for airway inflammation.
Participants each had a two-week “washout” period between dosing regimes. The researchers are now calling for further larger trials to confirm their findings.
Dr Durrington added: “Mid-afternoon dosing of inhaled beclomethasone may lead to better clinical outcomes without increasing steroid-related morbidity or costs.
“Our findings warrant further validation in a larger clinical trial to establish clinical feasibility in a real-life setting and to evaluate the health and economic impacts.”
Commenting on the study, Dr Erika Kennington, head of research and innovation at Asthma and Lung UK, said: “A brilliantly simple piece of respiratory research shows that altering the time of day you take your preventer inhaler dose may have a huge impact on your medication’s effectiveness.
“It’s incredible to think that something so easy as switching the timing of your inhaler dose to the afternoon, has the potential to improve your symptoms and ultimately could save your life.
“Inhaler medication is vital to keep your asthma under control. It’s easy to forget that asthma attacks can be fatal and require daily management in the form of inhalers to stay healthy.”
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