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. 2018 Jun 1;4(1):29–43. doi: 10.1007/s41030-018-0058-6

Fig. 3.

Fig. 3

Asthma varies over 24 h. A summary of the changes that occur in asthma over 24 h. Airways become more narrowed at 4 am in asthma, coincident with increased symptoms and increased airway inflammation also at this time. The most efficacious time to take steroids (systemic and inhaled) may well be about 3 pm. There is no adrenal suppression of steroids are given between 8 am and 4 pm, but there is adrenal suppression if given between midnight and 4 am. Theophylline, leukotriene antagonists and LABAs may be more efficacious if taken in the early evening rather than the morning