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As a follow-up to a previous blog, there are still a handful of issues that have yet to be explored regarding sleep apnea and problems breathing at night. Feeling breathless in the middle of the night is a common occurrence for people who have excess weight, narrow airways, nasal congestion, and asthma — which all can contribute to sleep apnea. However, there are still a few other issues that can contribute to sleep apnea. Nocturnal asthma, mold, mildew, smoking, and sinus issues can all contribute to sleeping problems as well. Below are a few more causes that may be inciting your sleep apnea.

Mold and mildew, found everywhere in the environment, are fungi that thrive in moist areas that are dark and have poor air quality. These fungi spread seeds or spores into the air, which can be inhaled and can cause health problems, which can worsen your sleep apnea and can even incite an allergic reaction. To prevent this, make sure you run an air purifier in your sleeping environment to keep the air free of spores that may be growing in your home. In addition, if you use a CPAP machine or a humidifier, you want to make sure those pieces of equipment get cleaned frequently!

In my previous article, I already touched upon asthma and how it can encourage sleep apnea. However, there is also nocturnal asthma, which only makes its appearance at night. You may frequently find yourself waking up at night coughing, wheezing, and feeling breathless, most likely between 3 and 4 in the morning.

“During the wee hours of the morning, levels of the hormones that protect against asthma symptoms are at their lowest,” says Ileen Gilbert, MD, a pulmonary specialist at Froedtert & The Medical College of Wisconsin in an interview with Everyday Health. Without those hormones, your lungs are more prone to have trouble performing its basic task! If you have asthma, you’re more likely to wake up coughing and wheezing as these levels fall in the early hours of the morning.

Did you know that smokers are three times more likely to have sleep apnea than people who don’t smoke? Because of the chemicals found in cigarettes, this can encourage lung inflammation and fluid retention in the upper airway — limiting airflow and potentially blocking your airways.

Are you a frequent sufferer from sinusitis or postnasal drip? Both of these sinus issues can contribute to sleep apnea. Frequent sinusitis or chronic postnasal drip can cause nasal secretions to accumulate in your airways when you lie down. With sinuses blocked up and extra nasal secretions dripping into the back of your throat, this makes it harder for you to breathe.