Asthma: Symptoms, Treatment, and More

Asthma occurs because of inflammation and mucus in the lining of your airways. During an attack, this inflammation causes a wheezing or whistling sound when you breathe, along with other symptoms.


Asthma is an inflammatory disease that can affect the airways to your lungs. It makes breathing difficult and can make some physical activities challenging or even impossible.

According to the Centers for Disease Control and Prevention (CDC), about 25 million people in the United States have asthma. It’s the most common chronic lung condition among children in the United States: In 2018, the CDC reported that about 1 of every 12 children had asthma.

To understand asthma, it’s necessary to know a little about what happens when you breathe. Usually, with every breath you take, air goes through your nose or mouth, down into your throat, and into your airways, eventually reaching your lungs.

There are lots of small air passages in your lungs that help deliver oxygen from the air to your bloodstream.

Asthma symptoms happen when the lining of your airways swells and the muscles around them tighten. Mucus then fills your airways, further reducing the amount of air that can pass through.

These effects can bring on an asthma “attack,” which involves the coughing and chest tightness that are typical of asthma.

The most common symptom of asthma is wheezing — a squealing or whistling sound that happens when you breathe.

Other possible asthma symptoms include:

  • coughing, especially at night, when laughing, or during exercise
  • tightness in your chest
  • shortness of breath
  • difficulty talking
  • anxiety or panic
  • fatigue
  • chest pain
  • rapid breathing
  • frequent infections
  • trouble sleeping

The type of asthma you have can determine which symptoms you experience.

Some people experience symptoms consistently throughout the day. Others may find that certain activities make their symptoms worse.

But not everyone with asthma will experience these particular symptoms. If you think the symptoms you’re experiencing could be related to a condition such as asthma, make an appointment to see a healthcare professional.

If you have asthma, remember that even if your condition is well managed, you may occasionally have a flare-up of symptoms. Flare-ups often decrease with the use of quick-acting treatments, such as inhalers, but may require medical attention in severe cases.

Symptoms of an asthma flare-up may include:

  • coughing
  • wheezing
  • throat clearing
  • difficulty sleeping
  • chest pain or tightness
  • fatigue

If your symptoms worsen or don’t improve with the use of an inhaler, you should seek immediate medical treatment.

You should also seek treatment if you have symptoms of an asthma emergency, such as:

  • severe trouble breathing
  • gasping for air
  • confusion
  • pale or blue lips or fingernails
  • dizziness
  • difficulty walking or talking

Although asthma is especially common in children, many people don’t develop asthma until adulthood.

Health experts have not identified a specific cause of asthma. Instead, researchers believe it’s caused by a variety of factors, including:

  • Genetics: If your parent or sibling has asthma, you’re more likely to develop it.
  • History of viral infections: People with a history of severe viral infections during childhood, such as respiratory syncytial virus infection (RSV), may be more likely to develop asthma.
  • Hygiene hypothesis: When babies are not exposed to enough bacteria in their early months and years, their immune systems may not become strong enough to fight off asthma and other allergic conditions.

Many factors can also trigger asthma, causing the symptoms to worsen. Triggers for asthma can vary, and some people may be more sensitive to certain triggers than others.

The most common triggers include:

  • health conditions such as respiratory infections
  • exercise
  • environmental irritants
  • allergens
  • intense emotions
  • extreme weather conditions
  • pests
  • certain medications, including aspirin and nonsteroidal anti-inflammatory drugs (NSAIDs)

Your doctor will need to determine the type of asthma you have. The most common type is allergic asthma, which accounts for 60% of all cases of asthma.

Some types of asthma are related to your stage of life. While asthma can appear at any age, pediatric asthma specifically affects children, and adult-onset asthma doesn’t begin until adulthood.

The sections below describe other specific types of asthma.

Allergic asthma

This common type of asthma is triggered by allergens, including:

  • pet dander from animals such as cats and dogs
  • food
  • mold
  • pollen
  • dust

Allergic asthma is often seasonal because it goes hand-in-hand with seasonal allergies.

Non-allergic asthma

Irritants in the air that are not related to allergies trigger this type of asthma. These irritants might include:

  • burning wood
  • cigarette smoke
  • cold air
  • air pollution
  • viral illnesses
  • air fresheners
  • household cleaning products
  • perfumes

Occupational asthma

Occupational asthma is triggered by irritants in the workplace, such as:

  • dust
  • dyes
  • gases and fumes
  • industrial chemicals
  • animal proteins
  • rubber latex

These irritants can exist in a wide range of industries, including:

  • farming
  • textiles
  • woodworking
  • manufacturing

Exercise-induced bronchoconstriction (EIB)

EIB usually affects people within a few minutes of starting exercise and can last until 10–15 minutes after physical activity.

This condition was previously called exercise-induced asthma.

Up to 90% of people with asthma also experience EIB, but not everyone with EIB will have other types of asthma.

Aspirin-induced asthma

Aspirin-induced asthma (AIA), or aspirin-exacerbated respiratory disease, is usually severe.

It’s triggered by taking aspirin or another NSAID, such as naproxen (Aleve) or ibuprofen (Advil).

The symptoms may begin within minutes or hours. People with AIA also typically have nasal polyps.

About 9% of people with asthma have AIA. It usually develops suddenly in adults ages 20–50 years.

Nocturnal asthma

In this type of asthma, symptoms worsen at night.

Triggers that might bring on symptoms at night include:

  • heartburn
  • pet dander
  • dust mites

Your body’s natural sleep cycle may also trigger nocturnal asthma.

Cough-variant asthma (CVA)

CVA doesn’t cause the classic asthma symptoms of wheezing and shortness of breath. Instead, it involves a persistent dry cough.

However, if it’s not treated, CVA can lead to full-blown asthma flares that include the more common symptoms.

No single test or exam can determine whether you or your child has asthma. Instead, healthcare professionals will use a variety of criteria to find out whether your symptoms are the result of asthma.

The following steps can help healthcare professionals diagnose asthma:

  • Health history: Tell your doctor if you have family members with asthma, since this can mean you have a greater chance of developing it.
  • Physical exam: Your doctor will listen to your breathing with a stethoscope. They may also perform a skin test to look for signs of an allergic reaction, such as hives or eczema. Allergies increase your risk for asthma.
  • Breathing tests: Pulmonary function tests measure the airflow into and out of your lungs. For the most common test, spirometry, you blow into a device that measures the speed of the air.

In children

Doctors don’t typically perform breathing tests in children under 5 years of age because it’s difficult to get an accurate reading.

Instead, they may prescribe asthma medications to your child and wait to see whether their symptoms improve. If your child’s symptoms improve with medication, your child likely has asthma.

In adults

Your doctor may prescribe a bronchodilator or another asthma medication if your test results indicate asthma. If your symptoms improve with the use of this medication, your doctor will continue to treat your condition as asthma.

To help treat asthma, the National Asthma Education and Prevention Program (NAEPP) classifies the condition based on its severity before treatment.

Asthma classifications include:

  • Intermittent: Most people have this type of asthma, which doesn’t interfere with daily activities. Symptoms are mild, occurring fewer than 2 days per week or 2 nights per month.
  • Mild persistent: The symptoms occur more than twice per week, but not daily, and up to 4 nights per month.
  • Moderate persistent: The symptoms occur daily and at least 1 night every week, but not nightly. They may limit some daily activities.
  • Severe persistent: The symptoms occur several times every day and most nights, and they greatly limit your daily activities.

Treatments for asthma fall into four primary categories:

  • quick-relief medications
  • long-term control medications
  • a combination of quick-relief and long-term control medications, which is recommended by the most recent asthma clinical guidelines (released in 2020 by the NAEPP) but not yet approved by the Food and Drug Administration
  • biologics, which are given by injection or infusion and typically used for only severe forms of asthma

Your doctor will recommend one treatment or a combination of treatments based on:

  • the type of asthma you have
  • your age
  • your triggers

Your treatment plan may also involve learning your triggers, carefully monitoring your symptoms, and taking steps to avoid flare-ups.

Quick-relief asthma treatments

These medications should be used only in the event of asthma symptoms or an attack. They provide quick relief to help you breathe again.

Bronchodilators

Bronchodilators work within minutes to relax the tightened muscles around your airways and quickly decrease your symptoms.

Although they can come in the form of an oral medication or injection, bronchodilators are most commonly taken with an inhaler (rescue) or nebulizer.

Your doctor may recommend that you use them to treat sudden asthma symptoms or take them before exercise to prevent a flare-up.

First aid asthma treatment

If you think someone you know is having an asthma attack, tell them to sit them upright and help them use their rescue inhaler or nebulizer.

The dosage will depend on the medication. Check the instructions insert to make sure you know how many puffs of medications you need in the event of an attack.

If symptoms persist for more than 20 minutes and a second round of medication doesn’t help, seek emergency medical attention.

If you need to use quick-relief medications frequently, ask your doctor about another type of medication for long-term asthma control.

Long-term asthma control medications

You can take these medications daily to help reduce the number and severity of asthma symptoms. But they don’t manage the immediate symptoms of an attack.

Long-term asthma control medications include:

  • Anti-inflammatories: Taken with an inhaler, corticosteroids and other anti-inflammatory medications help reduce swelling and mucus production in your airways, making it easier to breathe.
  • Anticholinergics: These help stop your muscles from tightening around your airways. They’re usually taken daily in combination with anti-inflammatories.
  • Long-acting bronchodilators: These should be used only in combination with anti-inflammatory asthma medications.

Biologics

Doctors use biologics to treat severe asthma that doesn’t respond to other medications or to treatment by trigger management.

They work by targeting specific antibodies in your body, disrupting the pathway that leads to asthma-causing inflammation.

There are five types of biologic medications on the market, and others are in development. You can receive this type of medication either as an injection or as an infusion in your doctor’s office.

Bronchial thermoplasty

This treatment uses an electrode to heat the airways inside your lungs, helping to reduce the size of the surrounding muscle and prevent it from tightening.

A doctor will perform this minimally invasive procedure in a clinic or hospital. It usually takes about an hour.

Bronchial thermoplasty is intended for people with severe asthma and can provide relief from symptoms for up to 5 years.

However, because it’s a relatively new procedure, it’s not yet widely available.

When your asthma symptoms get progressively worse, it’s known as an exacerbation, or an asthma attack.

Breathing becomes increasingly difficult because your airways are swollen and your bronchial tubes have narrowed.

The symptoms of an exacerbation may include:

  • hyperventilation
  • cough
  • wheezing
  • shortness of breath
  • increased heart rate
  • agitation
  • confusion
  • blue lips

Although an exacerbation can end quickly without medication, you should contact your doctor when you experience one, because it can be life threatening.

The longer an exacerbation lasts, the more it can affect your ability to breathe. That’s why exacerbations often require a trip to the emergency room.

You can help prevent exacerbations by taking medications that help manage your asthma symptoms.

Because researchers have not yet found the exact cause, it’s challenging to know how to prevent asthma.

But some strategies can help prevent asthma attacks, including:

  • Avoiding triggers: Try to steer clear of chemicals, smells, or products that have caused breathing problems in the past.
  • Reducing exposure to allergens: If you’ve identified allergens, such as dust and mold, that trigger asthma attacks, avoid them whenever possible.
  • Getting allergy shots: Allergen immunotherapy is a type of treatment that may help change your immune system. With routine shots, your body may become less sensitive to triggers you encounter.
  • Taking preventive medication: Your doctor may prescribe medication for you to take every day (in addition to the one you use in case of an asthma attack).

Your doctor can help you create an asthma action plan so you know which treatments to use and when.

In addition to using maintenance medications, you can take steps each day to improve your overall health and reduce your risk for asthma attacks. These include:

  • Eating a nutritious diet: A healthy, balanced diet can help improve your overall health.
  • Avoiding any foods you’re allergic to: Nutrient-rich foods are vital to helping reduce symptoms, but food allergies can trigger asthma symptoms.
  • Making efforts to maintain a moderate weight: Asthma tends to be worse in people with overweight or obesity. If your doctor recommends that you lose weight, doing so may be beneficial for your heart, joints, and lungs.
  • Quitting smoking, if you smoke: Cigarette smoke is an irritant that can trigger asthma and increase your risk of developing chronic obstructive pulmonary disease (COPD).
  • Exercising regularly: Physical activity can trigger asthma attacks, but regular exercise may actually help reduce your risk of breathing problems.
  • Finding healthy ways to manage stress: Stress can trigger asthma symptoms and make it more difficult to stop an asthma attack.

At the moment, there’s no cure for asthma. But there are many effective treatments that can decrease the symptoms. Lifestyle strategies and medications can also help improve your quality of life.

If you haven’t received an asthma diagnosis but you’re experiencing symptoms such as wheezing, coughing, and shortness of breath, it’s a good idea to make an appointment with a healthcare professional. You can find one in your area using the Healthline FindCare tool.

If you receive a diagnosis of asthma, you should see your doctor at least once per year. If you have persistent symptoms even after trying some treatments, you may need to see your doctor more often.

Call your doctor immediately if you:

  • feel weak
  • can’t perform daily activities
  • have a wheeze or cough that won’t go away

It’s important to learn about your condition and its symptoms. The more you know, the more proactive you can be in improving your lung function and how you feel.

Talk with your doctor about:

  • your type of asthma
  • what triggers your symptoms
  • what daily treatments are best for you
  • your treatment plan for an asthma attack

Can you use an expired inhaler?

Most inhalers are safe to use for up to 1 year after their expiration date. However, the medication will gradually lose its potency over time, and the manufacturer can no longer guarantee its effectiveness.

Can you die from asthma?

While asthma attacks can be mild and short, a severe asthma attack is a serious medical condition and has the potential to be fatal. Seek medical attention if you or someone else experiences the following symptoms:

  • breathlessness or wheezing that’s severe or quickly worsens
  • shortness of breath that’s so bad you can speak in only short phrases
  • the need to strain hard in order to breathe
  • lips or fingernails that have turned gray or blue
  • no symptom relief after using your rescue inhaler

Am I having an asthma attack or an anxiety attack?

An anxiety attack and an asthma attack can sometimes feel very similar, as both can involve shortness of breath, insomnia, and fatigue.

Watch for wheezing and coughing, which are clear symptoms of asthma. Choking sensations and muscle tension are more common in an anxiety attack.

Asthma is a condition that inflames your lungs and makes breathing difficult. It can affect both adults and children and has multiple forms and varying levels of severity.

There are some medications available to treat asthma. The most common treatments are bronchodilators, which can be used in the short term to treat an asthma attack or in the long term to manage symptoms over time.

Lifestyle strategies such as dietary changes, exercise, and stress management may also help reduce asthma flare-ups. A doctor can identify the type of asthma you have and help you find the best treatment and management options.

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