What are the symptoms of asthma?

GB37401 DOP 04.2023

Asthma symptoms

You may experience one or more of the above symptoms, and both the severity and the frequency in which they come can vary greatly. Doctors generally class asthma symptoms as either mild, moderate, or severe. Your level of asthma severity largely comes down to how sensitive your airways are to your particular asthma triggers.

If you suspect that you may have undiagnosed asthma, it's important that you consult your GP for an assessment. It's possible that these symptoms could be an indication of a different health condition. If it is asthma, your GP will be able to offer treatment to help you manage your symptoms.

Mild asthma

Your asthma symptoms:

• Rarely or never prevent you from normal daily activities like talking, eating, and sleeping.

• Are non-existent most of the time.

• May flare up as a result of common triggers, such as having a cold, when you exercise, or during hay fever season.

Moderate asthma

Your asthma symptoms:

• Are moderate and can be debilitating, causing you breathlessness and coughing.

• Typically occur at some point on most days. However, you may have long periods where symptoms don't flare up.

• May be worse at night or in the early morning, and you may sometimes wake up coughing.

Severe asthma

You are more likely to be classified as having severe asthma if your symptoms:

• Are more extreme and can result in you having a tight chest, especially if you find it difficult to breathe, to the point that talking is hard.

• Have resulted in at least two asthma attacks needing urgent medical treatment in the last year.

• Mean you need to take your reliever inhaler three or more times a week.

• Interfere with your sleep on a regular basis.

• Persist despite you taking all prescribed treatments (including a higher dose of inhaled steroids and a long-acting bronchodilator or a 'preventer' tablet) as advised by your healthcare team.

• Have a significant impact on your ability to live a completely normal life.

Asthma attacks

An asthma attack is a debilitating episode of severe asthma symptoms. These episodes will usually flare up quite suddenly, but the time they last for can vary significantly.

"During an asthma attack, the muscles within your airways can become swollen and inflamed with increased mucus production. This results in one or more of the following symptoms: difficulty breathing, difficulty speaking, experiencing a wheeze, blue colour to the lips, and feeling distressed," says Kelman.

You may be able to manage asthma attacks with an inhaler. If you experience very severe asthma attacks, you may need to seek urgent or emergency medical help.

Asthma deaths

Asthma deaths are rare, but it's crucial to seek emergency medical attention if you suffer a really severe asthma attack and your inhaler is ineffective. According to a national review by the Royal College of Physicians, around 65% of asthma deaths could be avoided with proper asthma management. It's also thought that 45% of people die before they seek medical help.

The waring signs of a severe asthma attack include:

• Rapid breathing.

• Severe and/or worsening chest tightness, wheezing, coughing, or shortness of breath.

• A blue shade on the lips, face, or fingernails.

• An inability to inhale or exhale fully.

• An inability to speak in full sentences or to walk.

• Confusion or agitation.

• Little or no relief from using a reliever inhaler, or only very short-lived relief.

Asthma symptoms in children

According to WHO, asthma is the most common long-term disease among children. Some will naturally 'grow out' of asthma as they get older, while others will need to manage it for life.

"Children may describe tightness in the chest as tummy ache or may rub their tummy or chest," says Kelman. "Often, children will have a cough during the night-time or early morning. They may also cough/become breathy after being active or when laughing or excited."

Why treating childhood asthma is important

• Treatment can't cure asthma but can greatly improve day-to-day symptoms.

• Treatment can help to prevent severe asthma attacks, which in the most extreme cases can result in death.

• Children who experience asthma symptoms during exercise may be discouraged from physical activity. This could lead to being overweight or obese.

Asthma symptoms in adults

Adults and children experience the same symptoms, although research suggests that there are more cases of severe asthma and related deaths in adulthood. While childhood asthma is more common among boys, adult asthma is more likely in women.

In adult asthma and especially if you smoke, there's a risk to the long-term health of your lungs and of your airways becoming partially obstructed permanently. That's why asthma treatment is not only important for quick relief, but also for long-term health.

How long do asthma symptoms last?

This will depend on how mild or severe your asthma is. Symptoms might only last for a few minutes, but they could continue for hours or even days at a time. It's important to identify and remove yourself from any asthma triggers that may have prompted a flare-up. For example, hay fever can trigger asthma, in which case going inside, washing, and changing your clothes may help.

What can cause asthma symptoms?

There are many possible causes of asthma. Both genetics and environmental factors can increase your risk of either having the condition from birth or developing it later.

Emma Rubach, head of health advice at Asthma + Lung UK, says that "you are more likely to develop asthma if it runs in your family, you have allergies, were born prematurely, or had bronchiolitis or croup as a child. Smoking and being exposed to toxic chemicals can also increase the risk. There are various well-known asthma triggers, and the most common are colds and viruses, stress, exercise, exposure to cold air, and pollution."

Common questions

Can hay fever cause asthma symptoms?

Hay fever is an allergy to pollen, which is released by plants, flowers, and trees at different times of year. For example, in the UK, hay fever triggered by grass pollen - the most common cause - tends to cause symptoms from around May to July. Tree pollen can cause symptoms from early spring and weed pollen levels can be high from early spring to early autumn. "Pollen can be a seasonal trigger," says Rubach. "Research reveals that almost half of all people with asthma find their symptoms are triggered by pollen."

Can alcohol cause asthma symptoms?

"Some people's asthma is triggered by alcohol so always have your reliever inhaler with you if you are planning on drinking. If you are sensitive to alcohol, it is best to avoid red wine, rosé, beer and soda which all contain high levels of sulphites which are known to aggravate the airways," cautions Rubach.

Can heartburn cause asthma symptoms?

Heartburn happens when stomach acid enters the tube that connects your stomach to your throat. It can trigger asthma when this acid sets off a chain reaction, telling your brain to protect your airways by closing them. The acid can also irritate your airways and bring on your usual asthma symptoms.

What can help with asthma symptoms?

Even though asthma can't be cured, the good news is it can be managed and controlled. Your doctor or asthma nurse can create an asthma action plan which could include prescribed inhalers - some can help to prevent asthma attacks, while others provide quick relief for symptoms.

"Whatever your trigger, the main thing is to manage your asthma proactively with an asthma action plan," says Rubach. "Take your preventer inhaler as prescribed, rather than relying on your reliever inhaler."

If your symptoms persist despite taking high doses of regular preventer inhalers, your GP or practice nurse may recommend a referral to a hospital clinic. There are non-inhaler treatments available for people with severe asthma, but these are usually prescribed by a specialist.

Alongside medication, there are things you can do that can help make your asthma symptoms better or less frequent. These include:

• Avoiding your known asthma triggers.

• Not smoking.

• Exercising regularly.

• Eating a balanced diet.

• Having the annual flu jab.

• Avoiding stress.

"The worst thing you can do with asthma is to be complacent about it, as it's a serious condition that needs to be managed properly," says Rubach.