Asthma might seem like one of those health conditions that is absolutely unmistakeable. It’s kind of obvious if you just…can’t really breathe, right? Actually, asthma symptoms can present with a lot more complexity and subtlety than that. There’s a range in how severe your asthma can be and which signs you might experience, Raymond Casciari, M.D., a pulmonologist at St. Joseph Hospital in Orange, California, tells SELF. As a result, it’s possible to write off asthma symptoms for months or even years without realizing you have a persistent—and ultimately treatable—health condition.
What is asthma, anyway?
Even though asthma symptoms can be diverse, at its core the condition follows a pretty specific playbook. Asthma impacts your airways, which extend between your nose and mouth and your lungs. Those airways have the critical role of carrying air in and out of your body, and they can get inflamed by triggers like animal dander, pollen, mold, cold air, cigarette smoke, exercise, and respiratory infections like colds, according to the National Heart, Lung, and Blood Institute (NHLBI).
That inflammation can cause swelling, which in turn can prompt the muscles around your airways to tighten, making it hard to get air in and out. At the same time, your airways might also expel more mucus than they usually do, making it even harder to breathe.
So what are the asthma symptoms and signs you should watch out for?
It’s possible that you’ll have such a mild reaction to one of your personal asthma triggers that you don’t take much note of it. But if the effects get worse, they can turn into an asthma attack, which is a potentially life-threatening exacerbation of asthma symptoms. That’s why it’s so important to know the common signs of asthma, including the more subtle ones.
Common symptoms of asthma
These are classic asthma signs you should know:
Shortness of breath: This is an obvious complication that happens when you can’t get enough oxygen due to the way your airways and their surrounding muscles are reacting to asthma triggers, Sadia Benzaquen, M.D., a pulmonologist and associate professor in the department of internal medicine at the University of Cincinnati College of Medicine, tells SELF.
Cough: If you have asthma, you may notice that you have a cough, which makes sense. Coughing is your body’s way of trying to get rid of irritants and secretions in your lungs, according to the Mayo Clinic. You may also notice your cough is worse at night, May-Lin Wilgus, M.D., a pulmonologist and assistant clinical professor at UCLA, tells SELF. This is likely because at night, your body can release higher levels of the stress hormone cortisol that may promote more bodily inflammation, including in your airways. That can cause your airways to narrow and make you cough, Dr. Wilgus says.
Wheezing: When your airways narrow, you don’t have as much space through which to breathe. As a result, you can experience wheezing, which may sound similar to the whistling sound you might hear if you were to breathe through a straw, Purvi Parikh, M.D., an allergist/immunologist with Allergy & Asthma Network, tells SELF.
Chest tightness: When you have asthma, it’s tough to get air in—but it’s also tough to get air out, Dr. Casciari says. “If you take a really deep breath and then try to take another one on top of it, your chest feels tight. That’s what it can feel like when you have asthma, because air gets trapped in there,” he says.
Less common symptoms of asthma
Some people may have these less common signs of asthma:
Just a cough that won’t go away: OK, so we did cover that coughing can be one of many common signs of asthma—but a persistent cough might also be the only sign of asthma you have. That’s because there’s this entire type of asthma called cough-variant asthma, which can make it easier for this health condition to fly under the radar. If you have it, you can cough in response to triggers like pollen, animal dander, and mold, but you won’t experience other signs of asthma like wheezing or breathlessness, Dr. Wilgus says.
Difficulty sleeping: Depending on the severity of your asthma, you might have trouble sleeping at night. Things like trouble breathing and coughing can make it hard to fall asleep or wake you up, then make it hard to get back to sleep, Dr. Parikh says.
Rapid breathing: If you have too much trouble fully expelling air from your lungs, which can happen often if you have asthma, you might automatically breathe more quickly to make up for it, Dr. Casciari says.
Awful colds: Obviously having a terrible cold or getting sick all the time doesn’t automatically mean you have asthma. But people with asthma often have viral infections that seem to last longer and be worse than what others experience, because that infection causes even more inflammation in their airways, Dr. Casciari says.
Constant fatigue: If you have uncontrolled asthma, you’re not getting enough oxygen to your muscles, which can make you feel physically wiped out, Dr. Benzaquen says.
Symptoms of an asthma attack
In general, the symptoms of an asthma attack are similar to those of having asthma—they’re just magnified, Dr. Casciari says.
If you’re having an asthma attack, your symptoms might not get better with a rescue inhaler, which is a portable device with a quick-acting agent to open up your airways. Low readings on a peak flow meter, a different portable device that measures lung capacity, can also be a sign of an asthma attack, the Mayo Clinic says.
How do I get an asthma diagnosis?
First things first, you need to get yourself to a doctor. There, you’ll probably undergo a physical exam to look at your overall health before your doctor gives you specific tests to look at your lung function.
One of those tests is a spirometry, which checks how much air you can blow out after taking a deep breath, as well as how fast you can blow it out, the Mayo Clinic says. Your doctor may also have you do a peak flow test, which measures how hard you can expel air. If you can’t blow out enough air or do it quickly enough, it could be a sign that you have asthma, Dr. Casciari says.
Typically, doctors will start there, and see how you do, Dr. Benzaquen says. But there are other tests that your doctor can use, like exposing you to methacholine, a known (and mild) asthma trigger, to see if your airways narrow, or allergy testing, since allergies and asthma are often linked. (Allergic asthma, which is when exposure to allergens triggers asthma symptoms, is clear evidence of this connection.)
Like many health conditions, all forms of asthma aren’t alike. When making a diagnosis, doctors generally divide asthma into four categories, per the Mayo Clinic:
- Mild intermittent asthma: This means you have minimal asthma symptoms for up to two days a week and up to two nights a month.
- Mild persistent asthma: You have symptoms more than twice a week, but not more than once on any given day.
- Moderate persistent asthma: This means you have symptoms once a day and more than one night a week.
- Severe persistent asthma: You have constant symptoms most days and often at night, too.
What are my options for treating asthma symptoms?
One of the most important ways to treat asthma is to avoid being exposed to your triggers, Dr. Wilgus says. Of course, that can feel impossible if your trigger is something that’s seemingly everywhere, like dust or pollen. Though you can definitely take steps to reduce your exposure to those, avoiding them entirely is tough. Luckily, there are medications that can help when you’ve done everything you can trigger-wise.
Asthma medications can generally be split into two categories: long-term preventive medications and fast-acting drugs that can help when you’re having an asthma attack or on your way to one. Long-term preventive medications like allergy medications and inhaled anti-inflammatory corticosteroids are designed to help control your asthma so you’re less likely to have an asthma attack in the first place, the Mayo Clinic says. Quick relief medications (also called rescue medications) like short-acting beta agonists that you use via an inhaler can help relax your airways when they’re acting up enough that your asthma is noticeably worse.
What about an asthma action plan?
Once you and your doctor have figured out the best way to treat your asthma, the two of you should jot it all down in an asthma action plan. That’s essentially a written document that spells out your treatment, including which medications to take when your asthma is well-controlled, which to turn to when you’re having some asthma issues, and which to try when you’re having an asthma attack. It also includes information like your doctor’s contact information and notifies you of which asthma symptoms are signs that you should seek immediate medical treatment. Make no mistake: If you have asthma, creating an action plan is crucial. “It’s important to have a plan with your physician for what to do when your asthma symptoms flare,” Dr. Wilgus says.
Whatever you do, don’t resign yourself to living with asthma symptoms like trouble breathing and coughing all the time. “Asthma is a very controllable illness as long as the signs and symptoms are not ignored,” Dr. Parikh says.