In people with asthma, the airways of the lungs become narrow and inflamed. This narrowing and inflammation can make breathing difficult — either some of the time or all the time — and it can also trigger a range of other symptoms (more on that will follow). (1)
There are different types of asthma. Some types are defined by their causes, while others are defined by their symptoms. Also, asthma may often be categorized based on its severity or the age at which it first shows up. In some people, asthma is so mild and situation-specific that it doesn’t require medication. In others, it can be severely debilitating most or all the time.
“We sometimes call asthma a syndrome, not a disease, because it’s so complex,” explains Chitra Dinakar, MD, a clinical professor of medicine at Stanford University and the clinical chief of allergy, asthma, and immunodeficiency at Stanford Health Care.
Asthma can show up in many forms and for different reasons, Dr. Dinakar says. And it’s sometimes hard for doctors to predict how asthma will progress or evolve as a patient grows older. In some people, it gets worse over time. In others, it goes away. “It’s not an easily defined disease,” she says.
In understanding where your or someone else’s asthma fits on the spectrum of diagnoses, it’s helpful to know more about the common symptoms of asthma and asthma attacks — and when you can expect both to show up.
Common Symptoms of Asthma May Be Present Some or All of the Time in People With the Condition
The most common symptoms of asthma include the following: (2)
- Shortness of breath or trouble breathing
- Chest tightness or pain
- A wheezing or whistling sound while breathing
Asthma symptoms develop when the lining of the bronchial tubes (airways) becomes inflamed, which is often in response to an environmental trigger, rather than symptoms that are continuously present.
Exercise and breathing cold air are two common asthma triggers. Seasonal allergies, emotional stress, inhaling pollution or airborne particles, and common colds or other viral infections tend to make asthma symptoms worse. These symptoms also tend to be more severe at night or first thing in the morning. (2)
If you notice any of these symptoms, it’s important to get them checked out by your physician so you can get a proper asthma diagnosis if needed. If you are diagnosed with asthma, your doctor will create an asthma action plan with you, detailing what to do when you experience symptoms and if and when you should take medication for symptoms. (1)
Some Asthma Symptoms Are Only Present During an Asthma Attack
An asthma attack is when a person’s asthma symptoms become worse or more noticeable. (2) During an attack, the muscles around the airways tighten more than usual, and the airways produce an overabundance of mucus.
The typical signs of an asthma attack can include any of the following: (2,3)
Wheezing This refers to a whistling or squeaky, almost musical sound during breathing.
Shortness of Breath This simply means feeling like you can’t get enough air into your lungs.
Rapid Breathing In response to not getting enough air in each breath, your body may speed up your rate of breathing.
Coughing A cough during an asthma attack may contain phlegm.
Chest Tightness This can take the form of pain, pressure, or feeling like something is squeezing or sitting on your chest.
Not everyone with asthma experiences symptoms the same way, and asthma symptoms can differ between attacks. Asthma attacks require immediate treatment with a rescue or quick-relief inhaler or other medication recommended by your doctor. (3,4)
Severe Asthma Attacks Are Defined by These Symptoms
Any worsening of symptoms qualifies as an asthma attack. But a severe attack is one that requires a trip to the ER or some other form of immediate medical attention after at-home treatment (such as a rescue or quick-relief inhaler) does not improve symptoms. (4)
Symptoms of a severe attack can include the following: (3,4)
- Extreme breathing difficulties and heavy wheezing — the kind that makes it hard for you to finish a sentence
- The need to strain your chest muscles in order to breathe
- Symptoms that don’t get any better after you use an inhaler
- Uncontrollable coughing
- Rapid nostril movement
- Low peak flow readings when you use a peak flow meter
- Cyanosis (a condition in which the skin of your face, lips, or fingers turn blue)
- Your ribs or stomach suck in and push out dramatically as you breathe
- Your chest expanding, but not deflating as you exhale (a sign that air isn’t able to escape your lungs)
Disrupted Sleep, Difficulty Exercising, and Some Other Signs Can Indicate You Might Have Asthma
Along with its short-term symptoms, asthma can cause other problems or disruptions.
Because symptoms often become worse at night, asthma can disrupt sleep or cause insomnia. Poor sleep, along with daytime asthma symptoms, can make it hard to complete work or school tasks, as well as day-to-day chores.
Asthma can make exercise challenging or impossible, which may put you at risk for a host of other medical problems. (5)
RELATED: Complications That Can Occur With Asthma (Particularly With Poorly Managed Asthma)
Over time, if asthma is not properly treated or controlled with medication, it can cause airway remodeling, when the airways become scarred or permanently deformed. This can make breathing and treatment even more difficult. (6)
Asthma is also associated with a greater risk for anxiety, depression, and other mental health disorders. (5) If you see patterns of any of these problems or complications, it’s important to talk to your doctor to get to the root cause of the problem.
And remember, asthma symptoms do not look the same in everyone. “Each person with asthma is unique and so are their symptoms,” Dr. Dinakar says.
In some people with asthma, symptoms are very mild and seldom show up. In others, symptoms may be severe but situational, for example, after running hard or while going to bed. In others, symptoms are always around and may make everyday life difficult.
The important takeaway is that good management of symptoms and the right asthma treatment plan can help improve anyone’s asthma. Ask your doctor about an asthma action plan and follow it when symptoms flare up. Whatever your symptoms, it’s important to consult with a doctor to ensure that asthma is not disrupting your sleep, your health, or your life.
With additional reporting by Quinn Phillips and Markham Heid.