What is asthma?

Asthma is a chronic disease that affects the airways of the lungs. During normal breathing, the bands of muscle that surround the airways are relaxed and air moves freely. During an asthma episode or "attack," there are three main changes that stop air from moving easily through the airways:

  • The bands of muscle that surround the airways tighten and make the airways narrow. This tightening is called bronchospasm.
  • The lining of the airways becomes swollen or inflamed.
  • The cells that line the airways produce more mucus, which is thicker than normal and clogs the airways.

These three factors - bronchospasm, inflammation, and mucus production - cause symptoms such as difficulty breathing, wheezing, and coughing.

Who is affected by asthma?

Asthma affects 22 million Americans; about 6 million of these are children under age 18. People who have a family history of asthma have an increased risk of developing the disease. Asthma is also more common in people who have allergies or who are exposed to tobacco smoke. However, anyone can develop asthma at any time. Some people may have asthma all of their lives, while others may develop it as adults.

What causes asthma?

The airways in a person with asthma are very sensitive and react to many things, or "triggers." Asthma “triggers” are those things that make the airways tighten and become inflamed. Contact with these triggers causes asthma symptoms. Sometimes a trigger brings on a reaction right away, but other times it may take several hours or days before symptoms begin. One of the most important parts of asthma control is to identify your triggers and then avoid them when possible. The only trigger you do not want to avoid is exercise. Pre-treatment with medicines before exercise can allow you to stay active yet avoid asthma symptoms.

What are the most common asthma triggers?

There are many kinds of triggers. The most common asthma triggers are:

  • Infections: colds, viruses, sinus infections, flu
  • Weather: cold air or changes in temperature and humidity
  • Allergens: outdoor - pollens (trees, grasses, ragweed and weeds); mold spores ; indoor: molds, animal dander, dust mites, cockroaches
  • Exercise
  • Tobacco smoke
  • Irritants (strong odors from perfumes, cleaning agents, wood smoke, air pollution, etc.)
  • Strong emotions such as anxiety, or episodes of crying, yelling, or laughing hard
  • Certain medications
  • Food allergies (not a common trigger in adults, but can cause asthma symptoms, usually in children under age 5)

Some people are affected by a number of triggers, while others may only have one trigger such as in exercise-induced asthma. It is important to recognize your triggers and avoid them, if possible.

For those triggers you cannot avoid, there are steps you can take to limit your contact and treat your asthma before you encounter them. This is an important step in controlling asthma.

The only trigger you do not want to avoid is exercise. If your asthma is well-controlled, you should be able to participate in any activity you want to do.

What are the symptoms of asthma?

People with asthma have symptoms when the airways are narrowed (bronchospasm), swollen (inflamed), or filled with mucus. Common symptoms of asthma include:

  • Coughing, especially at night
  • Wheezing
  • Shortness of breath
  • Chest tightness, pain, or pressure

Not every person with asthma has the same symptoms in the same way. You might not have all of these symptoms, or you might have different symptoms at different times. The symptoms might also vary from one asthma episode to the next, being mild during one and severe during another.

Some people with asthma might have extended symptom-free periods, interrupted by periodic asthma episodes, while others have some symptoms every day. In addition, some people with asthma might only have symptoms during exercise, or when they are exposed to allergens or viral respiratory tract infections.

Mild asthma episodes are generally more common. Usually with treatment, the airways open up within a short time period. Severe episodes are less common, but last longer and require immediate medical help. It is important to recognize and treat even mild symptoms to help prevent severe episodes and keep asthma in better control.

What are the early warning signs of asthma?

Early warning signs are changes that happen just before or at the very beginning of an asthma episode. These changes start before the well-known symptoms of asthma and are the earliest signs that a person's asthma may be worsening.

In general, these signs are not severe enough to stop a person from going about his or her daily activities. By recognizing these signs, you can stop an asthma episode or prevent one from getting worse. Early warning signs include:

  • Frequent cough, especially at night
  • Losing your breath easily or shortness of breath
  • Feeling very tired or weak when exercising
  • Wheezing or coughing during or after exercise
  • Decreases or changes in a peak expiratory flow
  • Signs of a cold, upper respiratory infection, or allergies (sneezing, runny nose, cough, congestion, sore throat, and headache)
  • Trouble sleeping

If you have early warning signs or symptoms, you should follow the steps listed in your Asthma Action Plan. If you do not have one, you should notify your provider.

What are the symptoms of worsening asthma?

If early warning signs and symptoms are not recognized and treated, the asthma episode can progress and symptoms might worsen. As symptoms worsen, you might have more difficulty performing daily activities and sleeping. Symptoms of worsening asthma include:

  • A cough that won't go away (day and night)
  • Wheezing
  • Tightness in the chest
  • Shortness of breath
  • Poor response to quick relief, inhaled medicines (bronchodilators)

What are the late, severe symptoms of asthma?

When asthma symptoms become severe, you will be unable to perform regular activities. If you have late, severe symptoms, follow the "Red Zone" or emergency instructions in the Asthma Action Plan immediately. These symptoms occur in life-threatening asthma episodes. You need medical help right away.

Late, severe symptoms include:

  • Severe wheezing (both when breathing in and out)
  • Coughing that won't stop
  • Very rapid breathing
  • Inability to catch your breath
  • Chest pain or pressure
  • Difficulty talking
  • Inability to fully exhale
  • Feelings of anxiety or panic
  • Pale, sweaty face
  • Blue lips or fingernails

Last reviewed by a Cleveland Clinic medical professional on 06/08/2017.

References

Cleveland Clinic is a non-profit academic medical center. Advertising on our site helps support our mission. We do not endorse non-Cleveland Clinic products or services. Policy