Living with asthma

Overview

Asthma is a long-term condition that affects the airways in your lungs. The airways become swollen and sensitive, and can narrow when something triggers them, making it harder to breathe. It often comes and goes, and treatment can help keep it under control.

Yes. Asthma is one of the most common long-term conditions in the world. In the UK, around 5.4 million people receive treatment for asthma.

Asthma can affect people of all ages, backgrounds, and both sexes. It often starts in childhood, but can also appear for the first time in adults, including older adults.

Symptoms

Common symptoms

• Shortness of breath
• Wheezing (a whistling sound when you breathe)
• Chest tightness
• Coughing, especially at night or early in the morning

Symptoms in children

• Coughing that is often worse at night or during play
• Wheezing
• Sighing or breathing faster than usual
• Tiredness or less energy for activities

Symptoms in older adults

• Shortness of breath during everyday activities
• Wheezing or coughing that may be mistaken for another condition
• Sleeping problems due to breathlessness
• Feeling tired more easily

Causes

Main causes

• The exact cause of asthma is not fully understood. It often involves a mix of genetics (inherited tendency) and environmental factors.
• Common triggers include allergens like pollen, dust mites, or pet fur.
• Respiratory infections, air pollution, tobacco smoke, cold air, exercise, and stress can also trigger symptoms.

Risk factors

• A family history of asthma or allergies
• Having allergies, eczema, or hay fever
• Being born prematurely or with low birth weight
• Smoking or being exposed to second-hand smoke
• Working in jobs with dust, chemicals, or fumes

When to see a doctor

See a doctor urgently if:

• Your symptoms are getting worse despite using your treatment plan
• You need your reliever inhaler more often than every 4 hours
• You wake at night with asthma symptoms
• You have had a severe attack and were treated in an urgent care setting

Book a routine appointment if:

• You have a cough, wheeze, or shortness of breath that keeps coming back
• You think you may have asthma and have never been diagnosed
• You want to review your asthma action plan or inhaler technique

Diagnosis

Diagnosis is based on your symptoms, your medical and family history, and breathing tests. There is no single test, so your doctor may do several checks to see if your airways narrow and open back up.

Tests that may be done

• Spirometry – you blow into a tube to measure how fast and how much air you can exhale
• Peak flow test – you blow into a small hand-held meter to measure your peak expiratory flow; you may use this at home to track changes
• FeNO test – you breathe into a device that measures nitric oxide in your breath, which can indicate airway inflammation
• Allergy tests – skin or blood tests to see if allergens trigger your symptoms

What to expect at your appointment

Your doctor may ask you to keep a symptom diary and check your peak flow at home. Diagnosis can take time. You may be referred to a lung specialist if more tests are needed. You will be involved in creating a written asthma action plan.

Treatment

The goal of treatment is to keep your lungs working well, reduce symptoms, and prevent asthma attacks. Most people need a combination of medicines, knowing your triggers, and regular check-ups.

Self-care at home

• Take your medicines exactly as prescribed, even when you feel well.
• Learn to use your inhaler correctly. Ask your doctor, nurse, or pharmacist to check your technique.
• Keep a written asthma action plan with your doctor.
• Learn your triggers and avoid them where possible.
• Stop smoking and avoid second-hand smoke.

Medical treatments

Medical treatment typically involves inhalers. Some are 'reliever' inhalers used as needed to open the airways quickly. Others are 'preventer' inhalers used daily to reduce inflammation in the airways and prevent symptoms. Your doctor may adjust your treatment based on how well controlled your asthma is. More severe asthma may need additional medicines, such as tablet treatments or injections, which are prescribed by specialists. Never change or stop medicines without medical advice.

Living with this condition

With asthma, your daily routine may be adjusted to avoid triggers and manage symptoms. A personalised action plan can help you notice when things are getting worse and tell you what to do.

Lifestyle tips

• Build a routine that includes regular moderate exercise, which can improve lung fitness.
• Maintain a healthy weight.
• Avoid smoking and smoky places.
• Reduce exposure to dust mites, pet fur, and mould where possible.
• Manage stress with relaxation techniques.

Diet and exercise

There is no special asthma diet, but eating a balanced diet helps your overall health. Some people find that very cold or salty foods trigger symptoms; it's personal. Exercise is encouraged. With the right treatment, many people with asthma can exercise normally. If exercise bothers you, talk to your doctor about adjusting your action plan.

Mental health and emotional wellbeing

Living with a long-term condition can sometimes be worrying. Stress and strong emotions can also trigger asthma symptoms. It's normal to feel anxious at times, especially before an attack. If you feel overwhelmed, speak to your healthcare team. In a crisis, remember to call your local emergency number.

Prevention

There is no known way to prevent asthma, but you can reduce the risk of attacks by treating it early and avoiding triggers. Childhood exposure to tobacco smoke is a risk factor, so avoiding smoking during pregnancy and around children may help.

Vaccines

It's recommended to stay up to date with the flu vaccine. Pneumococcal and COVID-19 vaccines are also recommended for people with long-term conditions. Ask your doctor or pharmacist about what applies to you.

Screening programmes

There is no routine screening test for asthma in people without symptoms. If you have symptoms, see a doctor for breathing tests.

Complications

If left untreated

• Persistent symptoms that disrupt sleep, school, or work
• A higher risk of severe asthma attacks requiring emergency care
• Long-term narrowing or 'remodeling' of the airways, which may lead to reduced lung function

Long-term outlook

The outlook is generally good. Most people with asthma can live full, active lives with the right treatment and support. Some children may find symptoms improve or disappear as they grow, though asthma often remains long-term. With good management, serious attacks are largely preventable.

Find support

International organisations

• European Federation of Allergy and Airways Diseases Patients Associations (EFA) ↗
• Allergy & Asthma Network ↗

Local organisations

• Asthma + Lung UK ↗ · UK

Helplines

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