Asthma
What Is Asthma?
Asthma is a disease that affects your lungs.It causes repeated episodes of wheezing, breathlessness, chest tightness, and nighttime or early morning coughing. Asthma can be controlled by taking medicine and avoiding the triggers that can cause an attack. You must also remove the triggers in your environment that can make your asthma worse.
It is one of the most common long-term diseases of children, but adults can have asthma, too. If you have asthma, you have it all the time, but you will have asthma attacks only when something bothers your lungs.
Asthma causes wheezing, breathlessness, chest tightness, and coughing at night or early in the morning.We don’t know all the things that can cause asthma, but we do know that genetic, environmental, and occupational factors have been linked to developing asthma.
If someone in your immediate family has asthma, you are more likely to have it. “Atopy,” the genetic tendency to develop an allergic disease, can play a big part in developing allergic asthma. However, not all asthma is allergic asthma.
Being exposed to things in the environment, like mold or dampness, some allergens such as dust mites, and secondhand tobacco smoke have been linked to developing asthma. Air pollution and viral lung infection may also lead to asthma.
Occupational asthma occurs when someone who never had asthma develops it because he or she is exposed to something at work. This can happen if you develop an allergy to something at work such as mold or if you are exposed to irritants such as wood dust or chemicals at work over and over at lower levels or all at once at higher levels.
How Can You Tell if You Have Asthma?
It can be hard to tell if someone has asthma, especially in children under age 5. Having a doctor check how well your lungs work and check for allergies can help you find out if you have asthma.
During a checkup, a doctor will ask if you cough a lot, especially at night. He or she will also ask whether your breathing problems are worse after physical activity or at certain times of year. The doctor will then ask about chest tightness, wheezing, and colds lasting more than 10 days. He or she will ask whether anyone in your family has or has had asthma, allergies, or other breathing problems. Finally, the doctor will ask questions about your home and whether you have missed school or work or have trouble doing certain things.
The doctor may also do a breathing test, called spirometry, to find out how well your lungs are working by testing how much air you can breathe out after taking a very deep breath before and after you use asthma medicine.
What Is an Asthma Attack?
An asthma attack may include coughing, chest tightness, wheezing, and trouble breathing. The attack happens in your body’s airways, which are the paths that carry air to your lungs. As the air moves through your lungs, the airways become smaller, like the branches of a tree are smaller than the tree trunk. During an asthma attack, the sides of the airways in your lungs swell and the airways shrink. Less air gets in and out of your lungs, and mucous that your body makes clogs up the airways.
You can control your asthma by knowing the warning signs of an asthma attack, staying away from things that cause an attack, and following your doctor’s advice. When you control your asthma:
you won’t have symptoms such as wheezing or coughing,
you’ll sleep better,
you won’t miss work or school,
you can take part in all physical activities, and
you won’t have to go to the hospital.
What Causes an Asthma Attack?
An asthma attack can happen when you are exposed to “asthma triggers.” Your asthma triggers can be very different from someone else’s asthma triggers. Know your triggers and learn how to avoid them. Watch out for an attack when you can’t avoid your triggers. Some of the most common triggers are tobacco smoke, dust mites, outdoor air pollution, cockroach allergen, pets, mold, smoke from burning wood or grass, and infections like flu.
How Is Asthma Treated?
Take your medicine exactly as your doctor tells you and stay away from things that can trigger an attack to control your asthma.
Everyone with asthma does not take the same medicine.
You can breathe in some medicines and take other medicines as a pill. Asthma medicines come in two types—quick-relief and long-term control. Quick-relief medicines control the symptoms of an asthma attack. If you need to use your quick-relief medicines more and more, visit your doctor to see if you need a different medicine. Long-term control medicines help you have fewer and milder attacks, but they don’t help you while you are having an asthma attack.
Asthma medicines can have side effects, but most side effects are mild and soon go away. Ask your doctor about the side effects of your medicines.
Remember – you can control your asthma. With your doctor’s help, make your own asthma action plan. Decide who should have a copy of your plan and where he or she should keep it. Take your long-term control medicine even when you don’t have symptoms.
https://www.cdc.gov/asthma/default.htm
CDC’s National Asthma Control Program works to help Americans with asthma achieve better health and improved quality of life. The program funds states, school programs, and non-government organizations to help them improve surveillance of asthma, train health professionals, educate individuals with asthma and their families, and explain asthma to the public.
Types of asthma
Asthma is broken down into types based on the cause and the severity of symptoms. Healthcare providers identify asthma as:
Intermittent: This type of asthma comes and goes so you can feel normal in between asthma flares.
Persistent: Persistent asthma means you have symptoms much of the time. Symptoms can be mild, moderate or severe. Healthcare providers base asthma severity on how often you have symptoms. They also consider how well you can do things during an attack.
Asthma has multiple causes:
Allergic: Some people’s allergies can cause an asthma attack. Allergens include things like molds, pollens and pet dander.
Non-allergic: Outside factors can cause asthma to flare up. Exercise, stress, illness and weather may cause a flare.
Asthma can also be:
Adult-onset: This type of asthma starts after the age of 18.
Pediatric: Also called childhood asthma, this type of asthma often begins before the age of 5, and can occur in infants and toddlers. Children may outgrow asthma. You should make sure that you discuss it with your provider before you decide whether your child needs to have an inhaler available in case they have an asthma attack. Your child’s healthcare provider can help you understand the risks.
In addition, there are these types of asthma:
Exercise-induced asthma: This type is triggered by exercise and is also called exercise-induced bronchospasm.
Occupational asthma: This type of asthma happens primarily to people who work around irritating substances.
Asthma-COPD overlap syndrome (ACOS): This type happens when you have both asthma and chronic obstructive pulmonary disease (COPD). Both diseases make it difficult to breathe.
https://my.clevelandclinic.org/health/diseases/6424-asthma
How Is Asthma Classified?
Doctors rank how bad asthma is by its symptoms:
Mild intermittent asthma. Mild symptoms less than twice a week. Nighttime symptoms less than twice a month. Few asthma attacks.
Mild persistent asthma. Symptoms three to six times a week. Nighttime symptoms three to four times a month. Asthma attacks might affect activities.
Moderate persistent asthma. Daily asthma symptoms. Nighttime attacks five or more times a month. Symptoms may affect activities.
Severe persistent asthma. Ongoing symptoms both day and night. You have to limit your activities.
Your asthma may be getting worse if:
You have symptoms more often and they interfere more with your daily life.
You have a hard time breathing. You can measure this with a device called a peak flow meter.
You need to use a quick-relief inhaler more often.
Types of Asthma
There are several:
Adult-onset asthma. Asthma can start at any age, but it’s more common in people younger than 40.
Status asthmaticus. These long-lasting asthma attacks don’t go away when you use bronchodilators. They’re a medical emergency that needs treatment right away.
Asthma in children. Symptoms can vary from episode to episode in the same child. Watch for problems like:
Coughing often, especially during play, at night, or while laughing. This may be the only symptom.
Less energy or pausing to catch their breath while they play
Fast or shallow breathing
Saying their chest hurts or feels tight
A whistling sound when they breathe in or out
Seesaw motions in their chest because of trouble breathing
Shortness of breath
Tight neck and chest muscles
Weakness or fatigue
Exercise-induced bronchoconstriction. You might hear this called exercise-induced asthma. It happens during physical activity, when you breathe in air that’s drier than what’s in your body, and your airways narrow. It can affect people who don’t have asthma, too. You’ll notice symptoms within a few minutes after you start to exercise, and they might last 10 to 15 minutes after you stop.
Allergic asthma. Things that trigger allergies, like dust, pollen and pet dander, can also cause asthma attacks.
Nonallergic asthma. This type flares in extreme weather. It could be the heat of summer or the cold of winter. It could also show up when you’re stressed or have a cold.
Occupational asthma. This usually affects people who work around chemical fumes, dust, or other irritating things in the air.
Eosinophilic asthma. This severe form is marked by high levels of white blood cells called eosinophils. It usually affects adults between 35 and 50 years old.
Nocturnal asthma. Your asthma symptoms get worse at night.
Aspirin-induced asthma. You have asthma symptoms when you take aspirin, along with a runny nose, sneezing, sinus pressure, and a cough.
Cough-variant asthma. Unlike with other types, the only symptom of this kind of asthma is a long-term cough.
Asthma Causes and Triggers
When you have asthma, your airways react to things in the world around you. Doctors call these asthma triggers. They might cause symptoms or make them worse. Common asthma triggers include:
Infections like sinusitis, colds, and the flu
Allergens such as pollens, mold, pet dander, and dust mites
Irritants like strong odors from perfumes or cleaning solutions
Air pollution
Tobacco smoke
Exercise
Cold air or changes in the weather, such as temperature or humidity
Gastroesophageal reflux disease (GERD)
Strong emotions such as anxiety, laughter, sadness, or stress
Medications such as aspirin
Food preservatives called sulfites, found in things like shrimp, pickles, beer and wine, dried fruits, and bottled lemon and lime juices
Asthma Risk Factors
Things that might make you more likely to have asthma include:
Things in the world around you before you’re born or while you’re growing up
Whether your parents have asthma, especially your mother
Your genes
Your race. Asthma is more common in people of African American or Puerto Rican descent.
Your sex. Boys are more likely to have asthma than girls. In teens and adults, it’s more common in females.
Your job
Other conditions like lung infections, allergies, or obesity
Asthma Diagnosis
If you think you have asthma, see your doctor. They may refer you to a lung doctor, called a pulmonologist, or a specialist in allergy and immunology.
The doctor will start with a physical exam and ask about your symptoms and medical history.
You’ll have tests to see how well your lungs work, which may include:
Spirometry. This simple breathing test measures how much air you blow out and how fast.
Peak flow. These measure how well your lungs push out air. They’re less exact than spirometry, but they can be a good way to test your lungs at home, even before you feel any symptoms. A peak flow meter can help you figure out what makes your asthma worse, whether your treatment is working, and when you need emergency care.
Methacholine challenge. This and similar tests involve using triggers or challenges. Adults are more likely to have this test than children. You might get it if your symptoms and spirometry test don’t clearly show asthma. During this test, you inhale a chemical called methacholine before and after spirometry to see if it makes your airways narrow. If your results fall at least 20%, it is possible that you have asthma. Your doctor will give you medicine at the end of the test to reverse the effects of the methacholine.
Exhaled nitric oxide test. You breathe into a tube connected to a machine that measures the amount of nitric oxide in your breath. Your body makes this gas normally, but levels could be high if your airways are inflamed.
Other tests you might get include:
Chest X-ray. It isn’t an asthma test, but your doctor can use it to make sure nothing else is causing your symptoms. An X-ray is an image of the inside of your body, made with low doses of radiation.
- This test takes a series of X-rays and puts them together to make a view of your insides. A scan of your lungs and sinuses can identify physical problems or diseases (like an infection) that may cause breathing problems or make them worse.
Allergy tests. These can be blood or skin tests. They tell if you’re allergic to pets, dust, mold, and pollen. Once you know your allergy triggers, you can get treatment to prevent them — and asthma attacks.
Sputum eosinophils. This test looks for high levels of white blood cells (eosinophils) in the mix of saliva and mucus (sputum) that comes out when you cough.
Asthma Treatment
Many asthma treatments can ease your symptoms. Your doctor will work with you to make an asthma action plan that will outline your treatment and medications. They might include:
Inhaled corticosteroids. These medications treat asthma in the long term. That means you’ll take them every day to keep your asthma under control. They prevent and ease swelling inside your airways, and they may help your body make less mucus. You’ll use a device called an inhaler to get the medicine into your lungs. Common inhaled corticosteroids include:
Beclomethasone (QVAR)
Budesonide (Pulmicort)
Fluticasone (Arnuity Ellipta, Armonair Respiclick, Flovent)
Leukotriene modifiers. Another long-term asthma treatment, these medications block leukotrienes, things in your body that trigger an asthma attack. You take them as a pill once a day. Common leukotriene modifiers include:
Montelukast (Singulair)
Zafirlukast (Accolate)
Long-acting beta-agonists. These medications relax the muscle bands that surround your airways. You might hear them called bronchodilators. You’ll take these medications with an inhaler, even when you have no symptoms. They include:
Ciclesonide (Alvesco)
Formoterol (Perforomist)
Mometasone (Asmanex)
Salmeterol (Serevent)
Combination inhaler. This device gives you an inhaled corticosteroid and a long-acting beta-agonist together to ease your asthma. Common ones include:
Budesonide and formoterol (Symbicort)
Fluticasone and salmeterol (Advair Diskus, AirDuo Respiclick)
Fluticasone and vilanterol (Breo)
Mometasone and formoterol (Dulera)
Theophylline. It opens your airways and eases tightness in your chest. You take this long-term medication by mouth, either by itself or with an inhaled corticosteroid.
Short-acting beta-agonists. These are known as rescue medicines or rescue inhalers. They loosen the bands of muscle around your airways and ease symptoms. Examples include:
Albuterol (Accuneb, ProAir FHA, Proventil FHA, Ventolin FHA)
Levalbuterol (Xopenex HFA)
Anticholinergics. These bronchodilators prevent the muscle bands around your airways from tightening. Common ones include:
Ipratropium (Atrovent FHA)
Tiotropium bromide (Spiriva)
You can get ipratropium in an inhaler or as a solution for a nebulizer, a device that turns liquid medicine into a mist that you breathe in through a mouthpiece. Tiotropium bromide comes in a dry inhaler, which lets you breathe in the medicine as a dry powder.
Oral and intravenous corticosteroids. You’ll take these along with a rescue inhaler during an asthma attack. They ease swelling and inflammation in your airways. You’ll take oral steroids for a short time, between 5 days and 2 weeks. Common oral steroids include:
Methylprednisolone (Medrol)
Prednisolone (Flo-pred, Orapred, Pediapred, Prelone)
Prednisone (Deltasone)
You’re more likely to get steroids injected directly into a vein if you’re in the hospital for a bad asthma attack. This will get the medication into your system more quickly.
Biologics. If you have severe asthma that doesn’t respond to control medications, you might try a biologic:
Omalizumab (Xolair) treats asthma caused by allergens. You get it as an injection every 2 to 4 weeks.
Other biologics stop your immune cells from making things that cause inflammation. These drugs include:
Benralizumab (Fasenra)
Mepolizumab (Nucala)
Reslizumab (Cinqair)
Tezepelumab-ekko (Tezspire) is a first-in-class medicine indicated for the add-on maintenance treatment of adult and pediatric patients aged 12 years and older. Taken by injection, it targets a specific molicule that causes inflammation in the airways.
Home remedies
Medication will probably be key to getting your asthma under control, but you can do some things at home to help.
Avoid asthma triggers.
Exercise regularly.
Stay at a healthy weight.
Take care of conditions that can trigger symptoms, such as GERD.
Do breathing exercises to ease symptoms so you need less medication.
Some people use complementary treatments such as yoga, acupuncture, biofeedback, or supplements like vitamin C and ding chuan tang. Talk to your doctor before trying any of these.
Asthma Complications
When it’s not under control, asthma can cause problems with your daily life, such as:
Fatigue
Lack of exercise and weight gain
Hospital or ER visits
Missing work
Time away from school or trouble focusing on schoolwork
Mental health issues such as stress, anxiety, and depression
Asthma can also lead to serious medical conditions including:
Pneumonia and other complications from common infections like the flu
Early delivery or the loss of a pregnancy
Permanently narrowed bronchial tubes in your lungs
Lung collapse
Respiratory failure
Asthma Attack Prevention
Your action plan will include different ways to keep your asthma under control and prevent attacks. These might include:
Know your triggers and stay away from them.
Follow your doctor’s instructions on taking your asthma medications. Let them know if you notice that you’re using a quick-relief inhaler more often.
Keep track of your condition and learn the signs that it might be getting worse. A peak flow meter can help.
Know what to do if you think your asthma is getting worse.
https://www.aafa.org/asthma.aspx
Asthma Overview
Asthma affects more than 25 million Americans1. It is a chronic disease that causes your airways to become inflamed, making it hard to breathe. There is no cure for asthma. The best way to manage asthma is to avoid triggers, take medications to prevent symptoms and prepare to treat asthma episodes if they occur.
AAFA has a lot of information on their site to help you learn more about asthma. Also consider joining AAFA’s online asthma support community, a local support group or contacting a regional chapter if one is in your area.
Asthma Overview
Asthma affects more than 25 million Americans1. It is a chronic disease that causes your airways to become inflamed, making it hard to breathe. There is no cure for asthma. The best way to manage asthma is to avoid triggers, take medications to prevent symptoms and prepare to treat asthma episodes if they occur.
How Is Asthma Diagnosed?
A doctor may use a few different ways of testing for asthma. These include:
Taking a detailed medical history
A physical exam
Lung function tests
Chest or sinus X-ray
The doctor will look at the results from these tests. They will then decide what type of asthma you have. They will develop a treatment plan based on the type and severity of your symptoms.
People with asthma usually see a doctor that specializes in allergies or the immune system. You and your doctor will come up with a plan to treat your asthma. It often involves a blend of medication and avoiding triggers.
What Triggers Asthma?
Asthma symptoms can appear when you are exposed to a trigger. A trigger is something you are sensitive to that makes your airways become inflamed. This causes swelling, mucous production and narrowing in your airways. Common asthma triggers are pollen, chemicals, extreme weather changes, smoke, dust mites, stress and exercise.
How Can I Prevent an Asthma Episode?
The best way to prevent an asthma episode, or attack, is to follow your treatment plan. Learn your triggers and avoid them. Take your allergy and asthma medicines when you should. Use your quick-acting medicine as soon as you start to notice symptoms.
Many people live normal lives with asthma if it’s properly managed. With a good treatment plan and guidance from your doctor, you can still do much of what you enjoy. For example, many professional athletes have asthma.
Asthma Facts
More Americans than ever before have asthma — about 25 million people in the U.S. have asthma. It is one of the most common and costly diseases.
Asthma and obstructive sleep apnea
STUDY OBJECTIVES:Both asthma and obstructive sleep apnea (OSA) are strongly associated with poor sleep. Asthma and OSA also have several features in common, including airway obstruction, systemic inflammation, and an association with obesity. The aim was to analyze the effect of asthma, OSA, and the combination of asthma and OSA on objectively measured sleep quality and systemic inflammation.
METHODS:Sleep and health in women is an ongoing community-based study in Uppsala, Sweden. Three hundred eighty-four women ages 20 to 70 years underwent overnight polysomnography and completed questionnaires on airway diseases and sleep complaints. C-reactive protein (CRP), interleukin 6 (IL-6), and tumor necrosis factor α were analyzed.
RESULTS:The group with both asthma and OSA had higher CRP, higher IL-6, a longer sleeping time in stage N1 sleep and stage N2 sleep, and less time in stage R sleep than the control group with no asthma or OSA. The group with both asthma and OSA had lower mean oxygen saturation (93.4% versus 94.7%, P = .04) than the group with OSA alone. The results were consistent after adjusting for age, body mass index, and smoking status. Asthma was independently associated with lower oxygen saturation, whereas OSA was not.
CONCLUSIONS:Our data indicate that coexisting asthma and OSA are associated with poorer sleep quality and more profound nocturnal hypoxemia than either of the conditions alone. The results are similar to earlier findings related to OSA and chronic obstructive pulmonary disease, but they have not previously been described for asthma.
Asthma is strongly associated with poor sleep quality.1 This can be explained in part as a result of nocturnal asthma symptoms and frequent coexisting rhinitis,2,3 but these factors may not fully explain the increased prevalence of insomnia in asthma. Associations between asthma and obstructive sleep apnea (OSA) have been described in recent years and several studies have shown a considerably higher prevalence of OSA in individuals with compared with individuals without asthma.4,5 Although OSA and asthma are conditions with a different pathophysiological background, they have several features in common. First, obesity, which is strongly associated with OSA, has also been identified as a major risk factor for asthma,6 in particular, nonallergic, difficult-to-treat asthma.7 Second, both asthma and OSA are associated with local inflammation in the upper airway, nasal obstruction, and snoring.8 Third, there are similarities in the systemic inflammatory patterns in OSA and certain asthma phenotypes. For example, inflammatory markers, such as C-reactive protein (CRP), tumor necrosis factor α (TNF-α), and interleukin 6 (IL-6), are elevated in nonallergic, neutrophilic asthma phenotypes and also in obesity and OSA.9–13
An overlap syndrome between chronic obstructive pulmonary disease (COPD) and OSA has previously been described14 and it is known that coexisting COPD and OSA result in more profound nocturnal hypoxemia than either of the conditions alone.15 Further, treatment with continuous positive airway pressure (CPAP) has been shown to reduce airway reactivity among individuals with asthma without OSA16 and to improve asthma-related quality of life among individuals with asthma and OSA.17
https://www.nhlbi.nih.gov/health/asthma
About 1 in 13 people in the United States has asthma, according to the Centers for Disease Control and Preventionexternal link. It affects people of all ages and often starts during childhood. Certain things can set off or worsen asthma symptoms, such as pollen, exercise, viral infections, or cold air. These are called asthma triggers. When symptoms get worse, it is called an asthma attack.
There is no cure for asthma, but treatment and an asthma action plan can help you manage it. The plan may include monitoring, avoiding triggers, and using medicines.
