Managing your asthma

Whether you’ve just been diagnosed with asthma, or have been living with your condition for a while, it is natural to have questions. We’re here to help.

The information on this page is designed to help you better understand your asthma and steps you can take to manage it effectively.

What is asthma?

You probably went to see your doctor or nurse because there have been times when you have had difficulty breathing. This is because the tubes that carry air in and out of your lungs can become irritated, which causes them to become inflamed and narrow, leading to the symptoms of asthma.1

What are the symptoms of asthma?

Not all people with asthma experience the same range of symptoms, but they can include:2

  • feeling breathless
  • tightness in the chest
  • wheezing
  • coughing.

Many people with asthma find that their symptoms get worse at some times, but better at others. In fact, some people find that there are periods when they experience no symptoms at all.1

An asthma attack – sometimes called an exacerbation – is when the symptoms of asthma become a lot worse, particularly when they are accompanied by shortness of breath. Find out what to do if you have an asthma attack.

What irritates the lungs in asthma?

What sets off your asthma symptoms can range from things around you like pollen and dust to emotions and viral infections. These are referred to as triggers.3

Not all people with asthma have the same triggers, so one of the most useful first steps in managing asthma is to identify your personal triggers. Then you can work out which of yours can be avoided. Have a chat with your doctor, nurse or pharmacist about how to work out which triggers affect your asthma.

Controlling your asthma

When it comes to controlling your asthma, you’ll need to know what medicines to take and when to take them. Asthma is usually treated with inhalers. There are two different types:

  • preventer inhalers are taken every day to reduce the inflammation in the airways4
  • reliever inhalers (usually blue) help the airways to open up again when you are having asthma symptoms.5

If you have been prescribed a preventer inhaler it is really important to take it regularly, and in the way your doctor, nurse or pharmacist has advised you to.

Sometimes a preventer and reliever inhaler are combined in a single inhaler. This is referred to as a Maintenance and Reliever Therapy (MART), and will be listed on your prescription.6

Taking your inhaler as prescribed will mean you are less likely to have asthma symptoms or an asthma attack.

A personalised action plan, developed with your doctor or asthma nurse can help you to monitor your symptoms and advise you what action to take.7 You can ask your doctor or asthma nurse to create a personalised action plan with you. It is also helpful to ensure you have an annual review to ask your doctor, nurse or pharmacist to check your inhaler technique to make sure you are getting the most out of your device.

Asthma and smoking

Cigarette smoke makes asthma symptoms worse and can also affect how well your medication works.8

If you smoke, giving up can be difficult, but you are likely to see a big improvement in your asthma control.

NHS Smokefree can give you lots of support and advice if you decide to quit.

If you are not a smoker yourself, avoiding being around other people’s smoke could also help to reduce your symptoms.8

Exercise

Many people think that having asthma means you can’t exercise.

In reality, staying fit and eating a healthy diet can be really good for improving your asthma symptoms.9

You should check with your doctor or asthma nurse about what precautions to take, but if your asthma is well managed and under control, you should have no problem in keeping an active lifestyle.

Asthma attacks

Taking your medication correctly and monitoring your symptoms are really important steps to preventing asthma attacks – sometimes called exacerbations – but there are other ways you can help avoid these.

It might be a good idea to speak with your doctor or asthma nurse about whether you have any other conditions that could be making your asthma worse. Examples of these include hay fever and perennial rhinitis.10

  • If you have asthma, your airways are considered to be more ‘sensitive’. As a result of this increased sensitivity, the airways may experience a reaction when met with an irritant, this is known as a ‘trigger’.1 Triggers can include cigarette smoke, pets, pollen, pollution, and cold weather. Everyone with asthma has their own set of triggers.3

    When faced with an asthma trigger, you may experience the following reactions:1

    • tightened muscles around airways’ walls, which in turn narrows the airways themselves
    • inflammation of the airway’s lining
    • build-up of phlegm and mucus, causing airways to narrow

    One or more of these reactions can lead to difficulties such as chest tightness, coughing and wheezing, and in some cases, lead to an asthma attack.1

    Some infections can trigger asthma attacks. That’s why you may be advised by your doctor or asthma nurse to receive flu and pneumococcal vaccinations. Sometimes there is no obvious cause or trigger to an asthma attack.11

    The Asthma UK asthma attack risk checker may help assess your risk of an asthma attack.

  • During an asthma attack, the muscle wall of your lungs contracts, and the lining of your airways becomes swollen and inflamed.

    These changes cause your airways to narrow. The production of mucus may also increase, which may block your smaller airways.

    The muscles wrapped around air passages within your lungs eventually become constricted or tightened, and the air passing through the narrowed channels can produce a wheeze.

    This obstruction to your airflow leads to a significant increase in the effort needed to move air in and out of your lungs, giving rise to wheezing, coughing and breathlessness.12,13

  • You are having an asthma attack if:14

    1. You’re wheezing a lot, have a very tight chest, or you’re coughing a lot
    2. Your blue reliever inhaler isn’t helping, or you need to use it more than every four hours
    3. Your symptoms (coughing, wheezing, tightness in the chest and shortness of breath) continue to get worse after you have used your blue reliever inhaler
    4. Your breathing is getting faster and it feels like you can’t breathe properly
    5. You are breathless and find it difficult to walk or talk

What to do in an asthma attack

If you have an asthma attack, you should follow your written asthma action plan if you have one, or follow the steps below:15

  1. Sit up straight – don’t lie down. Try to keep calm.
  2. Take one puff of your reliever inhaler (usually blue) every 30-60 seconds, up to a maximum of 10 puffs.

If you have been prescribed a Maintenance and Reliever Therapy (MART) regimen, please speak to your GP or asthma nurse to get the appropriate asthma attack information.

If you feel worse at any point while you’re using your inhaler, or you don’t feel better after 10 puffs, or you’re worried at any time, call 999 for an ambulance.14 If the ambulance is taking longer than 10 minutes you can repeat step 2.

Frequently asked questions

Asthma triggers

  • Food allergies and sensitivities can trigger your asthma symptoms:16

    • If you’re allergic to certain foods, your allergic reaction can set off your asthma symptoms
    • If you’re sensitive to certain foods, this may set off your asthma symptoms

    Two common food sensitivities are:

    • histamine – found in yogurts, cheese, and smoked meats
    • sulphites – found in processed meats, pickled foods, and some wine, beer and cider.

    If you think certain foods may be triggering your asthma, speak to your doctor or asthma nurse who can help you work out if you any have food allergies or sensitivities. Your doctor or asthma nurse may refer you for an allergy test, or support you in keeping a food and symptom diary to identify potential triggers.

  • Cooking can produce fumes, for example when cooking on the hob. Gas cookers give out the most pollution as these give off nitrogen dioxide, and fine particles small enough to get into your lungs.17 Ensuring good ventilation in the kitchen is important. You can help ventilate by:17

    • using an extractor fan if you’ve got one, or open a window when cooking
    • using the highest setting at the back of the hob when you can, as this works best with the extractor fan
    • letting the fan run for 10 minutes after you finish cooking
    • having your cooker checked and maintained at least once a year to make sure it is not giving out too many fumes.
  • Many people think dust triggers their asthma symptoms, however it’s dust mites – which are tiny insects that live in dust – which are the real cause. Dust mites are too small to see and very difficult to get rid of altogether.18

    There is a substance found in dust mite droppings that some people are sensitive or allergic to. Your doctor or asthma nurse can talk about your symptoms and arrange a skin prick test or blood test to confirm if you’re allergic to dust mites.

    It’s impossible to get rid of dust mites completely, but there are some routine steps you can take to reduce dust mites in your home:18

    • clean and vacuum regularly to keep dust levels down
    • use a damp cloth when you’re dusting, which stops the dust from getting into the air
    • wash bedding once a week at 60 degrees
    • keep windows and doors open when you can
    • if possible, avoid drying clothes indoors.
  • If you have an allergy to the proteins found in animal skin, in feather dust or in the saliva of an animal, this can cause an immune response that triggers your asthma symptoms.

    Touching or inhaling these proteins can trigger asthma symptoms, and the allergens can stay in carpets, furniture and clothes. Lots of different types of animals can trigger asthma, including cats, dogs, horses, rabbits, hamsters, mice, gerbils, and birds. You may be allergic to one type of animal, or many.

    Animal allergies can develop at any stage in life. Speak to your doctor or asthma nurse if you suspect you have an animal allergy, who may refer you for a skin prick test or blood test.19

Asthma and the weather

  • If you have asthma, you might notice that your symptoms get worse in cold weather. This is because the air is drier and colder.20

    Your airways are lined with a thin layer of fluid called the ‘airway surface fluid’ or ASL. When you breathe in drier air, this fluid evaporates faster than it can be replaced, causing your airways to become irritated.21

    Colder air can also cause an increase in mucus production and lead to colds and flu which can set off asthma symptoms.22

    When the temperature drops, you are also more likely to be indoors. This can increase your exposure to indoor asthma triggers like dust mites.

    If your asthma is triggered by the cold, there are a few things you can do to control it, including:23

    • Taking your preventer inhaler as prescribed and always carrying your reliever inhaler
    • Wrapping a scarf loosely around your nose and mouth
    • Using your asthma action plan and making sure you go for regular asthma reviews.
  • Hot, humid air can be a trigger for asthma symptoms. If you have allergic asthma, you might find managing your asthma particularly challenging. This is because allergens like pollen and dust mites thrive in humid, hot conditions.24

    Humid air is also heavy air, meaning it is harder to breathe in general. Breathing in hot summer air causes the airways to narrow which can lead to shortness of breath and coughing.25

    You can take steps to control your asthma in hot weather, including:

    • Regularly taking your preventer inhaler and always carrying your reliever inhaler
    • Planning any outdoor activities earlier in the day – when the air quality is thought to be better
    • Taking a cool bath or shower – or placing a cool wet flannel around your neck.

Further support

There is a lot of information available online, but it’s important to go to a reliable source. The suggested resources listed below can offer you further support on the various aspects of living with asthma.

Asthma + Lung UK

Helpline: 0300 222 5800 (non-emergency)
Explore support for asthma

Health and Safety Executive

Asthma and the workplace – advice, tips and support www.hse.gov.uk/asthma

NHS

Helpline: 111 (non-emergency)
NHS asthma information

NHS smokefree

Support to quit smoking NHS Smokefree

NHS smokefree

References

    1. Asthma UK. What is asthma? Available at: https://www.asthma.org.uk/advice/understanding-asthma/what-is-asthma/
    2. NHS Choices. Asthma – Symptoms. Available at: http://www.nhs.uk/conditions/asthma/symptoms
    3. Asthma UK. Understanding asthma triggers. Available at: http://www.asthma.org.uk/advice/triggers/understanding/
    4. Asthma UK. Preventer inhalers. Available at: https://www.asthma.org.uk/advice/inhalers-medicines-treatments/inhalers-and-spacers/preventer/
    5. Asthma UK. Reliever inhalers. Available at: https://www.asthma.org.uk/advice/inhalers-medicines-treatments/inhalers-and-spacers/reliever/
    6. Asthma UK. Maintenance and Reliever Therapy (MART). Available at: https://www.asthma.org.uk/advice/inhalers-medicines-treatments/inhalers-and-spacers/mart/
    7. Asthma UK. Your asthma action plan. Available at: https://www.asthma.org.uk/advice/manage-your-asthma/action-plan/
    8. Asthma UK. Smoking and second-hand smoke. Available at: https://www.asthma.org.uk/advice/triggers/smoking/
    9. Asthma UK. Activity is good for asthma. Available at: https://www.asthma.org.uk/advice/living-with-asthma/exercise-and-activities/#activityhelpsasthma
    10. Asthma UK. Hay fever treatments. Available at: https://www.asthma.org.uk/advice/inhalers-medicines-treatments/other/ hay-fever/
    11. Mayo Clinic. Asthma attack – symptoms and causes. Available at: https://www.mayoclinic.org/diseases-conditions/asthma-attack/symptoms-causes/syc-20354268
    12. Health and Safety Executive. Your lungs – an asthma attack. Available at: https://www.hse.gov.uk/asthma/lungs.htm
    13. Patient Info. What happens during an asthma attack? Available at: https://patient.info/news-and-features/what-happens-during-an-asthma-attack
    14. NHS UK. Asthma Attacks. Available at: https://www.nhs.uk/conditions/asthma/asthma-attack/
    15. Asthma UK. Asthma attacks. Available at: https://www.asthma.org.uk/advice/asthma-attacks/
    16. Asthma UK. How Food Triggers. Available at: https://www.asthma.org.uk/advice/triggers/food/#howfoodtriggers
    17. Asthma UK. Indoor Asthma Triggers. Available at: https://www.asthma.org.uk/advice/triggers/indoor-environment/#cookers
    18. Asthma UK. Dust Mites. Available at: https://www.asthma.org.uk/advice/triggers/dust-mites/
    19. Asthma UK. Animals and pets. Available at: https://www.asthma.org.uk/advice/triggers/animals-and-pets/
    20. Asthma UK. Why does cold weather make my asthma worse? Available at: https://www.asthma.org.uk/advice/triggers/weather/
    21. D’Amato, M., Molino, A., Calabrese, G. et al. Clin Transl Allergy 2018; 8(20)
    22. Asthma UK. What can trigger my asthma in winter? Available at: https://www.asthma.org.uk/advice/triggers/winter-asthma-triggers/
    23. NHS UK. Cold weather and asthma. Available at: https://www.nhs.uk/conditions/asthma/living-with/
    24. British Lung Foundation. Looking after your lungs in hot weather. Available at: https://www.blf.org.uk/support-for-you/hot-weather
    25. Asthma UK. Hot weather. Available at: https://www.asthma.org.uk/advice/triggers/weather/

Reporting of side effects: If you get any side effects, talk to your doctor, pharmacist or nurse. This includes any possible side effects not listed in the package leaflet. You can also report side effects directly via the Yellow Card Scheme at: www.mhra.gov.uk/yellowcard. By reporting side effects you can help provide more information on the safety of this medicine.