Overview
A cough that will not quit, especially at night, or a tight, breathless feeling after running or in cold air, these are often the first signs of asthma, a condition affecting the airways rather than the lungs failing outright. It is extremely common, and with the right inhaler and a bit of know-how, most people with asthma live completely normal, active lives.
Disease Summary
- Category
- Non-Communicable Disease
- Cause
- Chronic inflammation and narrowing of the airways, arising from a combination of genetic and environmental factors
- Transmission
- Not applicable; asthma is a non-communicable condition and cannot be spread between people
- Body System
- Respiratory System
- Preventable
- Yes
- Curable
- No
Symptoms
Common Symptoms
Symptoms can be mild or severe and often come and go over time, sometimes worsening with a cold or a change in weather.
Persistent Cough
Especially at night, a cough that lingers or keeps returning is a common sign of asthma.
Wheezing
A whistling sound when breathing out, and sometimes breathing in, is one of the more recognisable signs.
Shortness of Breath
Difficulty breathing, sometimes even while resting, can occur during a flare-up.
Chest Tightness
A tight, squeezed feeling in the chest can make it difficult to breathe deeply.
Danger Signs
Seek emergency medical attention immediately if any of the following develop.
Severe Difficulty Breathing
Rapid, laboured breathing that does not improve with a reliever inhaler is a medical emergency.
Unable to Speak in Full Sentences
Being too breathless to complete a sentence indicates a severe attack.
Blue Tinge to the Lips or Fingertips
A sign that the blood may not be carrying enough oxygen, a medical emergency.
No Improvement After Using a Reliever Inhaler
If symptoms do not improve, or worsen, after using a reliever inhaler, seek emergency care immediately.
Diagnosis
Clinical History
Doctors ask about the pattern of symptoms, what triggers them, and whether asthma or allergies run in the family.
Lung Function Test (Spirometry)
Measures how much air you can breathe out and how quickly, and whether this improves after using a bronchodilator.
Peak Flow Measurement
A simple, handheld device that measures how forcefully you can breathe out, useful for tracking asthma control over time.
Laboratory Tests
Spirometry
Measures lung function and checks whether airflow improves after using a bronchodilator, a key part of confirming asthma.
Peak Flow Measurement
A simple daily or clinic-based test that tracks how well the airways are functioning over time.
Allergy Testing
Identifies specific allergens that may be triggering symptoms, such as dust mites or pollen.
Chest X-ray
Not used to diagnose asthma directly, but can help rule out other causes of breathing difficulty.
Treatment
Reliever Inhaler (Bronchodilator)
Opens the airways quickly to relieve symptoms during a flare-up. Every person with asthma should have one readily available.
Preventer Inhaler (Steroid)
Reduces inflammation in the airways over time, lowering the risk of attacks. This is the medication most linked to preventing severe attacks and death, yet it is the one most often unavailable in under-resourced areas.
Prevention
Reduce exposure to tobacco smoke
Avoiding tobacco smoke, including secondhand smoke during pregnancy and childhood, lowers the risk of developing asthma and reduces flare-ups.
Identify and avoid personal triggers
Dust, mould, pollen, strong fumes, and pet fur are common triggers. Knowing your own triggers helps prevent flare-ups.
Use preventer medication consistently
Taking a prescribed steroid inhaler daily, even without symptoms, significantly reduces the risk of severe attacks.
Follow an asthma action plan
A written plan from a healthcare provider helps you recognise worsening symptoms early and know exactly what to do.
Risk Factors
Higher Risk
These factors increase the likelihood of developing asthma.
- A close family member with asthma
- Other allergic conditions, such as eczema or hay fever
- Low birth weight or premature birth
Environmental Risk Factors
Exposures linked to a higher risk of asthma or worse symptoms.
- Exposure to tobacco smoke, including before birth
- Indoor and outdoor air pollution
- Occupational exposure to dust, fumes, or chemicals
Other Contributing Factors
Additional factors linked to asthma risk.
- Being overweight or living with obesity
- Living in an urban area
- Frequent viral respiratory infections in early childhood
Complications
Severe Asthma Attacks
Can require emergency treatment or hospitalisation, and in the most serious cases, can be fatal.
Sleep Disruption and Fatigue
Frequent night-time symptoms can lead to poor sleep, tiredness, and difficulty concentrating.
Reduced Lung Function Over Time
Poorly controlled asthma over many years can lead to lasting changes in the airways.
When to Seek Medical Care
Severe Difficulty Breathing
Needs emergency medical attention immediately.
No Improvement After Using a Reliever Inhaler
If symptoms persist or worsen after treatment, seek emergency care.
Frequent Night-Time Symptoms
Regularly waking due to coughing or breathlessness suggests asthma is not well controlled and needs review.
Needing a Reliever Inhaler More Than Twice a Week
Can indicate that preventer treatment needs to be adjusted.
Prognosis
Highly Manageable With Treatment
Most people with asthma can lead full, active lives with the right inhaler and a clear action plan.
Cannot Be Cured, But Can Be Well Controlled
Asthma is a lifelong condition, though symptoms can be minimal or absent for long periods with good management.
Outcomes Depend Heavily on Access to Treatment
Most asthma deaths occur in places where inhaled medication is not consistently available, not because the condition itself is especially deadly when properly treated.
Differential Diagnosis
Chronic Obstructive Pulmonary Disease (COPD)
Causes similar breathing difficulty but usually develops later in life, often linked to long-term smoking, and does not improve as fully with bronchodilators.
Pneumonia
Can cause cough and breathlessness, but typically also involves fever and is confirmed through imaging rather than breathing tests.
Tuberculosis
Can cause a persistent cough in the same regions and should be considered, particularly if the cough is accompanied by weight loss or night sweats.
References
World Health Organization (WHO)
World Health Organization fact sheet on asthma causes, symptoms, treatment, and the global treatment access gap.
Global Initiative for Asthma (GINA)
Global clinical guidance and awareness resources on asthma diagnosis and management.
WHO Package of Essential Noncommunicable Disease Interventions (PEN)
WHO’s primary care protocols for assessing, diagnosing, and managing asthma and other chronic respiratory diseases in low-resource settings.
Frequently Asked Questions
Can asthma be cured?
No, asthma cannot be cured, but it can be very well controlled with the right inhaler and an asthma action plan. Most people with well-managed asthma live completely normal, active lives.
What should I do during an asthma attack?
Use your reliever inhaler right away, following your asthma action plan. If symptoms do not improve, you cannot speak in full sentences, or your lips turn blue, seek emergency care immediately.
Do I need to use my inhaler every day if I feel fine?
If you have been prescribed a daily preventer inhaler, yes. It works by reducing inflammation over time, and stopping it, even when you feel well, increases the risk of a severe attack.
Can children outgrow asthma?
Some children have fewer or milder symptoms as they get older, though the underlying tendency toward airway sensitivity often remains. Asthma can also develop or return at any age.