This information has been reviewed and approved by James Brock, DO (July 2021).
About one in 13 Americans have asthma. According to the American College of Asthma, Allergy and Immunology, it’s a condition that affects more than 9% of children and about 8% of adults. The main symptoms of asthma include coughing, chest tightness, wheezing or shortness of breath.
Asthma is caused by chronic inflammation in the airways, which leads to airway mucus hypersecretion, bronchial wall smooth muscle hypertrophy and when triggered, airway hyper-reactivity/bronchospasm.
Asthma is considered a chronic condition, which means it persists or lasts longer than three months. Chronic conditions need to be managed daily. Asthma treatments have advanced in the last few years, which when combined with the tools and tips below, can help you keep your asthma under control year-round.
Asthma Management Tools and Tips
Asthma Action Plan
An action plan is a written and customized plan, that is signed and dated by your healthcare provider or doctor, to help you manage your asthma. Your doctor will develop an action plan to explain how to monitor your asthma with a peak flow meter and what medicine to take for different types of symptoms. Learn more about an asthma action plan.
For children with asthma, it’s important to share your child’s asthma action plan with all caregivers. School nurses, babysitters, coaches, split households and extended family all need access to the action plan so they can see how to best take care of your child’s asthma. “The strength of the plan,” explains James Brock, DO, pulmonologist for National Jewish Health for Kids, “is that it can go all the places that you go. It’s so easy to make hard or digital copies of the plan, and take it to other households, the school nurse’s office and grandma’s house.”
Follow your asthma action plan. Take a copy with you when traveling and post it on the refrigerator for family members to see.
Peak Flow Meter
A peak flow meter is a small, easy-to-use instrument that measures how fast you can blow air out of the lungs. It can help you monitor lung function for performance patterns. These patterns can help prevent asthma episodes and better manage your disease. Remember to carry a peak flow meter with you and have one at school for your child. Learn more about a peak flow meter.
With advances in asthma medications over the last few years, there are many different oral and inhaled drugs that are safe and effective treatments. Your doctor will prescribe medications specifically for your needs. Always take your medication as prescribed and according to your asthma action plan. If you feel the medication is not working, do not take more medicine, call your doctor and explain the situation. Learn more about asthma medication.
Spacers, Masks and Rinsing
Many adults and kids are prescribed asthma medication through a metered-dose inhaler (MDI). This is a pressurized medication canister in a plastic case that has a mouthpiece. Pressing the MDI releases a mist of medication into the mouth.
MDIs typically deposit molecules of the medicine at 80-100 mph into the mouth. It is recommended to use a spacer device with a MDI. Without a spacer device, more than half of the inhaled medicine is swallowed and ends up in the stomach and instead of the lungs. Asthma medication that goes into the stomach instead of the lungs may be less effective and take longer to work.
A spacer (such as an Aerochamber®) can direct more medication into the lungs. Some spacers for children come with masks. Spacers and masks are especially important for children to use.
The oropharynx (tube at the back of the throat that goes down to the stomach and lungs) is shorter in children because they have smaller faces. The shorter the oropharynx, the more likely it is for inhaled asthma medication to go into the stomach instead of the lungs without the help of a spacer. Using spacers and masks can help ensure that both rescue and controller medications make it into the lungs.
When the primary asthma rescue medication (albuterol) makes it into the oropharynx and stomach without using a spacer, it can increase the risk of side effects. Albuterol side effects include jitters and increased heart rate.
In children, the most common side effect of long-term use of the main controller therapy, inhaled corticosteroids (ICS), is reduced growth rate. To reduce the impact of ICS medication on your child’s growth rate, use a spacer and rinse out your child’s mouth each time after using the ICS inhaler.
Dr. Brock knows that spacers and masks can feel like a hassle to his patients. “They’ll say ‘that thing’s bulky,’ ‘I don’t want it in my backpack,’ ‘It’s hard to carry around,’ or ‘I can’t just keep it in my pocket.’” Spacers can get lost and broken as well. But it’s worth the extra effort to carry spacers around, and to use them the way your asthma care team taught you.
Spacers and masks are helpful tools that can help keep asthma symptoms, such as wheezing and shortness of breath, better-controlled. These tools can also help prevent unwanted adverse effects of both rescue and controller MDI medications.
Know Your Asthma Triggers
Another important way to manage asthma year-round is to know what triggers asthma symptoms and how to reduce exposure to those triggers. Common asthma triggers include:
If you or your child has asthma and is allergic to dust mites, remember that excess dust can trigger asthma episodes. You can dramatically reduce exposure to dust mites by putting zippered dust mite covers on box springs, pillows and mattresses; dusting the home regularly; laundering bedding frequently (at lease weekly); and keeping the residence thoroughly vacuumed.
If asthma is triggered by cold winter air, cover the nose with a scarf before going outside. Make sure teachers and school staff know how to help your child breathe well on cold days during recess and on field trips.
Winter viruses spread easily when we are indoors more and can trigger asthma symptoms. To prevent asthma symptoms, your health care provider may suggest a few daily doses of albuterol (a quick relief asthma medication) for a few days when you or your child starts to get a runny nose.
Grass and tree allergens
From February to April, trees and grasses start growing, which can be a trigger for adults and children who are allergic to those pollens. Watch local pollen counts. Stay inside when pollen counts are highest (usually afternoons) Shower or bathe after being outside to wash pollen out of hair and off the body.
Knowing what triggers your asthma, and when those triggers are more likely to occur, allows you to take steps that reduce exposure “You and your child can still engage in those things that you love by minimizing the parts of that activity that can be triggers,” explained Dr. Brock.
Don’t Pause Long-Term Control Medication
Asthma symptoms can appear less frequently and be less severe during certain parts of the year, such as very early spring, mid to late summer and early fall.
“When your asthma is not causing flares, you might be tempted to stop taking the controller medicine regularly and forget refills. This can cause bad asthma attacks because the controller medicine hasn’t been consistently used,” said Dr. Brock.
If your doctor prescribes a long-term control medication to help keep asthma symptoms under control, take it as prescribed, year-round to prevent flare-ups and to keep your lungs functioning well all the time.
Sometimes, the asthma doctor may reduce the number of puffs from inhaled medication during times when symptoms are less severe. This helps you to only use the controller medication prescribed (and not the rescue) when asthma is under control. Even if the prescription is for one puff instead of two, that one puff is still vital for keeping symptoms at bay. “Always take your controller inhaler as prescribed and use it consistently, then you’ll ultimately have fewer asthma exacerbations,” said Dr. Brock.
See Your Asthma Care Provider Regularly
You can receive asthma medical care from pediatricians, family or general doctors, or from an asthma specialist. Whoever provides asthma care for your family, it’s important to see that provider as regularly as they recommend.
“Pediatric asthma usually improves as children grow and age,” said Dr. Brock. Over time, your child may have reduced asthma problems, but the only way to know if your child’s asthma is improving, staying the same or getting worse, is to have regular follow up visits with your asthma care provider. Sometimes your child’s medications can be reduced to prevent side effects.
Adult asthma does not usually go away once you develop it, but symptoms may improve over time with consistent treatment and management.
If you’re experiencing uncontrolled symptoms, talk with your asthma care provider and revisit the asthma action plan in case changes are needed. Too little asthma medication can cause ongoing airway remodeling, which makes chronic changes to the airway structure. This makes it harder to treat asthma symptoms long term.