How do I know if my asthma is well controlled?

How much do I know about asthma and how it affects me?


Asthma is defined as a long term condition that affects your airways, the tubes that carry air in and out of your lungs. Currently, there is no ‘cure’, however, if asthma is controlled well with medication and lifestyle choices, asthma can be effectively controlled and be symptom free.

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Symptoms of asthma

The most fundamental symptom which is associated with asthma is difficulty breathing and most sufferers will have times will experience this symptom. For people with severe asthma, they may have difficulty breathing all the time.

The most common symptoms include:

  • Wheezing which is breathing accompanied by a whistling sound
  • Shortness of breath
  • A feeling of constriction in the chest
  • Coughing

These symptoms can be very common and have many different causes but asthma is the most likely cause if the following happens:

  • Symptoms are worse at night
  • Symptoms happen often and keep returning
  • The symptom appears to happen following an asthma trigger such as exercise or allergy

Asthma sufferers will likely suffer an asthma attack from time to time (this is less likely if the condition is well managed). When your asthma gets worse for a short time and is called an asthma attack; the attack may be sudden or come on over a period of time.

If you are having an asthma attack you may experience the following:

  • A fast pulse
  • Rapid breathing
  • Severe breathlessness leaving the sufferer unable to speak, eat or sleep
  • Severe and constant wheezing, tightness of the chest and coughing
  • Confusion and drowsiness
  • Blue lips or fingers, also known as cyanosis, and it is caused by low levels of oxygen in the bloodstream
  • Fainting

What to do to manage asthma?

Different asthma sufferers will experience asthma in different ways and some have constant asthma symptoms whilst others may only have symptoms from time to time. If a person is experiencing symptoms more than three times per week then their condition is not being well managed.

In this article, we outline a number of key points that will enable sufferers to improve their asthma management.

Have an action plan

An asthma action plan or management plan is written with the help of your asthma specialist to help manage the condition. It gives guidance on the following:

It outlines which medication you take daily to help prevent symptoms and so reduce the risk of having an asthma attack
Guidance and suggestions should your asthma symptoms be getting worse

What emergency action you need to take if you have an asthma attack as well as giving guidance on when to call an ambulance

Your asthma action plan is personal to you and to your particular condition. When you visit your asthma clinic or if you have to go to hospital, take the plan with you so that it can be kept up to date.

Take prescribed medication as directed

Your asthma practitioner has taken the time to prescribe medication that is best suited to your particular condition and for this reason, it is important that the medication is taken as directed.

Use a peak flow meter

Using a peak flow meter regularly is very useful in tracking the patterns of asthma. It tells you how fast you can blow air out and so can give a good gauge of your lung function at any time. If the reading is high then your lung function is also high and the opposite applies. This is a good gauge for your practitioner in deciding if and when medication needs to be changed in order to best manage your condition.

Visit your specialist asthma health care professional regularly

Develop a good relationship with your asthma management team. It is important to follow their advice and this will help you to reduce the number of symptoms you experience.

Exercise regularly

Physical activity improves lung function, blood flow and is calming. Some people are afraid that activity can bring on asthma symptoms but provided your case of asthma is well managed there should be no problems. If you are wheezing as a result of exercise then your treatment needs to be reassessed
People who exercise regularly find that their asthma is less frequent; just 30 minutes of brisk walking daily is sufficient.

Stay away from tobacco smoke

Tobacco smoke is a major trigger for asthma sufferers so keep away from it!

It is particularly bad for asthma sufferers because it:

  • Reduces lung function
  • It may cause more frequent asthma attacks
  • Controlling asthma is more difficult if exposed to cigarette smoke
  • You may need more asthma medication if you are around cigarette smoke
  • It may make you more sensitive to other asthma triggers such as pollen and pets
  • Tobacco smoke can potential permanently damage your lungs and airways leading to an increased risk of developing chronic bronchitis and emphysema

Signs of well controlled asthma

Signs which indicate that asthma is being well controlled include:

  • No symptoms of asthma such as coughing or wheezing during the day
  • No symptoms of asthma at night that cause you to wake up.
  • You can exercise without having any symptoms of asthma
  • Your lung function is normal
  • Medication to relieve asthma symptoms is not needed There are no day to day activities that cannot be performed properly
  • There have been no absentee days from work or school
  • There have not been any asthma attacks or flare ups

Provided your asthma is well controlled, aside from using an inhaler before exercise, you should only need your inhaler 2 - 3 times per week and shouldn’t be waking regularly as a result of asthma symptoms.

Signs of poorly controlled asthma

It is likely that your asthma is not properly controlled if you have any of the following symptoms:

  • Asthma symptoms such as coughing, wheezing or a tight chest either keep you awake or wake you from sleep
  • There are many occasions when you have difficulty breathing and you have bouts of coughing or wheezing most days
  • You are frequently absent from work or school as a result of asthma
  • If you try to exercise or exert yourself, you will experience breathing difficulties

Causes of poor asthma control

There are a number of possible causes of poorly controlled asthma and they include the following:

  • Using the correct asthma medication is vital and if you are not using the correct one for your particular condition, it is unlikely that it will be controlled. If you are unsure, seek the advice of your asthma practitioner
  • It is very important that inhalers given for asthma are used properly. If you are unsure then ask your pharmacist, doctor or nurse to instruct you on the correct procedure
  • Inhaler medication needs to be used regularly and it must be used as prescribed. If you are unsure then you must speak to your prescriber
  • If you are using your inhaler medication more than 3 times a week then you may be over-reliant on it. Again, speak to your prescriber to discuss the issues
  • Consult your asthma action plan to ensure that you are following it. Whilst not following the plan will not in itself cause you asthma to be poorly managed, it will help you to recognise if your asthma is getting worse and give guidance as to how to get back on track

Women and asthma

Some women can experience worse asthma symptoms when they begin menstruating although this largely settles down as the menstrual cycle settles down.

For some women who have bad asthma, they may find that symptoms become worse around the time of menstruation and this is worth noting in an asthma diary to establish whether this is an issue for you.

Asthma and pregnancy

For some women, their asthma improves during pregnancy, for others, it stays the same and for others, it may become worse, each group being approximately a third of asthmatics, pregnant women.

If pregnancy makes your particular asthma worse the it massy need to be worked into your asthma action plan along with plans for the delivery.

What to do if your asthma is poorly controlled

If your asthma is poorly controlled then it is vital that you consult your asthma practitioner as your action plan will need to be reviewed.

Other things to try include:

  • Ensure that you are using your inhaler medication as prescribed in order to minimise symptoms and reduce inflammation
  • Do not forget your inhaler, ensure you have it with you at all times
  • Avoid the triggers which will aggravate your asthma symptoms such as mould, pollen or pet hair
  • Work with your practitioner on the action plan
  • Stay in contact with your healthcare provider regularly so that your asthma is not allowed to get out of control


Provided asthma is kept under control it is possible to live a normal life with no symptoms.

In order to do this, however, it is extremely important to follow your treatment plan and raise any issues such as worsening symptoms with your healthcare professional.

If asthma is allowed to get out of control it can be a life threatening disease and so it is very important that it is kept under control so do not leave it to chance!

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