Asthma refers to a chronic respiratory malfunction that causes obstruction of the bronchial airways, making it increasingly difficult to breathe.
With the onset of an asthma attack, the lining of the respiratory airways that is responsible for carrying air in and out of the lungs becomes inflamed and produces larger amounts of dense mucus than usual. Also, the muscles surrounding the airways contract, causing further constriction of the air passage.
A mild asthma attack can be a minor nuisance with symptoms that are easily manageable by home treatment. However, in severe cases, it can be a major problem that is potentially fatal.
As there is no cure for asthma, the goal of treatment is to control the disease by identifying and limiting exposure to triggers, which can set off an array of symptoms that last from minutes to weeks.
It is also imperative that you must proactively work out a treatment plan by enlisting your doctor’s help. This plan should enumerate the steps to be taken in the event that the asthma symptoms begin to spiral out of control or during an ongoing attack.
Causes of an Asthma Attack
Although the exact cause of asthma remains unidentified, an attack usually sets in due to exposure to certain allergens. The immune system responds to these irritants by causing your bronchial tubes to swell and become narrow and choked with mucus, thereby blocking the flow of air in and out of the lungs.
Asthma triggers can vary from person to person, and the first step towards preventing an attack is to identify them and subsequently learn to avoid them.
Some common asthma culprits include:
- Smoking and secondhand tobacco smoke
- Respiratory infections, such as colds, flu, and pneumonia
- Allergens, such as food, pollen, mold, dust mites, and pet dander
- Air pollution and toxins
- Weather, especially extreme changes in temperature
- Drugs, such as aspirin, NSAIDs, and beta-blockers
- Food additives, such as MSG
- Emotional stress and anxiety
- Singing, laughing or crying
- Strong perfumes and fragrances
- Gastroesophageal reflux disease (GERD)
- Smoke from burning wood or grass
Genetics, pollution, and modern hygiene standards have also been proposed as probable causes for an asthma flare-up, but this claim is not backed by enough scientific evidence.
For some people, asthma signs and symptoms tend to aggravate in certain settings:
- Exercise-induced asthma, which may be worse when the air is cold and dry
- Occupational asthma, brought on by workplace triggers such as chemical fumes, gases, and dust
- Allergy-induced asthma, triggered by airborne irritants, such as pollen, mold spores, cockroach waste, or particles of skin and dried saliva shed by pets (pet dander).
Symptoms of an Asthma Attack
Asthma symptoms are not uniform across patients and differ in their frequency as well. While some people may only encounter asthma symptoms during certain times – such as when exercising – others may suffer from them at all times.
Asthma signs and symptoms include:
- Shortness of breath
- Chest tightness or pain
- Disrupted sleep caused by shortness of breath, coughing, or wheezing
- A whistling or wheezing sound when exhaling, particularly in children
- Coughing or wheezing episodes that are made worse by a respiratory viral infection, such as a cold or the flu
If your symptoms continue to persist or even worsen despite sticking to the doctor-prescribed action plan, you should look out for the following signals to preempt an asthma attack:
- Progressively deteriorating asthma symptoms that are more frequent and bothersome
- A lower peak expiratory flow score on the peak flow meter, a device used to check how well your lungs are working
- The need to use a quick-relief inhaler more often, which seems to become increasingly ineffective in alleviating the symptoms
- Feeling constantly fatigued and resulting mood swings
Primary Treatment for Asthma Attack
Although there is no ultimate cure for asthma, having a first-line treatment strategy can go a long way in inhibiting an asthma flare-up. Because panic only works to make the asthma symptoms worse, being prepared beforehand is fundamental to preventing a full-blown attack.
Thus, a meticulously worked-out action plan can help you control the symptoms and thereby live a normal, active life outside the shadow of an impending asthma episode.
A variety of medicines, as well as inhalers, can also help control asthma but only in conjunction with regular healthcare and the doctor-recommended action plan.
There is no common drug or dosage that works for all asthma patients, and so it is essential for you to work closely with your doctor to get the proper diagnosis and the prescribed course of action according to it.
When it comes to asthma medication, it is important to stick to the prescribed course and under no circumstances attempt to self-medicate or alter your dosage without your doctor’s go-ahead. Also, keep an eye out for potential triggers to further minimize the chances of an attack.
In case of a sudden attack:
- Sit up straight and try to breathe in slowly and steadily without losing your calm.
- Use your reliever inhaler to take regular puffs, every 30-60 seconds, going up to a maximum of 10 inhalations.
- In case you don’t have your inhaler with you at the time of an attack or it proves ineffective or even detrimental to use the inhaler after 10 puffs, contact emergency medical assistance pronto.
- If it takes longer than 15 minutes for the help to arrive, repeat step 2.
Tips and Remedies to Keep Asthma Attack in Check
Here are 10 ways to reduce the risk asthma attacks.
1. Avoid Exposure to Humidity
To reduce asthma attacks, you must pay attention to air quality. Extremely hot, humid weather and poor air quality can trigger symptoms for many people. Also, avoid highly polluted areas that can worsen your condition.
- Use an air conditioner to lower indoor humidity and reduce airborne pollen from trees, grasses, and weeds that find their way indoors.
- Keep your windows closed during pollen season.
- If you live in a damp climate, consult your doctor about using a dehumidifier.
- Avoid living near a highway or a busy intersection where there is a greater risk of air pollution.
- If possible, move to a location where you can enjoy fresh, dry air.
- Avoid exposure to erratic temperature fluctuations within a short span of time.
2. Limit Your Exposure to Dust
Due to its allergy-inducing properties, dust is one of the most common asthma triggers as it contains tiny particles of pollen, mold, fibers from clothing, and detergents.
A similar trigger is dust mites, which are tiny bugs that live in sheets, blankets, pillows, mattresses, soft furniture, carpets, and stuffed toys. Hence, do your best to keep your house free from dust and dust mites.
- Clean and replace air conditioner filters on a regular basis.
- Remove carpets and heavy drapes from the bedroom.
- Wash all bedding and stuffed animals frequently in hot water.
- Use allergen-barrier coverings for pillows and mattresses.
- Vacuum your house twice a week.
- Dust all surfaces with a damp cloth often.
- Wear a mask and gloves when cleaning or vacuuming to limit dust and chemical exposure.
- Avoid dust-collecting blinds or long drapes for your windows. You can use window shades and washable curtains.
- Keep clutter under control.
- Store washed clothes in drawers and closets.
- Keep bedrooms well ventilated.
3. Prevent Mold and Mildew Infestation
Be wary of damp places in your kitchen, bathroom, basement, and yard. Do your best to reduce exposure by preventing mold and cleaning it as soon as it appears.
- Run a dehumidifier or use an exhaust fan when taking a shower.
- Regularly clean damp areas in the bathroom, in the kitchen, and around the house to prevent mold spores from developing.
- At the first sign of mold, clean it up with mild soap and hot water.
- If not washable, throw away moldy items.
- Get rid of moldy leaves or damp firewood in the yard.
- Fix leaky plumbing or other sources of water as soon as possible.
- Remove household plants. Plant them in your garden or backyard instead. To prevent mold, make sure not to overwater plants and keep them in a sunny place.
4. Say No to Smoke
The smoke of any kind can irritate your lungs, especially when you have asthma. In fact, smoke is a well-known asthma trigger that you must avoid at all costs if you are asthmatic, especially because asthma symptoms such as coughing and wheezing become worse when exposed to smoke.
A study published in the American Journal of Respiratory Cell and Molecular Biology found that regular smoking increased the risk of asthma among adolescents, especially for nonallergic adolescents and those exposed to maternal smoking during the in utero period.
Another study published in the American Journal of Public Health reported that childhood cigarette smoking and environmental tobacco smoke are independently associated with asthmatic symptoms, even at low levels of exposure.
- If you smoke cigarettes, quit immediately.
- Avoid secondhand smoke.
- Do not allow others to smoke in your home or car.
- Avoid public places that permit smoking.
- Stay at a smoke-free hotel when traveling.
- Make sure your kitchen has a proper exhaust fan or chimney to remove cooking smoke.
- Minimize exposure to other sources of smoke, such as incense, candles, fires, and fireworks.
5. Stay Away from Pets
Pets can trigger an asthma episode in people who are allergic to them. Pet dander and particles of hair, fur, feathers, and saliva are common asthma triggers.
If parting ways with a beloved family pet is too hard to take, be sure that you:
- Keep the pet out of your bedroom completely.
- Do not allow your pet on any furniture.
- Have your pet regularly bathed or groomed.
- Do not allow children who suffer from asthma to play with dogs, cats, and other animals.
6. Get Rid of Cockroaches
Cockroaches can also trigger allergies and asthma attacks. They produce substances that cause allergic reactions in people who have asthma, plus coughing and wheezing in babies and small children. Thus, it is important to eliminate cockroaches from your home if you are an asthma sufferer.
- Do not leave food, water, and garbage uncovered.
- Do not leave pet food out overnight.
- Wash your dishes and utensils immediately after using them.
- Do not leave bits of food and spilled drinks on the countertops. Clean the counters and tables with soapy water.
- Use roach traps or gels to get rid of cockroaches.
- Every 2 to 3 days, vacuum, sweep and mop any areas where you see cockroaches.
- Inspect your backyard and garage to see where these bugs are hiding.
- Seal up any openings where cockroaches can enter, such as sinks and leaky pipes.
- Reduce humidity in your home as it promotes the growth of cockroaches and other pests.
- If necessary, call a pest control expert to get rid of cockroaches for good.
7. Free Yourself from Unnecessary Stress
When people are under stress, their breathing often becomes rapid and shallow. This causes constriction of the airways and can lead to an asthma attack. In addition, stress can weaken your immune system, making you more vulnerable to asthma attacks and infections.
To keep yourself away from stress:
- Practice deep breathing exercises to calm yourself during a stressful situation.
- Get regular exercise or practice meditation and yoga to ease stress. You can also take up a hobby to help calm your mind.
- Adopt a regular sleep schedule as lack of sleep can contribute to stress.
- Avoid stressors by improving your time management and organizing things properly.
- Ask for help when you cannot manage stress on your own.
- Make time to have fun with your family and friends.
8. Exercise Wisely
Many people suffer from exercise-induced asthma, which is asthma triggered by vigorous or prolonged exercise or physical exertion. However, you must not treat exercise as a trigger to be avoided. Physical activity is important, even for people with asthma.
In fact, regular exercise can strengthen your heart and lungs, which helps reduce asthma symptoms. The key is to know your limits and exercise with precaution in an appropriate setting.
- Try yoga, gentle biking, moderate-to-brisk walking, weight training, and sports such as golf, baseball, swimming, gymnastics, tennis, and other racquet sports that involve short and intermittent periods of exertion.
- Reduce the risk for exercise-induced asthma attacks by working out inside on very cold or very warm days. If you are exercising outside, wear a mask or scarf over your mouth.
- While exercising, make sure you breathe through your nose instead of your mouth.
- Before doing any exercise, start with a warmup period.
- Consult your doctor before taking part in any physical activity or sport.
9. Beware of Respiratory Infections
Respiratory infections such as colds, flu, or sinus infections are among the most common causes of asthma symptoms that lead to an asthma flare-up. Heartburn and GERD can also damage the airways that lead to the lungs and worsen asthma symptoms.
If your asthma seems to be triggered by an underlying illness, consult a doctor immediately to combat the root cause.
Proper and timely treatment will help lessen the duration and intensity of your illness and, subsequently, reduce the severity and frequency of asthma attacks. At the same time, take good care of yourself during the cold and flu season.
You can also get an annual flu shot. The Centers for Disease Control and Prevention (CDC) recommend that people aged 6 months and older who suffer from asthma get an annual flu shot to help protect against the flu virus.
10. Implement Dietary Changes
A good diet is important for everyone, but particularly so for people with respiratory ailments such as asthma. A diet high in vitamin C and E, beta-carotene, flavonoids, magnesium, selenium, and omega-3 fatty acids is considered highly beneficial for people suffering from asthma.
- Eat plenty of fresh and organic fruits and vegetables.
- Eat foods rich in omega-3 fatty acids, such as salmon, tuna, and flaxseed.
- Include herbs and spices such as rosemary, sage, oregano, ginger, and turmeric in your cooking.
- Avoid eating processed and packaged foods with artificial additives and preservatives.
- Avoid milk and dairy products if you are allergic to milk proteins or have lactose intolerance.
- Avoid heavy and fatty meals as they increase airway inflammation and inhibit relief provided by the common asthma medications.
Risk Factors Associated with Asthma Attack
There are a number of factors that can increase your susceptibility of getting asthma. These include:
- If you suffer from atopic conditions such as eczema, a food allergy, or hay fever
- If you have a family history of asthma or atopic conditions
- If you were afflicted with bronchiolitis, a common childhood lung infection
- If you were regularly exposed to tobacco smoke as a child
- If your mother used to smoke while she was carrying you
- If you were born prematurely (before 37 weeks) or with low birthweight
When to See a Doctor
- Persistent symptoms, such as frequent coughing or wheezing, that last more than a few days are an easy giveaway that you may be suffering from asthma. Seek your doctor’s counsel if you detect any of the warning signs because proactively treating the symptoms can help mitigate the long-term lung damage and help keep the condition from worsening over time.
- Collaborate with your doctor to come up with an asthma action plan to know exactly what to do when you experience a worsening of asthma symptoms or in the event of a full-blown asthma attack. Keep frequenting your doctor to keep tabs on your asthma symptoms and how well they are responding to the prescribed course of treatment.
- If your asthma symptoms get severely aggravated such that they fail to respond to the prescribed medication or you need to use your quick-relief inhaler more often, contact your doctor right away. It is extremely ill-advised to take such a sensitive situation in your hand and self-medicate without consulting your doctor. In fact, overusing asthma medication can cause further detrimental side effects and end up making your condition worse.
- Since asthma tends to evolve over time, it is essential that you meet with your doctor regularly to review your treatment and make any necessary tweaks to it in accordance with the change in symptoms.
Severe asthma attacks can be life-threatening. Work with your doctor to determine what to do when your signs and symptoms worsen and to know when you need emergency treatment.
Signs of an asthma emergency:
- The feeling of running out of breath or severe wheezing, which worsens during the night and early morning.
- Symptoms that fail to subside or show any improvement even after using a quick-relief inhaler, such as albuterol.
- Loss of breath even during minimal physical activity, such that you are unable to speak.
In addition, there are several things that you can do on your own to prevent or reduce asthma attacks and relieve symptoms.
Plus, make sure the people around you know about your condition. This will enable them to help you in case of a sudden asthma attack. At the same time, always keep some quick-relief asthma medicines readily available.
Expert Answers (Q&A)
Answered by Dr. Maeve O’Connor, MD (Allergist/Immunologist)
What is the prescribed way to manage an asthma attack in the absence of an inhaler?
If no quick-relief or rescue inhaler is available (having a rescue inhaler on hand is VERY IMPORTANT), the best way to manage an asthma attack is to CALL 911. While waiting for the ambulance, staying calm is one of the most important things you can do which can help your respiratory muscles become less constricted.
Sit in an upright position to stop breathing constriction. Take slow, deep and long breaths to prevent hyperventilation. Use the “relaxing breath” technique. I suggest breathing in through the nose for a count of 4, holding the breath for 1 second and then slowly exhaling for a count of 4.
Staying calm may prevent further tightening of your chest muscles and make your breathing easier. The most important thing to remember is to not delay seeking emergency care when needed.
Is it possible to cure asthma permanently?
Asthma is a chronic condition and unfortunately cannot be cured. It can be managed effectively by avoiding known triggers and taking controlling medications as prescribed. If asthma is limiting your daily activities or waking you up at night, it is important to talk to your doctor about your asthma action plan.
How can one control asthmatic coughing spells during the night?
Coughing at night is a hallmark sign of poorly controlled asthma. If you are waking up more than two nights per month with coughing, wheezing or shortness of breath, you should talk to your doctor to better understand your type of asthma and what treatments may be available to manage the symptoms.
Poor sleep impacts your entire life, resulting in lost productivity and mood disturbance. For these reasons it is very important to minimize coughing at night.
Are caffeinated drinks helpful for asthma patients?
Hot caffeinated drinks like coffee can help to open up the airways slightly, providing symptomatic relief for an hour or two; however, this is not a long-term solution to addressing asthma symptoms.
Are there any particular food items that can trigger an asthma attack?
Each individual patient has unique triggers for his/her asthma. Some patients may have food allergies that can worsen or often be confused with asthma. If you are experiencing a severe allergic reaction and an asthma flare-up, it is important to err on the side of caution and treat with epinephrine for anaphylaxis first. Time is of the upmost importance and epinephrine should be administered quickly.
How can the excess mucus secreted following an asthmatic episode be cleared naturally?
Nasal saline rinses may help to clear mucus in the upper airway which often impacts the lower airways. It is also important to stay well hydrated by drinking at least two liters of water per day, unless you have kidney or heart issues.
About Dr. Maeve O’Connor, MD: Dr. O’Connor provides a more progressive approach for treating allergy, asthma and immunology patients. She is Board Certified by both the American Board of Internal Medicine and the American Board of Allergy and Immunology. She is one of the only three specialists to have completed the University of Arizona Fellowship of Integrative Medicine, and has been selected by her peers to be included in the Best Doctors of America database from 2011 to currently.
Dr. O’Connor is the only board certified allergist in the region offering sublingual immunotherapy, and is also performing clinical research. She is currently involved in clinical research of asthma, allergic rhinitis, immune deficiency and novel treatment for atopic diseases.
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