Helping You Stay One Step Ahead of Asthma

Asthma is a primary noncommunicable disease (NCD) chronic condition that drastically affects the airways in the lungs, making them inflamed and narrow. This inflammation causes recurring wheezing, breathlessness, chest tightness, and coughing, especially at night and early morning.

  While it affects people of all ages, it initially begins in childhood and can persist throughout life. Despite being highly manageable, asthma remains underdiagnosed and undertreated in many parts of the world, which puts millions at risk of avoidable complications.

The impact of asthma can disrupt daily routines, affect sleep, limit physical activity, and interfere with work or school. And while some experience only mild symptoms, others face life-threatening attacks without warning. The good news is that most people with asthma can live whole, active lives with the correct information and consistent care. 

Let’s explore the topic.

What are the Types of Asthma

• Allergic (extrinsic) asthma: It is often triggered by allergens such as dust, pollen, mold, pet dander, or food. It is often associated with other allergic conditions like eczema or hay fever. It usually begins in childhood and tends to run in families.
• Non-allergic (intrinsic) asthma: It is unrelated to allergies and is often triggered by stress, infections, exercise, cold air, or irritants like smoke or strong smells. More common in adults and may be harder to treat.Tends to be more persistent and less responsive to standard asthma medications.
• Exercise-induced asthma (exercise-induced bronchoconstriction): Symptoms occur during or shortly after physical activity, especially in cold or dry air. They are common in athletes and children and may require pre-exercise medication or inhalers to prevent attacks.
• Occupational asthma: It is caused by exposure to workplace irritants like chemicals, dust, fumes, or gases. It can develop after months or years of repeated exposure. It improves when away from the workplace environment but worsens upon return.
• Cough-variant asthma: Characterized mainly by a persistent, dry cough—without the typical wheezing or shortness of breath. Often misdiagnosed as a chronic cough or post-viral symptom.
• Childhood asthma: Starts early in life and may improve, persist, or evolve over time. Often linked to a family history of allergies or asthma. Requires consistent monitoring, especially during growth spurts or seasonal changes.
• Severe asthma: A less common form that remains difficult to control despite high-dose medications. Requires specialist evaluation and may involve biological therapies or other advanced treatments. Often includes frequent flare-ups and hospitalizations.

Recognizing Asthma Symptoms 

Asthma symptoms don’t always look the same for everyone, and they can change over time. Some people experience symptoms only during physical activity or seasonal changes, while others might notice daily discomfort. Regardless, here are some common signs that may indicate asthma

• Shortness of breath, particularly during or after physical activity
• Wheezing (a high-pitched whistling sound) while exhaling
• Persistent coughing, often worse at night or early morning
• Tightness or pressure in the chest, sometimes described as a squeezing feeling
• Frequent respiratory infections, which can worsen or trigger symptoms
• Difficulty sleeping due to coughing or breathing discomfort
• Increased mucus production, leading to a sensation of congestion or blockage

What Happens During an Asthma Attack

An asthma attack, or exacerbation, is a worsening of asthma symptoms due to tightening of the muscles around the airways (bronchospasm), increased inflammation, and excess mucus production. It can develop gradually or come on quickly & can become life-threatening if not treated promptly.

Here’s what typically happens during an asthma attack

• Shortness of breath that makes it hard to speak or complete sentences
• Rapid, shallow breathing or feeling like you can’t catch your breath
• Wheezing that may intensify or, in severe cases, disappear altogether due to restricted airflow
• Chest tightness or pain that increases with each breath
• Persistent coughing that doesn’t subside, sometimes producing thick mucus
• Noticeable retractions, where skin pulls in between the ribs or at the base of the neck with each breath—especially in children
• Pale or bluish lips and fingernails, a warning sign of low oxygen levels
• Anxiety or panic, which can further disrupt breathing
• Rapid heartbeat and fatigue as the body works harder to get oxygen

What Can Cause or Worsen Asthma

Asthma has no single cause. It’s the result of a complex interaction between genetic and environmental factors. While some people are born with a higher likelihood of developing asthma, others may develop it later due to exposure to certain triggers. 

Here are the most common causes and contributing factors

• Allergens
• Pollen from trees, grasses, and weeds
• Dust mites
• Pet dander or saliva
• Mold spores
• Cockroach droppings
• Respiratory infections
• Viral infections such as the common cold, flu, or RSV
• Sinus infections or bronchitis can also lead to flare-ups
• Airborne irritants
• Tobacco smoke (first- or second-hand)
• Air pollution and smog
• Strong chemical fumes from cleaning products or industrial exposure
• Perfumes or scented sprays
• Weather conditions
• Cold air or sudden temperature shifts
• High humidity or arid air
• Physical activity
• Exercise-induced asthma can cause symptoms during or after workouts (especially in cold or dry environments)
• Emotional stress or strong emotions
• Intense laughter, crying, or stress can disrupt standard breathing patterns and act as a trigger
• Medications
• Aspirin, nonsteroidal anti-inflammatory drugs (NSAIDs), and beta-blockers can worsen symptoms in some individuals
• Occupational triggers
• Dust, chemicals, or fumes in specific workplaces (e.g., construction, farming, hairdressing, or manufacturing)
• Gastroesophageal reflux disease (GERD)
• Acid reflux can irritate airways and worsen asthma symptoms

How Asthma is Identified and Tested

• Medical history review
• Discussion of symptoms: when they occur, how often, and what seems to trigger them
• Family history of asthma, allergies, or eczema
• Occupational or environmental exposures that may act as irritants
• Response to any previous asthma or allergy treatments
• Physical examination
• Listening carefully to the lungs with a stethoscope for wheezing or abnormal sounds
• Checking for signs of allergic conditions like nasal swelling or skin rashes
• Identifying visible signs of breathing difficulty or chest tightness
• Spirometry
• A standard lung function test that measures how much air you can exhale & how quickly
• Helps determine the presence and extent of airway obstruction
• Often repeated before and after using a bronchodilator to assess the reversibility of symptoms
• Peak flow measurement
• Uses a handheld device (peak flow meter) to track how fast a person can blow air out
• Helps monitor daily asthma control and detect worsening symptoms early
• Often used as part of ongoing self-monitoring rather than initial diagnosis
• FeNO (Fractional exhaled nitric oxide) test
• Typically measures the amount of nitric oxide in exhaled breath—a marker of airway inflammation
• More commonly used in specialized settings or when diagnosis is unclear
• Methacholine challenge test
• Involves inhaling a known irritant (methacholine) in gradually increasing doses
• If airways narrow in response, it suggests asthma
• Conducted strictly under medical supervision due to the risk of triggering symptoms
• Allergy testing
• Skin & blood tests to identify specific allergens that may be triggering asthma symptoms
• Helps guide environmental control and targeted treatment
• Imaging tests (in selected cases)
• Chest X-rays or CT scans may be ordered to rule out other lung conditions
• Not routinely required for asthma diagnosis, but helpful in complex or severe cases

Managing and Treating Asthma

• Inhaled therapies
• Daily-use inhalers help reduce airway inflammation and prevent symptoms
• Fast-acting inhalers provide immediate relief during an asthma attack or sudden symptoms
• Breathing exercises and pulmonary rehab
• Techniques that improve lung function and breathing control and reduce anxiety during episodes
• Trigger avoidance
• Identifying and minimizing exposure to allergens, irritants, or environmental factors that worsen symptoms
• Includes using air purifiers, managing indoor humidity, and avoiding smoke or pollutants
• Lifestyle changes
• Maintaining a healthy weight, staying physically active (with guidance), and managing stress levels
• Building a consistent sleep routine and staying hydrated
• Immunotherapy (in selected cases)
• Allergy shots or similar treatments may be considered when asthma is triggered by specific allergens
• Regular monitoring and follow-ups
• Using peak flow meters at home to track symptoms
• Routine checkups to adjust the treatment plan as needed

Why Asthma Often Worsens at Night

Many people with asthma notice that their symptoms become more intense at night. This pattern, known as nocturnal asthma, can interfere with sleep and signal poor asthma control.

Here are key reasons why asthma tends to worsen during nighttime

• Natural changes in lung function: Lung function typically declines at night due to the body’s circadian rhythm. For people with asthma, this reduction can make breathing more difficult and trigger symptoms.
• Increased exposure to indoor triggers: Dust mites, pet dander, & mold are common indoor allergens that may be more concentrated in bedrooms. Lying down can also stir up allergens trapped in bedding or mattresses.
• Posture-related effects: When lying flat, mucus can pool in the airways and nasal passages, increasing airway resistance. This can make breathing feel more labored, particularly in people with underlying inflammation.
• Cooling of airways: Breathing cooler, drier air at night can irritate sensitive airways and lead to bronchoconstriction
• Hormonal fluctuations: At night, levels of certain hormones that help regulate inflammation—like cortisol—drop, potentially leading to increased airway inflammation
• Unnoticed reflux: Silent acid reflux (without heartburn) can worsen at night when lying down, irritating the airway and triggering asthma symptoms

Asthma After COVID-19

• Increased airway sensitivity: COVID-19 can lead to lingering inflammation in the lungs, which may heighten airway sensitivity in people with asthma—even after the virus has cleared
• Worsening of pre-existing asthma: In some cases, COVID-19 has triggered more frequent flare-ups or intensified asthma symptoms that were previously under control
• New breathing challenges: Some people who had mild or no asthma symptoms before COVID-19 report persistent shortness of breath, wheezing, or fatigue, which may resemble or overlap with asthma
• Risk of long COVID: Asthma does not directly cause long COVID, but respiratory symptoms common in long COVID—like coughing and breathlessness—can complicate asthma management
• Impact on lung function: In more severe cases, especially if hospitalization was required, there may be lasting changes in lung capacity or airway function that require reassessment of asthma treatment

Contact Your Doctor If You Notice Any of the Following

• Your symptoms are becoming frequent or severe
• You need to use your quick-relief inhaler more often than usual
• You experience nighttime coughing or shortness of breath that disrupts sleep
• Physical activities like walking or climbing stairs leave you breathless
• You notice a drop in the reading of your peak flow over several days
• Your medications don’t seem to be working as effectively
• You develop new or unusual symptoms, such as chest pain or fatigue
• You’ve had a recent asthma attack or emergency room visit

Sterling Hospital is Your Partner in Better Health Across Gujarat

At Sterling Hospital, we provide the utmost care and comfort throughout your journey to a healthier life. If you are looking for the best pulmonologist in Vadodara, Rajkot, or  Gandhidham, we've got you covered. 

Ourpulmonary department is built with a team of the best pulmonologists in these regions to provide premium treatment and the best results.Contact Sterling Hospital to schedule a consultation and embark on a journey towards a healthier future.