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Symptoms of Asthma

Updated on June 19, 2021
Medically reviewed by
Allen J. Blaivas, D.O.
Article written by
Alison Channon

Asthma is a chronic lung condition that causes symptoms like shortness of breath, wheezing, and coughing. Severe asthma symptoms can be life-threatening. Asthma is caused by airway inflammation that inhibits the ability to breathe.

Respiratory Symptoms of Asthma

Respiratory symptoms of asthma can range from mild to severe and can be persistent or intermittent. Some symptoms can be managed with asthma medications at home, while others may require emergency medical attention. Asthma symptoms can be treated with long-term control medications, like inhaled corticosteroids, and with quick-acting medications in the event of an asthma flare. Learn more about asthma treatments.

Asthma symptoms have many triggers, including the common cold, extreme temperatures, allergens like pet dander and dust mites, and irritants like cigarette smoke or air pollution. Exposure to allergens and environmental irritants are also risk factors for developing asthma.

Learn more about asthma risk factors and triggers.

Shortness of Breath

Shortness of breath, also called dyspnea, is a common symptom of most types of asthma, including allergic asthma and exercise-induced bronchoconstriction (exercise-induced asthma). Shortness of breath is a sensation of being unable to breathe enough air.

Mild shortness of breath may only occur with physical exertion and stop upon resting. More severe shortness of breath occurs even when you’re not moving. Mild shortness of breath can be an early warning sign of an asthma attack.

Wheeze

Wheezing is a whistling sound when breathing. Wheezing is the result of the bronchial tubes (tubes that carry air to the lungs) narrowing. Mild wheezing occurs when a person exhales. During a more serious asthma attack, wheezing can occur when a person inhales.

Wheezing isn’t always a sign of asthma. Young children may wheeze when they have a respiratory infection.

Cough

A chronic cough can be a symptom of asthma. Usually asthma-related coughing is dry, meaning it doesn’t produce mucus. Sometimes, however, asthma coughing can produce a lot of mucus. Asthma-related coughing often occurs at night. It can also be triggered by physical activity, allergens, or irritants like smoke, dust, or chemicals in cleaning products.

Cough can be a symptom of many types of asthma. In cases when cough is the only symptom, a person may have cough-variant asthma.

Chest Tightness

Chest tightness can make it difficult to take a full breath and can be an early sign of an asthma episode. Chest tightness can be worse when exposed to cold air or when exercising. Sometimes children experiencing chest tightness will complain of a stomach ache.

Chest Pain

Chest pain can be a symptom of asthma attacks. Asthma-related chest pain is often felt in the sternum. In a study of 100 people admitted to the hospital for asthma, 76 percent of participants described chest pain that was dull and aching or sharp and stabbing. Some participants noted that dull chest pain became sharp or stabbing when they coughed or breathed in deeply. Chest pain usually subsided when the asthma attack resolved.

Trouble Breathing

Difficulty breathing in asthma does not always appear as the classic symptoms. The following are signs of severe breathing difficulty:

  • Rapid breathing
  • High-pitched sound when inhaling
  • Taking a long time to exhale
  • Sniffing the air

Intercostal Retractions

The intercostal muscles are muscles between the ribs that allow the rib cage to expand and contract. These muscles are important for breathing. Intercostal retractions occur when the intercostal muscles pull inward. Retractions may occur if the trachea (windpipe) or bronchioles (airways in the lungs) are blocked.

Intercostal retractions indicate breathing difficulty and may be present in moderate and severe asthma attacks. Seek immediate medical care in the event of intercostal retractions.

Other Symptoms of Asthma

Asthma can cause nonrespiratory symptoms related to breathing difficulties as well as symptoms related to the emotional burden of living with a chronic condition.

Trouble Sleeping

People with asthma may experience difficulty sleeping due to symptoms like shortness of breath, wheezing, or nighttime coughing. They may also have a greater risk of developing obstructive sleep apnea, a condition that causes breathing to start and stop during sleep. Obstructive sleep apnea interrupts sleep and can lead to fatigue and daytime sleepiness. People with obstructive sleep apnea may also have a harder time controlling their asthma.

Fatigue

Some people with asthma may experience fatigue if their symptoms disrupt their sleep, or if they have a related sleep disturbance like obstructive sleep apnea. Feeling tired or sleepy can be signs of an oncoming asthma attack or occur during an attack. Fatigue can also occur in the days following an asthma attack.

Fatigue is prevalent in people with asthma. In a Dutch study of 733 adults with asthma, 62.6 percent reported experiencing severe fatigue. Sixty percent of the participants in the study had uncontrolled asthma. Fatigue was found to have a negative effect on quality of life.

Sweating

Sweating can be an indication of an oncoming asthma attack and can occur during asthma attacks. In the study of 100 people admitted to the hospital for asthma symptoms, 32 percent reported sweating before their asthma attack, and 61 percent reported sweating during the attack. Sweating can be a symptom of a severe asthma attack.

Rapid Pulse

A rapid pulse can be a symptom of a severe asthma attack. A pulse of 140 or more beats per minute signals a severe attack in children aged 2 to 5. A pulse of 125 or more beats per minute signals a severe attack in children older than 5. In adults, a pulse of 120 or more beats per minute indicates a severe exacerbation.

There is emerging evidence that persistent asthma may be associated with atrial fibrillation, a heart condition that causes irregular and rapid heart rate. A 2020 study of 6,615 adults with asthma over 13 years found those with persistent asthma were at greater risk of developing atrial fibrillation. Some medications used to treat asthma, particularly a type of drug known as a beta-agonist, may contribute to a rapid heart rate and atrial fibrillation.

Mood Disorders

Mood disorders like anxiety and depression are common in people with asthma. A study of more than 65,000 children and young adults with asthma found nearly a quarter were diagnosed with anxiety, depression, or both.

Anxiety and depression can impact a person’s asthma management. The same study of 65,000 young people with asthma found those with a diagnosis of anxiety, depression, or both had a higher rate of asthma-related emergency room visits than those without a mental health diagnosis. Another study of 767 adolescents with asthma found those with anxiety or depression reported more asthma symptoms in the previous two weeks than adolescents without a mood disorder.

Anxiety

Anxiety and asthma have a cyclical relationship. Anxiety can trigger asthma and, at the same time, poorly controlled asthma is associated with anxiety symptoms. Feeling a lack of control over your asthma can promote feelings of stress.

Sometimes it can be challenging to differentiate between the physical manifestations of anxiety and asthma. For example, anxiety symptoms like a tight feeling in the chest or shallow breathing can mimic asthma and can even exacerbate asthma symptoms.

Panic attacks can also be difficult to distinguish from asthma attacks. In both cases, you may feel short of breath or be unable to speak. Understanding the signs of an asthma attack can help you learn to distinguish between a panic attack and an asthma exacerbation.

If you’re experiencing symptoms of anxiety, speak to your health care provider about treatment options, including therapy, medication, and lifestyle modifications.

Depression

Depression is common in people with chronic health conditions — an estimated 1 in 3 people with a chronic illness experiences symptoms of depression. Depression can occur in chronic illness for several reasons, including changes to daily life caused by treatment or limitations to independence related to the condition.

Various studies have found a relationship between depression and asthma. One study of 504 adults with asthma found that adults with asthma were twice as likely to be depressed than the general population.

There is ongoing study into the relationship between depression and asthma. A 2016 editorial from the Journal of Allergy and Clinical Immunology describes the connection in its title: “Asthma and Depression: It’s Complicated.” The editorial cites evidence that suggests that depression may lead to asthma in some cases, and the two conditions may share some root causes.

Talk to your health care provider if you’re experiencing symptoms of depression. They can help you access treatment, including therapy or medication.

Recognizing an Asthma Attack

Understanding common symptoms of an asthma attack is important for keeping yourself or a child with asthma safe. Asthma attacks can be mild, moderate, or severe. Mild attacks can often be managed at home. Severe asthma attacks can be life-threatening and may require emergency intervention. It is beneficial to establish an asthma action plan with your or your child’s doctor to be prepared in the event of a serious flare-up.

Mild Asthma Attack Symptoms

  • Mild shortness of breath when walking
  • No shortness of breath when stationary
  • Ability to speak normally
  • Ability to lay flat
  • Mild wheezing

Mild asthma attacks can often be managed at home with a rescue asthma treatment like a quick-relief bronchodilator (inhaler). It’s always appropriate to reach out to your or your child’s doctor if you have questions or concerns.

Moderate Asthma Attack Symptoms

  • Shortness of breath when stationary
  • Ability to speak in phrases, but not in full sentences
  • Must sit up
  • Audible wheezing
  • Intercostal retractions

It may be necessary to seek medical care if you or your child is having a moderate asthma attack. Medical intervention is recommended for any of the following symptoms:

  • Quick-relief asthma medications last less than four hours or don’t work at all
  • Worsening wheezing and chest tightness
  • Bluish or gray lips and fingernails
  • Intercostal retractions

Severe Asthma Attack Symptoms

  • Severe shortness of breath
  • Ability to say only single words
  • Loud wheezing
  • Must sit up
  • Sweating
  • Rapid pulse
  • Severe intercostal retractions

Contact your doctor or seek medical care in the event of a severe asthma attack. Call 911 or emergency services immediately in the following circumstances:

  • Sudden wheezing in response to an allergen
  • Severe breathing difficulties
  • Bluish tinge to face and lips when not coughing
  • Fainting

Condition Guide

References
  1. Asthma — Centers for Disease Control and Prevention
  2. Asthma Facts and Figures — Asthma and Allergy Foundation of America
  3. Asthma — Cleveland Clinic
  4. Reduce Asthma Triggers — American Lung Association
  5. Allergens and Allergic Asthma — Asthma and Allergy Foundation of America
  6. Exercise-Induced Asthma — Mayo Clinic
  7. Asthma Symptoms — American Lung Association
  8. Asthma Attack — Seattle Children’s
  9. Asthma and Wheezing — HealthLinkBC
  10. Asthma Cough — American College of Allergy, Asthma & Immunology
  11. Cough and Asthma — Current Respiratory Medicine Reviews
  12. Chest Pain and Non-respiratory Symptoms in Acute Asthma — Postgraduate Medical Journal
  13. Intercostal Retractions — MedlinePlus
  14. Asthma and Sleep — Sleep Foundation
  15. Sleep Problems in Asthma and COPD — American Thoracic Society
  16. Sleep Apnea — Mayo Clinic
  17. Your Asthma Attack Recovery Plan — Asthma UK
  18. Fatigue Is Highly Prevalent in Patients With Asthma and Contributes to the Burden of Disease — Journal of Clinical Medicine
  19. Asthma: What Is It? — Harvard Health Publishing
  20. Acute Asthma and Other Recurrent Wheezing Disorders in Children — American Family Physician
  21. Clinical Review: Severe Asthma — Critical Care
  22. Persistent Asthma Is Associated With Increased Risk for Incident Atrial Fibrillation in the MESA — Circulation: Arrhythmia and Electrophysiology
  23. Depression, Anxiety, and Emergency Department Use for Asthma — Pediatrics
  24. Asthma and Mood Disorders — International Journal of Child Health and Human Development
  25. Manage Stress — American Lung Association
  26. Stressing Out About Your Next Asthma Attack — Anxiety.org
  27. Stress & Asthma — Cleveland Clinic
  28. Anxiety — Asthma UK
  29. Chronic Illness and Depression — Cleveland Clinic
  30. Asthma and Depression: It's Complicated — Journal of Allergy and Clinical Immunology
  31. Asthma Action Plan — Asthma and Allergy Foundation of America
  32. When to Take Child to ER — Asthma — University of Maryland Children’s Hospital
Allen J. Blaivas, D.O. is certified by the American Board of Internal Medicine in Critical Care Medicine, Pulmonary Disease, and Sleep Medicine. Review provided by VeriMed Healthcare Network. Learn more about him here.
Alison Channon has nearly a decade of experience writing about chronic health conditions, mental health, and women's health. Learn more about her here.

A MyAsthmaTeam Member said:

I Singular every night per my Pulmonologist and have not had an attak since 2019. When I feel Asthma starting I use my Nublizer, it stops an attack.

posted 29 days ago

hug

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