Doctors classify asthma based on what triggers your symptoms and how often they happen when making a diagnosis. Knowing your type and severity of asthma helps your allergist recommend the treatment that’s right for you.

In all types, symptoms of asthma can include wheezing, shortness of breath, chest tightness, coughing, and trouble breathing. When the only symptom of asthma is a dry cough, it may be referred to as cough-variant asthma.

What Are the Five Classifications of Asthma?

Asthma symptoms can be triggered by many different things, including certain substances, situations, and health conditions. It’s possible to have more than one type of asthma.

1. Allergic Asthma

Allergic asthma is the most common type of asthma, making up about two-thirds of asthma cases. It often begins in early childhood and becomes less frequent with age. Only about 30 percent of adult-onset asthma cases are allergic asthma.

Allergic asthma is caused by an overreaction of the immune system in response to a normally harmless substance, known as an allergen. Allergens vary widely between people, but some of the most common allergies involved in allergic asthma are to pollen, furry pets, mold, cockroaches, and dust mites.

Some people with allergic asthma receive immunotherapy, a treatment that helps the body build tolerance to the allergens that trigger their symptoms.

2. Nonallergic Asthma

Nonallergic asthma is more common in adults, peaking in late adulthood. Nonallergic asthma makes up about 70 percent of adult-onset asthma cases.

In people with nonallergic asthma, it can be more difficult to identify what triggers symptoms. Nonallergic asthma can be triggered by many different substances and situations. For example, triggers can include stress, strong emotions, certain medicines, food additives, cold air or weather changes, and air pollution from car exhaust or smoke.

3. Exercise-Induced Bronchoconstriction

Up to 90 percent of people with asthma will experience exercise-induced bronchoconstriction (EIB), also known as exercise-induced asthma. For some people, a cough is the only symptom.

Anyone, even people without asthma, can become short of breath after strenuous exercise. In people with EIB, exercise triggers bronchoconstriction — the narrowing of airways in the lungs. The result is an attack of asthma symptoms that may begin during physical activity, worsen for a few minutes after activity is stopped, and last for about 30 minutes to an hour and a half. Some people with EIB have milder, late-phase symptoms that start a few hours after exercise and last for up to a day.

4. Occupational Asthma

People who work in jobs where they’re exposed to airborne irritants, such as fumes or dust, may develop occupational asthma. This type of asthma makes up about 10 percent to 25 percent of adult-onset asthma cases in the United States.

If your asthma symptoms began when you started a job, improve when you’re away from your job, and become worse when you’re at work, you may have occupational asthma. Professions with a higher risk for occupational asthma include bakers, farmers, laboratory workers, and those who manufacture pharmaceuticals, metals, plastics, and wood products.

5. Asthma-COPD Overlap Syndrome

Chronic obstructive pulmonary disease (COPD) is a lung disorder that includes emphysema and chronic bronchitis. Asthma and COPD are separate lung conditions, and both can make it hard to breathe. People diagnosed with asthma-COPD overlap syndrome (ACOS) have the features of both asthma and COPD.

People with ACOS tend to experience more frequent and severe symptoms, as well as reduced lung function. Having both COPD and asthma can complicate the diagnosis of breathing problems and lead to one condition or the other being missed. COPD is most commonly diagnosed in people aged 50 to 74 who smoke or used to smoke.

Read more about other health conditions related to asthma.

What Is the Difference Between Asthma and Eosinophilic Asthma?

Eosinophils are one type of white blood cell that fights infections and parasites in the body. In people with eosinophilic asthma, too many eosinophils cause inflammation in the airways, which can lead to asthma symptoms. Eosinophilic asthma can develop at any age, but is most often diagnosed in adults between the ages of 35 and 50. People with eosinophilic asthma may or may not have allergies.

In addition to common asthma symptoms, people with eosinophilic asthma may have chronic nasal and sinus inflammation and nasal polyps. This type of asthma is often more severe and may be treated with biologic therapy, a type of medicine made from proteins in living cells.

How Severe Are Your Symptoms?

In addition to classifying asthma by its triggers, doctors also assess it based on how often and how severe your symptoms are. In adults and children aged 5 or older, doctors will often measure forced expiratory volume in one second (FEV1) — the amount of air you can blow out in the first second of a forced breath.

The National Asthma Education and Prevention Program has established criteria for classifying asthma severity.

Intermittent Asthma

Intermittent asthma is diagnosed when asthma symptoms:

• Don’t interfere with normal activities
• Happen two days a week or less
• Wake you up at night less than two nights a month
• Result in FEV1 80 percent or more of the predicted value

Mild Persistent Asthma

Mild persistent asthma is diagnosed when asthma symptoms:

• Limit daily activities to a mild degree
• Happen more often than two days a week, but not every day
• Wake you up at night up to three or four times a month
• Result in FEV1 80 percent or more of the predicted value

Moderate Persistent Asthma

Moderate persistent asthma is diagnosed when asthma symptoms:

• Limit daily activities to some degree
• Happen every day
• Wake you up at night more than once a week, but not every night
• Result in FEV1 between 60 percent and 80 percent of the predicted value

Severe Persistent Asthma

Severe persistent asthma is diagnosed when asthma symptoms:

• Limit daily activities to an extreme degree
• Happen every day, throughout the day
• Wake you up at night more than once a week, often every night
• Result in FEV1 60 percent or less of the predicted value

Healthcare providers classify asthma severity to determine which asthma medications are most appropriate. Your asthma classification can change over time. It’s important to remember that it’s possible to have a severe asthma attack, no matter how your asthma is classified.

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