Overview

When asthma symptoms suddenly occur, it's called a flare-up or an asthma attack. It may also be called an acute asthma episode or exacerbation. Attacks can be brief (about an hour) or last for several days. They may be seasonal (similar to hay fever) or occur during any season.

What are the symptoms?

When you have an asthma attack, airflow to the lungs is reduced.

During an asthma attack:

• It may be hard to breathe. You may feel short of breath. And your breathing may be rapid or shallow.
• You may feel like you can't take a deep breath (chest tightness). Children with chest tightness may complain of a stomachache.
• You may make whistling noises when you breathe (wheezing).
• You may cough.

Asthma symptoms may start suddenly or happen up to several hours after you have been exposed to triggers, such as smoke or an allergen, like pets with fur. In some cases, symptoms may not occur until 4 to 12 hours after contact. Although severe attacks may seem to occur suddenly, they usually occur after several days of increasing symptoms.

What causes it?

Asthma attacks are caused by:

• Long-term (chronic) inflammation in the tubes that carry air to the lungs (bronchial tubes). Inflammation causes the tubes to overreact to triggers (hyperresponsiveness).
• Tightening of the smooth muscles in the bronchial tubes, causing the airways to become smaller. This reduces airflow in and out of the lungs.
• Extra mucus produced by the mucous glands in the bronchial tubes. This can occur in some people who have asthma and can interfere with airflow.

Anything that makes your asthma or breathing worse can cause an asthma attack.

It may be something that you are allergic to, such as:

• Dust.
• Dust mites. These are tiny, nearly invisible creatures. They live in bedding, carpet, and furniture.
• Pets with fur, like dogs and cats, that might hold loose skin cells (like dandruff) in their fur.
• Cockroach droppings.
• Mold.
• Pollen.

Other things can cause an asthma attack too, such as:

• Infections like colds or the flu.
• Cigarette smoke, the aerosol mist from vaping, air pollution, and some plastics or chemicals.
• Exercise. Many people have symptoms when they exercise.
• Stress.
• Dry, cold air.
• Some medicines, such as aspirin, nonsteroidal anti-inflammatory drugs, or beta-blockers.
• Hormones, including those involved in pregnancy and menstrual periods. Symptoms may change just before or during a period.

How is it treated?

An asthma action plan is a written plan that tells you what asthma medicine to take every day and how to treat an asthma attack. It can help you make quick decisions in case you are not able to think clearly during an attack.

How can you prevent an attack?

There's no certain way to prevent flare-ups (asthma attacks). But you can reduce your risk of asthma attacks by avoiding things that cause them.

The goal is to reduce how many asthma attacks you have, how long they last, and how bad they get.

Here are some ways to help avoid asthma attacks.

• Make sure you take your asthma controller medicine. This helps prevent asthma attacks.
• Avoid your asthma triggers.
  • Don't smoke, vape, or use other tobacco or nicotine products. If you need help quitting, talk to your doctor about quit programs and medicines. Try to avoid being around smoke or the aerosol mist from vaping.
  • When you can, avoid things you're allergic to, like pets with fur, dust, cockroaches, mold, or pollen. It may also help to take certain kinds of allergy medicine.
  • If exercise is a trigger for you, ask your doctor about using a quick-relief medicine before you exercise.
  • Stay inside when air pollution levels are high.
  • Try not to exercise outside when it's cold and dry. If you're outdoors in cold weather, wear a loose-fitting mask or scarf around your face and breathe through your nose.
  • Avoid indoor irritants in the air. These include fumes from gas, oil, or kerosene or wood-burning stoves. Or you may want to use an air filtration unit in your home to reduce the amount of dust and other pollutants.
  • If a cleaning product seems to trigger your asthma, stop using it. Or use another product that doesn't cause symptoms.
  • Be alert to foods that may cause asthma symptoms. Some people have symptoms after eating processed potatoes, shrimp, nuts, and dried fruit, or after drinking beer or wine. These foods and liquids contain sulfites, which may cause asthma symptoms.
• Stay up to date on your COVID-19 vaccines. Remind others to stay up to date too.
• Get a flu vaccine every year. Have your family members get one too.
• Talk to your doctor about getting the pneumococcal and respiratory syncytial virus (RSV) vaccines. The vaccines may help prevent the infections. And they can prevent some of the serious complications of the infections.
• Avoid taking aspirin, ibuprofen, or any other medicines if they make your asthma symptoms worse. Think about using acetaminophen (Tylenol) instead. (Do not give aspirin to anyone younger than 20 because of the risk of Reye syndrome, a rare but serious problem.) Be safe with medicines. Read and follow all instructions on the label.