5 Signs It's Time to Step Up Your Asthma Treatment

  • Is it time to step up asthma therapy?
    Severity and frequency of asthma symptoms can vary greatly among individuals. Asthma treatment is individualized and medications selected for therapy will vary based on the seriousness and regularity of asthma symptoms. In cases of severe asthma, you may need more intensive treatment than most asthma patients. It may take a few tries to identify the right treatment plan for you, so it’s important to monitor your symptoms and be able to determine if your asthma medications are keeping your condition controlled. Make sure you talk to a healthcare provider honestly about symptom severity and frequency so the correct treatment can be chosen for you.

  • 1. Your asthma isn’t well-controlled with maintenance medications.
    If you’re still experiencing frequent asthma symptoms, you may need to try another medication. Asthma is typically treated with a variety of maintenance medications that act on different cells or chemicals in the body. These medications include long-acting beta agonists which relax tightened airway muscles and are administered via inhalers. Anti-inflammatory medications include leukotriene antagonists (given orally), inhaled steroids (given by inhaler or nebulizer), and oral steroids. These medications prevent and reduce inflammation in the lungs. Newer treatments for severe asthma include biologics, which block IgE (allergic) antibodies or eosinophils (inflammatory cells) in the body thus reducing asthma attacks. Biologics are administered by injection. Many asthmatics require a combination of medications to keep symptoms under control, but if these standard options don’t work, you may need a new plan.

  • 2. You have difficulty sleeping due to your asthma.
    If asthma is affecting your sleep, it may be time to step up treatment. Nocturnal asthma symptoms can include coughing during the night, shortness of breath while trying to sleep, wheezing, chest pain and chest tightness. These symptoms can occur while trying to fall asleep, or can cause you to wake up from sleep in the middle of the night. Experiencing these symptoms more than twice per month, twice per week, or an increase from your baseline symptoms may indicate that your asthma medications need to be increased.

  • 3. You have your usual asthma symptoms frequently during the day.
    Ideally, symptoms of asthma should be infrequent (e.g., less than twice per week). However, if you notice an increase in coughing, wheezing, chest tightness, or shortness of breath from your baseline, it may be time to step up treatment.

  • 4. Your asthma interferes with your usual daily activities.
    Often, poorly controlled asthma will cause interference in daily activities. Does asthma cause you to miss work or school? Have you noticed a decline in your ability to exercise or even just do housework or climb a flight of stairs? Are you socializing less because of your asthma symptoms? Have you needed to visit an emergency room or been hospitalized because of your asthma? Answering yes to any of these questions may indicate a need to step up asthma treatment.

  • 5. You’re using your rescue inhaler more than usual.
    Short-acting beta agonist inhalers, such as albuterol, provide quick relief from acute asthma symptoms. However, if you are using your inhaler more than twice per week (unrelated to exercise) or more than you previously have, it is time to visit your doctor to see if your asthma treatment plan needs to be stepped up.

Severe Asthma? 5 Signs It's Time to Step Up Your Treatment
  1. Akinbami LJ, Moorman JE, Bailey C, et al. Trends in asthma prevalence, health care use, and mortality in the United States, 2001-2010. NCHS data brief, no 94. Hyattsville, MD: National Center for Health Statistics. 2012.
  2. Colice GL. Categorizing Asthma Severity: An Overview of National Guidelines. Clinical Medicine and Research. 2004;2(3):155-163.
  3. National Asthma Education and Prevention Program, Third Expert Panel on the Diagnosis and Management of Asthma. Expert Panel Report 3: Guidelines for the Diagnosis and Management of Asthma. Bethesda (MD): National Heart, Lung, and Blood Institute (US); 2007 Aug. Available from:
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THIS CONTENT DOES NOT PROVIDE MEDICAL ADVICE. This content is provided for informational purposes and reflects the opinions of the author. It is not a substitute for professional medical advice, diagnosis or treatment. Always seek the advice of a qualified healthcare professional regarding your health. If you think you may have a medical emergency, contact your doctor immediately or call 911.
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