Complications

For many people with asthma, treatments can control symptoms. When asthma is well-controlled, you can enjoy daily activities. You can also reduce the risk of long-term complications (additional problems).¹

However, asthma can sometimes be severe or hard to control. When asthma is not well-controlled, it can interfere with school, work, and sleep. Asthma attacks can require medical care and hospital visits. Severe asthma attacks may be life-threatening. Talk to your doctor about how to lower the burden of asthma.¹

How does asthma disrupt daily life?

Asthma symptoms affect daily activities in many ways. Almost half of people with asthma have severe symptoms that interfere with everyday life.²

Sleep

Symptoms of asthma may make it hard to fall asleep or stay asleep. For many people, symptoms flare up or get worse at night. This is called nighttime or nocturnal asthma. People with asthma also have a higher risk of obstructive sleep apnea.³

Poor sleep can make asthma symptoms worse. It can also worsen overall physical and mental health. Studies have found that:³

• Almost half of people with severe asthma report daytime sleepiness
• Nighttime asthma worsens concentration, attention, and memory
• Nighttime asthma worsens school attendance and performance

Work and school absence

Asthma symptoms can cause children to miss time from school. Symptoms can impact work and career choices for adults. Caregivers of children with asthma may also miss time from work. Studies have shown that, in the United States:⁴

• Children with asthma miss 1.5 times the number of school days that children without asthma miss
• Children miss 8 million school days per year because of asthma
• Employed adults miss 11 million work days per year because of asthma
• Unemployed adults miss 63 million days of housework because of asthma

Other daily activities

Asthma symptoms can interfere with daily activities. For children, this includes playing with friends and participating in sports. For adults, this includes exercise, housework, and travel.⁵

Many people with asthma may avoid strenuous exercise. This can make their asthma appear to be better controlled. However, avoiding exercise can lead to worse health outcomes. It can also hide poorly controlled asthma.⁵

When asthma interferes with your daily life, it can affect your mental health. It is common to feel alone and misunderstood. Talk to people you trust for support. This may be loved ones, support groups, or a therapist. They can help you find healthy ways to cope with the burden of asthma.⁵

What are long-term medical complications of asthma?

Asthma is a chronic (long-term) condition that may require ongoing treatment. Treatment helps reduce the risk of medical complications. If asthma is harder to treat, certain long-term complications are possible. These include:¹

Airway remodeling

Ongoing airway inflammation can lead to airway changes. These changes are called “airway remodeling.” Airway remodeling can be permanent and hard to prevent. It can lead to:⁶

• Thicker airway muscles
• Narrower airways
• Worse asthma symptoms
• Poorer response to medicines

Side effects from asthma medicines

Some drugs that are used to treat asthma cause serious side effects. For example, adults with severe asthma may use oral corticosteroids (OCSs). OCSs cause serious side effects when used long-term. Side effects of OCS use include:⁷

• High blood pressure and blood sugar
• Fluid retention and weight gain
• Weak or brittle bones
• Cushing syndrome
• Infections
• Cataracts and other eye problems
• Gastrointestinal problems

Inhaled corticosteroids are less likely to cause serious side effects. Side effects are also less common with lower doses of inhaled corticosteroids. But they can still cause bothersome side effects, such as:⁸

• Throat irritation
• Hoarseness
• Fungal mouth infections

Hospital visits

Severe asthma attacks can require treatment in emergency departments (EDs) or urgent care centers (UCCs). They may also require overnight hospital stays. Studies have shown that:^9,10

• Asthma is the main cause of about 200,000 hospital stays per year
• Asthma is the main cause of about 1.7 million ED visits per year
• Rates of hospital visits are decreasing, but ED visits are increasing
• About 12 percent of people with asthma have visited an ED or UCC in the past year
• Children with asthma are more likely to visit the ED or UCC than adults with asthma

Respiratory failure and death

Severe asthma may increase the risk of respiratory failure. This happens when there is not enough oxygen traveling from your lungs to your blood. This can be life-threatening when not treated immediately.⁵

Life-threatening respiratory failure from asthma is rare. The death rate is about 1 in 100,000 people with asthma. About 3,500 people die from asthma each year. Death rates continue to decline with better treatments.^9,10

How can I lower the risk of complications?

If your asthma is under control, you are less likely to experience lifestyle and medical complications. The best way to lower the risk of complications is to follow your asthma action plan. This includes:⁵

• Taking the drugs your doctor prescribes for daily control and quick relief of your asthma symptoms
• Avoiding triggers
• Maintaining a healthy diet and exercise routine
• Following up with your doctor
• Treating other chronic conditions
• Having a plan with your doctor for when symptoms act up

If you still experience complications, you may need changes to your action plan. Talk to your doctor about other medicines to control symptoms.⁵