Complications

Asthma is a chronic disease, which means that asthma is likely to affect you for the rest of your life. Even when you are not experiencing asthma symptoms, your airways can still be inflamed.¹

For many people, asthma requires taking medication daily and taking steps to avoid triggers. At times, this can be overwhelming. However, if your asthma is under control, you should be able to:²

• Enjoy normal activities, including exercise.
• Attend school or work.
• Get a good night’s sleep.
• Have fewer or no symptoms.
• Use your rescue medication less often.

Poorly controlled asthma can interfere with school, work, and other activities. Asthma attacks often require medical care, either in a doctor’s office or at the hospital. Severe asthma attacks can be life-threatening and lead to other complications. Thankfully, asthma-related deaths are rare.

Interference with normal activities

For people with well controlled asthma, symptoms do not interfere with normal activity.² “Normal activities” include any kind and amount of activity that are typical for that age group.³ For children, this includes playing actively and participating in organized sports. For adults, this may include exercise, housework, and caring for others. A national survey in 2008 showed that asthma limited the activities for:³

• 5.5% of children.
• 6% of employed adults.
• 27% of not employed adults.

Interference with sleep

People with well-controlled asthma wake up less than once or twice per month due to asthma.² Unfortunately, as many as 75% of people with asthma report having nighttime asthma symptoms.⁴ If you are waking up frequently due to asthma, your quality of life is likely to suffer. Children with nighttime asthma are absent more often and do not do as well in school. Their parents also miss more work.⁵

Time missed from work or school

People with uncontrolled and severe asthma miss time from school and work. Symptoms may limit their participation in daily activities. Results from the 2008 national survey showed that among people who had had an asthma attack in the past year:³

• 60% of children had at least one asthma-related school absence; in total, this added up to 10.5 million missed days of school.
• 34% of employed adults missed at least one day of work due to asthma, which added up to 14.2 million days of missed work.
• 29.1% of adults who were not currently employed missed days of work around the house, totaling 22 million.

People with asthma may also miss school or work because of doctor’s visits. In 2008, there were 13.9 million asthma-related office visits.³ Not all of these visits were urgent. This figure includes regular follow-ups that are recommended for people with asthma.

Emergency department visits and hospitalizations

Asthma attacks can lead to emergency department visits and hospitalizations. Each year, asthma leads to 1.75 million emergency department visits and 456,000 hospitalizations.³ That is equal to 8.4 emergency visits and two hospitalizations per 100 people with asthma.⁶

Many emergency department visits are avoidable. When asthma is well controlled with medications, the risk of an asthma attack is lower.² Your health care provider should work with you to make a written Asthma Action Plan that describes what to do in the event of an asthma flare-up. Your plan should who and when to call based on your peak expiratory flow measurements and the type of symptoms you are having.² In some cases, it may be possible to be seen for an urgent visit with your primary care provider, rather than the emergency department.

Long term complications

Frequent asthma attacks and ongoing inflammation can lead to structural changes in the airways, called airway remodeling.² The muscles surrounding the airways become thicker. The layers of cells that line the airway become overgrown. When this happens, medications are not able to fully open the airways. Currently, available medications do not prevent these changes from occurring. It is not known whether these changes are permanent.

Long-term use of the steroid medications used to treat severe asthma attacks can have serious side effects. These side effects include high blood pressure, Cushings disease, osteoporosis, cataracts, as well as many other less serious side effects.²

Death

Compared with other serious lung diseases, asthma deaths are rare and declining.⁷ Per 10,000 people with asthma, there are 1.4 deaths each year.⁶ In 2008, there were 3,447 asthma-related deaths in the US. Still, even a single death from asthma is too much.³