5 Tips to Manage Asthma Triggers and Breathe Easier

Trigger management is probably the most important aspect of asthma control. It is a vital partner to taking your daily controller medication as prescribed. Reduce your contact with your asthma triggers, and you have the best chance at effective control of your asthma from day to day and of preventing asthma attacks before they start.

How to identify your personal asthma triggers

So, what is a trigger exactly? Well, it's any substance or condition that has the potential to set off asthma symptoms, such as:

• Coughing
• Wheezing
• Chest tightness
• Breathlessness

Triggers vary from person to person. It's also important to note that these so-called triggers are normally harmless substances in non-sensitive people. Experts aren't really sure why some people react to trigger substances, while others don't.

There are risk factors for asthma, certainly, but not everyone with a risk factor or two ends up being sensitive to the same, or any, triggers. But we do know that people who have asthma have inflamed airways, and inflamed airways are more sensitive to triggers.¹

Understanding the difference between allergens and irritants

Triggers fall into two different categories:²

1. Allergens, substances that elicit an allergic response
2. Irritants, substances or conditions that further aggravate existing asthma symptoms

Allergens

Most people who have asthma have the allergic type, affecting 6 out of every 10 people who have asthma.³ When you are exposed to an allergen to which you are sensitive, your body goes into protective mode. Airway inflammation increases, triggering or worsening the symptoms mentioned above. Common allergens that trigger asthma symptoms include:

• Dust mites, tiny organisms that live in house dust
• Pet dander, urine, and/or saliva
• Pollen from certain trees, types of grass, or weeds
• Molds, both indoor types found in warm, damp places and outdoor types found in soil, fallen leaves, and rotting wood
• Insect droppings, such as cockroaches

Some allergens are present year-round in your environment, while others tend to be more seasonal.

Irritants

Irritants are activities, substances, or conditions that can worsen airway inflammation but don't cause it in the same way that allergens do. You are not having an allergic reaction to this thing; it is simply irritating your already irritated airways. Common irritants can include:²

• Tobacco smoke, including secondhand smoke
• Wood fire smoke
• Strong fumes or odors, such as perfume or household cleaning chemicals
• Air pollution
• Cold, dry air

Other irritants may include:

• Strong emotions, even laughing
• Anxiety and stress
• Severe weather changes, possibly including thunderstorms
• Viral or bacterial infections of the respiratory system, such as colds and flu
• Acid reflux, with or without heartburn
• Certain medications

In some people, even exercise can be an irritant that triggers asthma symptoms. This is called exercise-induced asthma. Actually, the more accurate term is exercise-induced bronchoconstriction, since exercise doesn't cause asthma — it just triggers symptoms such as bronchoconstriction (narrowing of the airways).

Tips to help you prevent asthma attacks

If you want to maximize your asthma control, you have to get a handle on your triggers so that you can manage them effectively and prevent asthma attacks from taking hold. So, here are some tips to get you started:

Identify your triggers

It's hard to manage your triggers if you don't know what they are, so your first step is to figure that out. Keeping a journal or log of your asthma symptoms can help. Record when your symptoms arise, what you were doing immediately before they started, and maybe a couple of hours before as well.

Note what the symptoms were and how severe they were. Record how long they lasted and what, if anything, helped to relieve them. Look for any patterns. For example, every time you visited your friend who has a cat, you started wheezing and coughing, and it didn't get better until you left the home. Or, when you walk through the department store cosmetic counters, with their strong perfume odors, your asthma symptoms worsen.

You should also discuss with your doctor whether allergy testing would help identify your triggers.

Take steps to avoid your known triggers

Once you've started identifying what triggers your symptoms, you're ready to get proactive! It's almost impossible to avoid all of your asthma triggers all of the time, unless you happen to live in a bubble. But any effort you make to reduce your exposure to triggers helps keep your airways healthier and more stable. Here are some tips to get you started:

• Get a yearly flu shot! (The flu can be deadly to people who have asthma.)
• Avoid exposure to first-hand and secondhand tobacco smoke
• If you have pets, keep them out of your bedroom and off your furniture

Keep an updated asthma action plan

Once you know what your triggers are and how to avoid them, what do you do if all your efforts fail and you still have an asthma attack? Having an asthma action plan in place is essential for preventing asthma attacks and responding quickly if one occurs. On a plan like this, you can list your triggers and the exact steps to take should asthma symptoms begin to mount.

A plan is also something you can share with others, whether it's family, friends, your school, or your workplace. Educating others on your triggers and how to help you avoid them just makes sense — that way, everyone you know can help you avoid contact with these triggers.

Take your allergy medication as prescribed

Most people who have asthma need to be on some type of allergy medication. The reason is that it's impossible to never come into contact with any of your triggers. So, taking your medication — whether as a preventive measure, in the case of daily controller medicines, or after you're exposed to a trigger, in the case of quick-relief inhalers — is part of your asthma care and a key way to prevent asthma attacks.

Another preventive measure that works for some people is allergy shots, also called immunotherapy. With this approach, you are gradually exposed (over months or years) to increasing amounts of your main triggers. This helps you develop a natural immunity to them over time.⁴

Be vigilant

Sensitivities can change over time. You may become more or less sensitive to certain allergens and irritants over time. For instance, I used to be highly allergic to any contact with cats. Now, I own 2, because I no longer react to cats. On the other hand, I grew up with 4 smokers and was reasonably asthma symptom-free most of the time. But now, if I even walk by someone 10 feet away who is smoking, I immediately start coughing and wheezing.

So, if despite your best efforts to avoid your known triggers, your asthma control is still slipping, it could be that your triggers have changed. Try keeping a symptom diary again for a few days and see what pops up. Perhaps you'll notice a new pattern.

Also, keep in touch with your health care team. Asthma treatments change all the time. When you keep in regular contact with your team, they can best advise you on what will work for you and help you quickly identify if your asthma control is not where it should be.

Key takeaways for managing asthma triggers

Asthma triggers can be hard to identify and even harder to avoid, but with effort, it can be done. So, start taking steps today to be more aware of your triggers and to educate others around you about them. Then, take every possible step to reduce your exposure and prevent asthma attacks. I promise you, in most cases, your asthma control will improve and stabilize.

What has your experience been with managing asthma triggers?