Ask The Advocates: Asthma Attack Symptoms And Warning Signs

What is an asthma attack? How do I know when an asthma attack is coming? Many of you want to know how to recognize asthma attack symptoms and warning signs so you can be prepared, but are there any? Our advocate team of respiratory therapists and asthma educators help answer this question.

Asthma attack symptoms vary

Response from Leon Lebowitz, RRT

Asthma is considered to be a reversible, obstructive airway disease. The hallmark of asthma is hypersensitivity of the airways. The four most common symptoms of asthma include coughing, wheezing, shortness of breath, and a feeling of tightness, or pressure, in the chest.

Not every person with asthma has the same symptoms in the same way. You might not have all of these symptoms, or you might have different symptoms at different times. The symptoms might also vary from one asthma episode to the next, being mild during one asthma episode and severe during another.¹

Early warning signs are considered to be changes that happen just before an asthma episode or acute exacerbation. These changes actually start before the well-known symptoms of asthma occur and can be the earliest signs that a person's asthma is worsening or about to occur. Generally speaking, these signs are not severe enough to stop a person from going about his or her daily activities. If you are attuned to your own asthma tendencies and can recognize these signs, you may be able to stop an asthma episode or prevent one from getting worse.²

Early warning signs vary, but may include:³

• Frequent cough, especially at night
• Losing your breath easily or shortness of breath during the course of the day
• Feeling very tired or weak when exercising
• Wheezing or coughing after exercise
• Feeling tired, easily upset, grouchy, or moody or being uncharacteristically irritable
• Decreases or changes in your peak expiratory flow rate
• Signs of a cold, upper respiratory infection, or allergies (sneezing, runny nose, cough, congestion, sore throat, and headache)
• Trouble sleeping

This is not meant to be an exhaustive list, nor is it meant to apply to all our readers. These particular early signs tend to be the most common ones reported. Your own early warning signs will be unique to your individual asthma condition. If you are attuned to your own early warning signs, it can go a long way towards helping to maintain control over your asthma condition.

If you have early warning signs or symptoms, you may be able to prevent the exacerbation or poor control by taking more asthma medication. This should all be described in your own individualized Asthma Action Plan.⁴

Individual triggers may serve as warning signs

Response from John Bottrell, RRT

One of the neat things about asthma is that it communicates with you, letting you know when you are around one of your asthma triggers. How it communicates is by presenting you with early warning signs of asthma.

These signs include chest tightness, anxiety, runny nose, sneezing, coughing, headache, itchy chin, and neck, etc.

To learn your individual symptoms, you will actually have to experience an asthma attack. However, by observing the signs, and learning them, you can actually prevent future asthma attacks. So, once you observe your early warning signs, consider yourself "forewarned" that you are around something that is triggering your asthma, and it's time to stop what you are doing, remove yourself from the situation, and treat yourself according to your asthma management plan, if necessary.

My personal experience with recognizing warning signs

I can actually give an example here. I personally have a severe allergy to dust mites. When exposed to them I start sneezing, my chin itches, and I get chest tightness. These are my early warning signs. By heeding them, and getting away from dust mites right away, the symptoms usually go away on their own. However, if I wait too long, an asthma attack occurs, requiring me to resort to my Asthma Action Plan. So, I have learned through my own asthma experiences what my early warning signs are, and what to do when I observe them.

Your job as an asthmatic is to learn your early warning signs and work with your doctor on an asthma management plan for what to do when you observe them. If actually wrote a more in-depth article on this subject if you are interested: "Symptoms and Signs: How Asthma Communicates."

Your body may present with early symptoms

Response from Theresa Cannizzarro, Respiratory Therapist

There are several warning signs that can occur before an asthma attack happens. A very common one is that you will notice your peak flow numbers start to drop, often times days before you start experiencing symptoms. Noticing under your chin is itchy is another unusual, yet common warning sign of an impending asthma attack. Itchy throat, excessive tiredness, and moodiness can also occur a couple days to a couple hours before your asthma starts acting up.

It's important to start paying close attention to your body for any of these (or other) symptoms you may experience. I recommend to my patients (and I keep one myself) to keep an asthma diary/journal and write down every day how you are feeling as well as peak flows, and symptoms. You'll start to notice a pattern and be able to better predict if/when your asthma will start acting up.

Some people experience unusual asthma attack symptoms

Response from Lorene Alba, AE-C

It’s important to pay attention to your body for these often-subtle warning signs. My chin itches before I have an asthma episode, usually a day or two before. Other warning signs can be restless sleep, feeling tired or moody, having a stuffy nose, or clearing your throat. A drop in your peak flow meter reading is also a warning sign; peak flow meters often show your asthma worsening before you begin to feel symptoms.

Common symptoms to look out for

Response from Lyn Harper, MPA, BSRT, RRT

Yes, there can be many warning signs of an asthma attack. They may come on suddenly or over a period of days. Here are a few things to watch for:

• A reduction in your peak flow reading. This gives you very early notification that you’re headed for a flare-up.
• Sudden shortness of breath
• Tightening of your chest or a feeling that something is sitting on your chest
• A feeling of impending doom
• You’re not sleeping well
• Sudden mood swings – you’re grouchy and irritable but don’t know why.
• You wake up coughing at night
• You become pale or flushed.
• Headache
• Sore or itchy throat
• An itchy nose
• Runny or stuffy nose
• Itchy or watery eyes

What asthma attack symptoms have you experienced?

Please share your story or let us know in the comments below!

Editor's Note: The information in this article cannot be substituted for medical advice. Always consult your doctor before beginning, ending, or changing treatments.