Ask The Advocates: Invisible Asthma Symptoms

Last updated: March 2022

It can be very frustrating living with an invisible illness such as asthma, you are not alone in feeling this way. We wanted to know more about those invisible symptoms of asthma so we asked our team of respiratory therapists and asthma educators to weigh in about the invisible symptoms of asthma.

Invisible asthma symptoms

Response from Lyn Harper, MPA, BSRT, RRT:

Very often the early warning signs of an impending asthma flare-up are “invisible”. It may start with a night or two of waking up with a cough or just a general feeling of not sleeping well. It may be a slight tightening of the chest over a period of days or even weeks. You might notice you don’t have the stamina you did even a few days ago. For some it’s evidenced in mood swings that can’t be explained – you feel grouchy, irritable, and short-tempered for no particular reason.

If you regularly use your peak flow meter and have baseline data, you’ll be able to see the change in your lung function before you even start feeling symptoms. This is also where your Asthma Action Plan comes into play. If you see a change in your peak flow numbers it time to refer to the plan and up your medication accordingly (and possibly contact your doctor).

Response from John Bottrell, RRT:

With asthma, as with any disease, there are two different types of symptoms called subjective and objective. Subjective symptoms are those symptoms that are invisible to other people and can only be felt by you. These include mild shortness of breath, chest tightness, itchy chin, anxiety, stress, etc. In order for me to know if you feel these symptoms, you have to share this information. No one else but you can see or feel these invisible/ subjective asthma symptoms.

Objective symptoms are those symptoms that other people can see or hear, or otherwise, measure with a tool. For instance, severe shortness of breath can be observed by signs such as hunched shoulders, blue lips and fingertips, low oxygen levels, and the observation that you are leaning on things to breathe or speaking in short choppy sentences. Wheezes can be heard with a stethoscope. Coughing can be heard. Sneezing can be heard. Your pulse can be felt. Your blood pressure can be measured with a sphygmomanometer. Anyone can see, hear, or feel non-invisible/ objective asthma symptoms.

Response from Leon Lebowitz, RRT

Asthma can be defined as a common, acute or chronic, inflammatory disease of the airways. It is characterized by variable and recurring symptoms which include reversible airflow obstruction, and bronchospasm.

The hallmark of asthma is hypersensitivity of the airways. Common 'visible' symptoms include coughing, wheezing, coughing, shortness of breath and chest tightness. Whereas I don't think any typically common asthma symptoms would be considered invisible, it's more likely that what is considered 'hidden', might be the invisible disability that can be associated with the disease.

An invisible disability, or hidden disability, is defined as disabilities that are not immediately apparent. Although the disability creates a challenge for the person who has it, the reality of the disability can be difficult for others to recognize or acknowledge. Others may not understand the cause of the problem if they cannot see evidence of it in a visible way.

Think of those times when family, friends, and colleagues have had difficulty understanding how your asthma symptoms can be so debilitating to you. Or, when you've been seemingly fine throughout the day, and then experience an exacerbation that takes you out of your normal routine. Think of those times when a lack of understanding has resulted in you being told you're 'faking it' or worse, being met with hostility by your friends and family and even the general society at large!

Remember, asthma is an acute and/or chronic disease that is not curable, although the obstruction is considered to be reversible. So, even when one is in remission, they are still susceptible or predisposed to its hallmark airway hypersensitivity. Friends, family, and colleagues don't always understand or even perceive the deeper ramifications of the disease. They may have a very difficult time adjusting to what can be the ups and downs or highs and lows of your condition. This is the challenge of ‘invisible symptoms.’

Response from Theresa Cannizzarro, Respiratory Therapist:

The most common invisible symptom I've heard when it comes to asthma is fatigue. Fatigue is so common in asthmatics. I definitely experience it. When your body is working harder than normal to breathe it becomes downright exhausting. Also, tightness in the chest is another very common usually invisible symptom. It's not something a clinician can really see. It can often times be "heard" with a stethoscope (and by "heard" I mean there is a lack of air movement).

Response from Lorene Alba, AE-C:

Asthma can be painful. When you are having an episode, your lungs physically hurt or burn, and it can take days or weeks for the pain to subside. If you have cough-variant asthma, continual coughing leads to sore muscles in your core or back. Asthma tends to worsen at night and keep you awake, so experiencing brain fog or feeling tired all day is common.

Editor's Note: These suggestions may or may not be a good fit for you, depending on your asthma action plan assembled by your healthcare provider. Always consult your doctor before beginning, ending, or changing treatments.

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This article represents the opinions, thoughts, and experiences of the author; none of this content has been paid for by any advertiser. The team does not recommend or endorse any products or treatments discussed herein. Learn more about how we maintain editorial integrity here.

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