Quick Quiz: How Well Controlled Is Your Asthma?

When you have asthma, particularly anything more severe than mild, intermittent asthma, it can be easy to just "get used to" a certain level of asthma symptoms. The loss of asthma control can be slow and increasingly more severe, without you even realizing it until you get into a crisis that your usual medications no longer resolve.

But, there are ways to know if your asthma control is slipping. I'll be teaching you ways to monitor your degree of asthma control.

A Few Facts About Asthma and Asthma Contol

Here are a few things to keep in mind about asthma and your level of control. First off, asthma is a long-term, chronic disease with no cure. However, it can be controlled so that it is less likely to interfere with the quality of your life.

Effective asthma control will:

  • Prevent asthma symptoms, such as coughing, wheezing, chest tightness and shortness of breath
  • Lessen the need for quick-relief medicines
  • Improve healthy lung function
  • Enable you to maintain daily activities and sleep through the night
  • Prevent asthma attacks requiring emergency care or a hospital stay

Assessing Your Level of Asthma Control

Here are a few questions to ask yourself that can provide clues to your level of asthma control:

  1. Do you feel as though your asthma is ever not well-controlled?
  2. Do you feel short of breath or have other asthma symptoms?
  3. Have you had to use your rescue inhaler or nebulizer recently?
  4. Do asthma symptoms wake you up at night or make it hard to breathe?
  5. Have you had to miss work or school because of your asthma?
  6. Do you have trouble being active or exercising because of asthma symptoms?

The Asthma Initiative of Michigan another way of looking at control, recommending that we think in two's:

Do you:

  • Use your quick-relief/rescue inhaler more than twice a week?
  • Wake up at night with asthma symptoms more than twice a month?
  • Need to refill your rescue inhaler more often than twice a year?

If you answered "yes" to any of the above questions in either set above, then it is safe to say that your asthma is not as well-controlled as it should be. Of course, the degree of control (or lack thereof) may vary depending on how often any of the above factors are occurring.

For a more definitive answer, you may even want to take the Asthma Control Test.

It's important to your health to be completely honest in your assessment, using these factors. It's human nature to slip into denial about asthma control, but you will do yourself a disservice if you stay in denial. Acknowledge when asthma control slips and do something about it!

Another Way to Look at Degrees of Asthma Control

The Palo Alto Medical Foundation offers another way of measuring your degree of asthma control:

Your asthma is well controlled if:

  • You have daytime symptoms 2 or less days per week
  • You notice no consistent limitations on your ability to be active
  • Symptoms at night occur once a month or less for ages 0-11 and twice a month or less for ages 12 and older.
  • You don't need to use rescue medication more than once a week
  • You peak flow meter readings are greater than 80% of your personal best
  • Asthma flare-ups that require oral steroids happen no more than once a year

Your asthma is not well-controlled if:

  • You have daytime symptoms more than twice a week
  • You notice any limitations in your ability to be active
  • Symptoms occur during the night more than twice a month for ages 0-11 and more than 1-3 times per week for ages 12 and older
  • You need to use your rescue medication more than twice a week
  • Peak flow readings are between 50-80% of your personal best
  • Asthma flare-ups that require oral steroids occur more than twice a year

Your asthma is poorly-controlled if:

  • You have daytime symptoms throughout most every day
  • Your activity level is extremely limited
  • Symptoms occur during the night 2 or more times per week for ages 0-11 and 4 or more times per week for ages 12 and older
  • You need to use your rescue medication several times every day
  • Peak flow readings are consistently less than 50% of your personal best
  • Asthma flare-ups that require oral steroids occur more than twice a year

Actions to Take When Asthma Control Slips

Hopefully, you now have a better idea of how to assess your level of asthma control. But what do you do when you know control is not where it should be? Well, hopefully you have an Asthma Action Plan to guide you when control slips. Also, an open line of communication with your health care team and regular asthma check-ups are essential to your ongoing health. A peak flow meter, if recommended by your doctor, can also be useful in pinpointing the level of control, even  before you notice symptoms.

In addition, it can be helpful to figure out why asthma control is not where you and your doctor would like it to be. Here are a few possible factors:

  • You are not using the right asthma medication regime for you and your current asthma status
  • You need to improve your asthma inhaler technique
  • You are not taking your asthma controller medication regularly or as prescribed
  • You are having trouble avoiding your known asthma triggers, OR you do not have a handle on what triggers your asthma

Again, your doctor/health care team can help you figure out which of these factors may be having an influence on your asthma control and how to resolve them. It's important to understand that having consistent poorly controlled asthma can result in permanent damage to your airways that cannot be reversed. This is called airway remodeling, and you should work to avoid it if at all possible.

Here is another tool from the American Lung Association that you may find helpful: The Pathway to Managing Asthma

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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 Asthma.net 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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