Severe Asthma
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What is severe asthma?

Around 5% of people with asthma have what is called severe asthma.1 A person with severe asthma has trouble breathing almost all of the time, as well as having more frequent severe asthma attacks. Severe asthma is also called “severe persistent asthma.”
It is also important to understand what severe asthma is not1:

  • Having occasional asthma symptoms that are severe does not always mean that you have severe asthma
  • Finding it hard to manage your asthma symptoms effectively does not always mean that you have severe asthma

People with severe asthma have severe symptoms all or most of the time, and even when they take their medications exactly the right way, it may not reduce their symptoms. Life with severe asthma can be very challenging. The person may be unable to take full part in day-to-day activities, school, and/or work. People with severe asthma are also more likely to end up in the hospital for treatment than people with less severe asthma.

How is severe asthma diagnosed?

Severe asthma is one of the four categories, or levels, of asthma1-4:

  • Mild intermittent asthma
  • Mild persistent asthma
  • Moderate persistent asthma
  • Severe persistent asthma

These categories are based on how severe a person’s asthma is, and a person’s asthma severity will often change over time. To find out what category of asthma a patient has, healthcare providers will look at:

  • The asthma signs and symptoms the patient has without taking any medications
  • The results of the patient’s lung function tests

People with severe asthma generally have symptoms throughout the day on most (or all) days and they wake up frequently due to their symptoms at night (sometimes every night). These symptoms can make daily physical activities very difficult. People with severe asthma also have poor lung functioning that can change a lot from the morning to the afternoon. They often need to use their rescue inhalers several times each day, and they tend to have more frequent asthma attacks that require steroids to treat.
What causes severe asthma?
Severe asthma can have a range of different causes. Patients who are more likely to have severe asthma include1:

  • People who have other chronic medical conditions, like diabetes
  • People who are current smokers
  • People who have trouble taking their long-term asthma medications regularly and on time

How can severe asthma be treated?

Severe asthma can cause symptoms that are hard to manage, because they may not respond very well to typical asthma medicines. To treat and manage severe asthma, patients will often need more complex treatments that involve higher doses of several different medicines every day.1,4 For example, patients might take a combination of:

  • Long-term maintenance medicines to reduce inflammation in the airways (such as inhaled corticosteroids)
  • Long-acting and short-acting bronchodilators to relieve symptoms that suddenly get worse
  • Anti-inflammatory medicines called “leukotriene modifiers”

Sometimes, patients with severe asthma may need to take their medications using a special device called a nebulizer.
Physiotherapy can be very helpful for patients living with severe asthma. Specialists called physiotherapists can perform special types of therapies to clear the patient’s airways and coach patients about how to develop good breathing patterns. They can also provide guidance about ways patients with severe asthma can carry out regular exercise routines, even when their physical abilities are limited by their asthma.

view references
  1. Asthma UK. Severe Asthma. Accessed March 19, 2016. Available at https://www.asthma.org.uk/advice/understanding-asthma/types/severe-asthma/
  2. Asthma and Allergy Foundation of America. Asthma Diagnosis. Accessed March 20, 2016. Available at http://www.aafa.org/page/asthma-diagnosis.aspx
  3. Mayo Clinic. Tests and Diagnosis. Accessed March 20, 2016. Available at http://www.mayoclinic.org/diseases-conditions/asthma/basics/tests-diagnosis/con-20026992
  4. Carol Sorgen. Severe Persistent Asthma Classification: Symptoms and Treatment. Updated February 26, 2016. Accessed March 19, 2016. Available at http://asthma.about.com/od/asthmabasics/fl/Severe-Persistent-Asthma-Classification-Symptoms-and-Treatment.htm
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