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Symptoms and Signs: How Asthma Communicates

One of the neat thing about asthma is your body lets you know how things are going inside your lungs. Even better, it lets people around you — parents, siblings, aunts, uncles, grandparents, teachers, etc. — know how you are doing. The way it communicates is by offering symptoms and signs. So, what are these, what are they saying, and what can you do?

Asthma Action Plans: These are plans you work on with your doctor to help you decide what actions to take to control your asthma and when to seek help. They rely on your ability to recognize your asthma symptoms and signs.

Asthma Symptoms

 These are generally referred to as subjective, meaning only you can feel them. These are sometimes referred to as silent symptoms, as they are not seen or heard by anyone but you. What symptoms you feel can help you decide what actions to take.

Asthma Signs

 These are generally referred to as objective, meaning anyone can see, hear, or feel them. Sometimes a tool may be needed, such as a stethoscope to listen to lung sounds, but they are still objective. What signs are observed can help you decide what actions to take. They are also neat because they give other people an opportunity to help you  

Ideally, these plans are written on one side of one sheet of paper, and kept someplace where it can be easily found, either by you or someone trying to help you, such as on the refrigerator door. You should take it with you to your doctor’s appointments, as it can be adjusted as necessary to meet your changing needs.

There are three categories of symptoms and signs: early, acute, and severe.

Early Warning Symptoms

These are symptoms that precede an asthma attack, or just as it is beginning. They indicate that changes are occurring inside your airways, and actions need to be taken right away to prevent it from happening, or to prevent it from getting worse. Examples include: headache, itchy chin, itchy throat, feeling tired, trouble sleeping, feeling nervous, feeling anxious, feeling thirsty, dry mouth, itchy eyes, stomach ache, chest pain, chest tightness, and itchy or burning feeling in your chest.

Early Warning Signs

 These are signs that precede an asthma attack, or just as it is beginning. These are signs that warn you, and anyone else who observes them, that an asthma attack is imminent if actions are not taken right away.  Examples include: coughing, runny nose, rubbing the nose, throat scratching sounds, rubbing eyes, scratching the chin, looking tired, waking up at night, sneezing, dark circles under eyes, unable to exercise, moodiness, silence, and changes in breathing. Another neat sign is a downward trend in your peak flow numbers. This may start to occur long before an attack occurs, giving you time to take actions to prevent it from occurring.

What actions do you take?

 This depends on what is in your asthma action plan. My plan calls for me to  remove myself from whatever is triggering my symptoms and signs, and using my rescue inhaler if I feel it is necessary.

Acute Asthma Symptoms

These are symptoms that an asthma attack is happening right now, and that quick action is needed to prevent it from getting worse and to make breathing easy again. Examples include: anxiety increases, shortness of breath and chest tightness.

Acute Asthma Signs

 These are signs an asthma attack is happening right now. Examples include: coughing,  wheezing, or breathing fast. Your personal best peak flow will be in the 50-80% range.

What actions do you take?  

Refer to your asthma action plan. For me, this would entail removing myself from whatever is causing my symptoms and using my rescue inhaler. If I need to, I can also take 1-3 albuterol breathing treatments. If it persists, I’m allowed to use a steroid pack. If it still continues to persists, then I am to call my doctor in order to tweak my medicine regimen as necessary to get me back on track. Please note that my plan has been adjusted over time to meet my needs. Your plan should be tailored to meet your specific needs.

Severe Asthma Symptoms

 These are symptoms you feel when your attack is severe. The best example here is feeling you can’t catch your breath, severe anxiety, chest tightness, and trouble concentrating. Another neat sign is when rescue inhalers don’t work, or when you feel like you need more than what you normally use, or more than what is prescribed.

Severe Asthma Signs

 By the time your asthma attack is severe, symptoms are no longer silent, meaning they show up as signs that you or any other person can easily observe. Examples here include: trouble walking, leaning on things to breathe, hunched shoulders, fast heartbeat, breathing shallow and fast, paradoxical breathing, cyanosis, and talking in short, choppy sentences. Another neat sign, one easily spotted by vigilant observers, is you clutching an inhaler and using it frequently.  Your personal best peak flow will probably be 50% or less.

What Actions do you take?  

Immediate action is needed. Even educated and experienced asthmatics sometimes have trouble deciding when to seek help. This is when it comes in handy to have someone say, “Hey, you need to go to the emergency room!” Sometimes we asthmatics think we can tough it out, that we can treat ourselves. Having someone else tell you to seek help sort of puts the exclamation point on: “No you can’t! You need to seek help! Now!”

Learn your asthma symptoms and signs

And make sure that you share them with others around you. This will come in handy and can be used as part of your asthma action plan to help you decide what actions to take. And be sure to listen to others as they try to help you decide what actions to take. This is the best plan for keeping your breathing easy.

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.

  1. Warning Signs and Symptoms for Asthma. Asthma Initiative of Michigan. Accessed August 9, 2016.
  2. Early Warning Signs - Asthma Information. National Jewish Health. Accessed August 9, 2016.
  3. Signs vs. Symptoms. Answers Articles and Jobs for Nurses and Nursing Students RSS. Accessed August 9, 2016.


  • lucy4118
    1 year ago

    Thanks for posting this! I have severe persistent asthma and I am on my fourth Xolair shot. In the ten years that I have been dealing with my late-onset of asthma, no one has ever explained this. This was pretty accurate for me…but also helped me realize that I fall into the category of thinking I don’t need help, or that I have my asthma under control. Many times I have ignored what my body is telling me, and find myself worse off, than if I had just listened to the signs and symptoms. Keeping this information tucked in my back pocket!

  • John Bottrell, RRT moderator author
    1 year ago

    That’s okay. That’s the way it is with asthma: We’re always learning. We are always becoming better asthmatics. And, also know that you’re not alone in ignoring your symptoms. I’ve been there many times myself. To be honest, there were many, many severe asthma attacks before I learned to heed the warning signs. I think one of the reasons we write about our experiences is so others don’t have to experience them. So, glad to hear you found this helpful. John. Site Moderator.

  • lauren.tucker moderator
    1 year ago

    @lucy4118, thanks so much for sharing this with the community. There are a ton of great resources here to help you through your asthma journey. I hope we can help you in the future as you keep this information in your back pocket. Glad to have you here. Lauren ( Team)

  • krishwaecosse
    1 year ago

    I’ve never heard of an itchy chin being a warning sign before. Why is that?

  • John Bottrell, RRT moderator author
    1 year ago

    I will ditto what Leon said. I have experienced an itchy chin on various occasions, many times before attacks it happens (but not now so much that my asthma is controlled). I have also researched this extensively. From what I have learned, researchers remain unaware of why it happens. It’s kind of neat that they don’t know. A testament of how complex our disease is. John. Site Moderator.

  • Leon Lebowitz, RRT moderator
    1 year ago

    Hi krishwaecrosse and thanks for this post, too. It’s really an anecdotal report from many asthmatics (although certainly not ALL asthmatics!). For some, it’s an inexplicable warning sign of an impending issue. For others, it does not apply at all. We appreciate your comment! Leon (site moderator)

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