Wheeze is a common symptom of asthma. Coughing, shortness of breath, and chest tightness are other common symptoms. Wheezing is a musical, high-pitched, or whistling sound that typically happens when you exhale. In severe asthma, wheezing may also be heard while inhaling.1-4
Wheezing also can be a symptom of many other conditions. Your doctor will look at your medical history and run tests to determine its cause. If asthma is the cause, they will suggest treatments to reduce inflammation and control symptoms.1
What does wheezing look like in people with asthma?
Asthma is 1 common cause of wheezing. Other conditions that can cause wheezing include:1
- Allergies
- Respiratory infections, like a cold
- Chronic obstructive pulmonary disease (COPD)
- Epiglottitis (inflammation of a flap of skin in the back of the throat)
- Anaphylaxis (severe allergic reaction)
- Gastroesophageal reflux disease (GERD)
Wheezing from asthma and other causes is especially common in children. In adults, lung conditions and congestive heart failure may also cause wheezing.1
In people with asthma, wheezing often follows a pattern:2
- It comes and goes over time or within the same day.
- It starts or gets worse with viral infections, such as colds.
- It is triggered by exercise, allergies, or cold air.
- It is worse at night or in the morning.
Wheezing is a sign of airway obstruction. The way it sounds, how long it lasts, and how often it happens can point to the severity of the obstruction. The tone of the wheezing also may vary depending on its cause. Asthma affects the lower airways, which causes a more musical wheeze. Conditions that affect the upper airways may cause a hoarse wheeze.1
Wheezing can have a big impact on everyday life. For example, wheezing and other symptoms can interfere with sleep. Slight wheezing may be a warning sign of an oncoming asthma attack.5,6
Why does asthma cause wheezing?
People with asthma tend to have an overreactive immune system. This means their body responds to substances that are not actually harmful. There are many possible triggers of asthma attacks.6
Once the lungs come into contact with these triggers, the immune system reacts. After the immune system is activated, airway muscles tense up. These muscles start to swell and produce thick mucus. This causes the airways to become narrow or blocked.6
Wheezing happens because air is trying to pass through narrow airways. Wheezing means your maximum exhalation speed (peak expiratory flow rate) is less than half of the normal speed. The sound is produced by vibrations of narrowed airway walls.1
Children wheeze more than adults, in part because their airways are smaller. They also tend to get viral infections more often. About 1 in 4 children between ages 2 and 3 experience wheeze. This decreases to 1 in 8 children by adolescence.1
How is wheezing treated?
Talk to your doctor if you notice new or worsening wheeze. Your doctor will first confirm that the wheeze is caused by asthma. They will ask you questions about your symptoms and health history. They may perform tests, such as chest imaging and airway challenge tests.1
If asthma is the cause of your wheezing, your doctor will suggest treatments for asthma. Recurring wheezing may indicate persistent asthma, especially in young children. Treatment for persistent asthma usually starts with:1,7,8
- Avoiding triggers
- Taking daily low-dose inhaled corticosteroid drugs to relieve inflammation
- Taking short-acting beta agonists (SABAs) as needed for quick relief
Your doctor may then adjust the treatments depending on how your symptoms change. If wheezing is triggered only by respiratory infections, your doctor may suggest taking these medicines only at the start of an infection.8
Other treatments and lifestyle changes may improve wheezing as well. These include:5
- Doing breathing exercises
- Drinking hot beverages
- Avoiding smoking
- Using an air purifier and humidifier