Asthma affects about 235m people worldwide, including both adults and children. The symptoms of asthma can be well controlled by regular medications and lifestyle choices, but sometimes an Asthma Attack occurs – where the symptoms suddenly or gradually get worse. [1]

What is an Asthma Attack?

An asthma attack occurs when your normal asthma symptoms suddenly get worse. The muscles around your airways get tighter – known as a bronchospasm – the lining in your airways becomes swollen and inflamed and you produce thicker mucus than normal.

Together the bronchospasm, inflammation and mucus production create the symptoms of an asthma attack. Find out below what to do if you or a loved one suffers an asthma attack .

If your asthma is under control through the use of prescribed preventer and reliever inhalers or other asthma medication, you may go a while without having an asthma attack. But sometimes exposure to common asthma triggers, such as cold air, smoke or even exercise, can trigger an asthma attack.

Asthma attacks can be mild or severe. It’s more common to experience mild asthma attacks, which may only last minutes. However, severe asthma attacks can last from hours to days and can be a medical emergency.

Symptoms of Asthma Attacks

Symptoms of an asthma attack include:

  • Difficulty breathing
  • Shortness of breath
  • Wheezing
  • Coughing
  • A feeling of pressure or tightness in your chest
  • Difficulty talking
  • Getting no relief from using your normal blue reliever inhaler
  • Going pale in color, sometimes with blue lips or fingernails.

Asthma attack symptoms do not always occur suddenly. Sometimes they can come on slowly and steadily, over a number of hours or days. This is one reason why it’s important to be aware these symptoms, as it could help you prevent a full-blown asthma attack from happening.

There are some symptoms of asthma attacks that can be different between adults and children. In young children, it can sometimes be hard to identify signs and symptoms of asthma. They might not have all of the symptoms – it may seem as though they just have a cold and a lingering cough.

In Adults

  • Feeling of tightness or pressure in the chest
  • Tightened neck or chest muscles which cause the skin and soft tissue in the chest wall to sink in – this is called chest retraction
  • Feeling fatigued, nervous, or edgy – this can be an early warning sign of an asthma attack that is about to happen

In Children

  • Frequent coughing
  • A wheezing or whistling sound, especially when breathing out
  • Difficulty breathing – nostrils may flare or the child’s stomach may move more when they’re breathing
  • Sudden fast, shallow breathing
  • May find it difficult to talk

An acute (or severe) asthma attack is a medical emergency – you must seek immediate medical help and go to hospital.

Acute asthma attack symptoms to be aware of include:

  • Rapid breathing that does not ease with use of a reliever inhaler
  • Extreme shortness of breath – being unable to inhale or exhale fully
  • An inability to speak in full sentences
  • Confusion or agitation (anxious and distressed)
  • Developing a blue tint on the face, lips, or fingernails.

If you don’t seek treatment for an acute asthma attack, your life could be in danger. Find out more about acute asthma by reading our guide to severe asthma [2].

Coping with an Asthma Attack

If you have asthma, then it’s important that you know what to do – and not do – if you have an asthma attack.

  1. Sit upright in a comfortable position (do not lie down) and loosen any tight clothing. Leaning forward slightly or sitting backwards on a chair may help your breathing.
  2. Breathe slowly and deeply [3].
  3. If you don’t have your inhaler with you, call an ambulance. Dial 999 in the UK, 911 in the US or 112 in the Europe Union, or the emergency or ambulance number where you live [4].
  4. If you do have your reliever inhaler, take as prescribed. If you have a spacer device on hand, use that to administer the inhaler, as it can help the medicine get into your airways more efficiently [5].
  5. If you take the number of puffs that usually help your asthma attack, but you don’t feel better, call the emergency services.
  6. If you’re waiting for an ambulance and it hasn’t arrived within 15 minutes, use your reliever inhaler again and take one puff every 30 to 60 seconds, up to a maximum of 10 puffs.
  7. Stay as calm as you can, as panic and anxiety can make your symptoms worse.

It is hard to predict exactly when an asthma attack will occur, so it’s also important to discuss your condition with your family, friends, and employer. It is essential that they become familiar with what an asthma attack looks like and how to react and help if one happens.

Likewise, it’s important that schools and teachers [6] are aware when a child has asthma and know

If you are diagnosed with asthma, you should make sure you have an inhaler with you at all times. However, if a worst-case scenario occurs and you have an asthma attack when you don’t have a reliever inhaler with you, there are steps you can take to ease your symptoms.

  • Stay as calm as you can – find a way to reduce any anxiety, such as holding someone’s hand or playing music
  • Sit upright – this will help keep your airways open
  • Breathe slowly and deeply – slowing down your breathing can reduce the risk of hyperventilating
  • If something appears to have triggered your asthma, such as breathing in cold air or being exposed to smoke, move away from the trigger
  • Try breathing exercises [7] – the pursed lip breathing technique can help you deal with shortness of breath
  • Have a drink containing caffeine – there is some evidence to suggest that caffeine can help improve airway function for up to four hours [8].

Asthma can be a life-threatening condition, so at the very least, aim to keep a spare reliever inhaler in your handbag, locker at work, or coat pocket.

There is no set time for how long an asthma attack lasts. As a guideline, you might only have a mild asthma attack for minutes before you get your symptoms under control and they begin to ease.

If you have severe asthma, an asthma attack can last longer, from hours to days. Severe asthma is harder to control than mild asthma and often doesn’t respond in the same way to medications. A severe asthma attack is a medical emergency and you need to call for help for emergency help right away.

What to do after an Asthma Attack?

How you feel after an asthma attack will depend on how severe the attack was and what triggered it.

If the attack was triggered by an irritant, such as cold weather, pollutants, or allergens such as pollen, animal fur, or dust, you should recover relatively quickly. If your asthma attack was caused by an infection, such an upper airway infection, then it might take longer for you to recover. You may have symptoms such as fatigue and exhaustion after your asthma attack.

Follow the advice given to you by your doctor or medical professional. Rest, drink plenty of fluids, take your medication, and attend any necessary follow-up appointments.

If you have not seen your doctor or asthma nurse for a routine appointment recently, book one as soon as possible.

Causes of Asthma Attacks

When you experience an asthma attack, your airways narrow and it gets more difficult to breathe. An asthma attack can come on slowly and gradually, for example, if your usual symptoms aren’t so well controlled or if you’ve not been using your preventer inhaler as regularly as you should be. If you’ve got an upper airway infection [9] then this can also trigger an asthma attack.

Other factors that can trigger asthma attacks [10] include a sudden change in the temperature and cold weather, environmental factors, allergens and even stress or certain foods and drinks.

Common asthma attack triggers include:

  • Stress or extreme emotion
  • Coming into contact with allergens, such as pollen, animal fur, mould or dust
  • Eating certain foods
  • Environmental factors, such as pollution, poor air quality or cold air
  • Taking non-steroidal anti-inflammatory medications, such as ibuprofen
  • Taking medication such as beta blockers

If you know what your asthma triggers are, then where possible, it’s helpful to try to avoid them.

If there’s a particular allergen cause you know of, then keeping your home clean and dust free can help. For example, you could consider swapping carpets for wooden floors to reduce the amount of dust build-up or hiring a cleaner so you are not exposed to dust when cleaning.

It can be more difficult to avoid asthma triggers completely at work, especially if your asthma is occupational and linked to your working environment. In an ideal world, you could simply change jobs to something more suitable for your health, but in reality this is not always possible.

Consider letting your employer or the human resources department know about your asthma. You should be able to discuss the options available for optimizing your work environment to be more suitable to your needs.

Keeping on top of your Asthma Plan, working alongside your doctor and health care team, and making sure you take your inhalers or other asthma medications should help to control your symptoms. Making practical lifestyle choices is important too, such as eating healthily, exercising, and not smoking.

It can also be beneficial to learn an asthma breathing technique [11]. There are various breathing techniques that can help asthma and knowing how to breathe properly could help if something unexpected triggers an attack.

Asthma Food Triggers

Some people with asthma find that certain foods can trigger an attack. This can be due to being allergic to particular foods or ingredients. If you have a food allergy [12], it often starts during childhood.

Food can also trigger asthma symptoms if someone is sensitive to foods or food additives, such as preservatives.

Some of the foods that could cause issues include:

  • Eggs
  • Milk
  • Peanuts
  • Shellfish
  • Sesame seeds
  • Soya
  • Foods containing gluten, such as pasta or bread
  • Food preservatives such as sulphites, which are found in drinks, pickled foods and processed meats

If you think you’re experiencing asthma attacks due to food, keep a food diary. This can help you to identify a pattern and work out what foods might be causing you problems. Speak to your doctor for more advice or to find out about allergy testing.

Citations

  1. NHS Choices. Symptoms – Asthma. Published 2024. Accessed March 29, 2024. https://www.nhs.uk/conditions/asthma/symptoms/.
  2. Severe Asthma – Global Allergy & Airways Patient Platform. Global Allergy & Airways Patient Platform. Published April 3, 2023. Accessed March 29, 2024. https://gaapp.org/diseases/asthma/severe-asthma/.
  3. How to Survive an Asthma Attack if You’re Caught Without Your Inhaler – HealthXchange. Healthxchange.sg. Published 2019. Accessed March 27, 2024. https://www.healthxchange.sg/asthma/complications-management/survive-asthma-without-inhaler.
  4. NHS Choices. Salbutamol inhaler – Brand names: Ventolin, Airomir, Asmalal, Easyhaler, Pulvinal, Salamol, Easi-Breathe, Salbulin. Published 2024. Accessed March 29, 2024. https://www.nhs.uk/medicines/salbutamol-inhaler/.
  5. item. Who.int. Published 2020. Accessed March 27, 2024. https://www.who.int/news-room/questions-and-answers/item/chronic-respiratory-diseases-asthma.
  6. Kew KM, Carr R, Donovan T, Gordon M. Asthma education for school staff. The Cochrane library. 2017;2017(4). doi:https://doi.org/10.1002/14651858.cd012255.pub2.
  7. Breathing Exercises and Techniques for Asthma – Global Allergy & Airways Patient Platform. Global Allergy & Airways Patient Platform. Published April 3, 2023. Accessed March 29, 2024. https://gaapp.org/diseases/asthma/breathing-exercises-and-techniques-for-asthma/.
  8. Coffee and Asthma | Allergy & Asthma Network. Allergy & Asthma Network. Published July 26, 2023. Accessed March 29, 2024. https://allergyasthmanetwork.org/news/coffee-and-asthma/.
  9. Imperial College London. Study finds potential new target to treat asthma attacks brought on by colds | Imperial News | Imperial College London. Imperial News. Published October 2, 2014. Accessed March 29, 2024. https://www.imperial.ac.uk/news/160006/study-finds-potential-target-treat-asthma/.
  10. CDC. Common Asthma Triggers. Centers for Disease Control and Prevention. Published July 31, 2023. Accessed March 29, 2024. https://www.cdc.gov/asthma/triggers.html.
  11. Breathing Exercises and Techniques for Asthma – Global Allergy & Airways Patient Platform. Global Allergy & Airways Patient Platform. Published April 3, 2023. Accessed March 29, 2024. https://gaapp.org/diseases/asthma/breathing-exercises-and-techniques-for-asthma/.
  12. Food. Asthma & Allergy Foundation of America. Published January 24, 2024. Accessed March 29, 2024. https://aafa.org/asthma/asthma-triggers-causes/food-as-an-asthma-trigger.