Asthma Attacks – Causes, Symptoms and Triggers

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 asthma attacks occur – where the symptoms suddenly get worse.

Read on to discover the facts about asthma attacks, what causes them, the symptoms to look out for and common asthma attack triggers.

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 an asthma attack

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 colour, sometimes with blue lips or fingernails.

Asthma attack symptoms don’t always occur suddenly. Sometimes they can come on slowly and steadily, over a number of hours or days. That’s one reason why it’s important to be aware of what the symptoms are, as it could help you prevent a full-blown asthma attack occurring.

What to do when having 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. 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.
  4. If you do have your reliever inhaler (usually blue), take one puff every 30-60 seconds up to a maximum of 10 puffs. If you have a spacer device to hand, use that to administer the inhaler, as it can help the medicine get into your airways more efficiently.
  5. If you’re using your inhaler and feel worse or you don’t feel any better after you’ve had 10 puffs, 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’s 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’s essential that they all become better acquainted with what happens and how to react and help if you have an asthma attack.

Likewise, it’s important that schools and teachers are aware when a child has asthma and know how to handle the situation if an asthma attack occurs during school hours. Providing them with a copy of your child’s asthma plan can be beneficial.

Symptoms in adults

There are some symptoms of asthma attacks that can be different, depending on whether you’re an adult or a child.

In the case of adults, symptoms can include:

  • A feeling of tightness or pressure in your chest
  • Tightened neck or chest muscles, which cause the skin and soft tissue in your chest wall to skin in – this is called a chest retraction
  • Feeling fatigued, nervous or edgy – this can be an early warning sign of an impending asthma attack.

Symptoms in 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 residue cough.

The key asthma symptoms to look out for in children include:

  • Frequent coughing
  • A wheezing or a whistling sound, especially when they breathe out
  • Difficulty breathing – you may notice their nostrils flaring or their tummy moving more when they’re breathing
  • Sudden fast, shallow breathing.

Some children may also say their tummy or chest aches.

Acute asthma attack symptoms

An acute asthma attack is a medical emergency – you’ll must seek immediate medical help and go to hospital.

Acute asthma attack symptoms to be aware of include:

  • Rapid breathing that doesn’t 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
  • 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.

Symptoms 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.

Do follow any recovery guidance given to you by a doctor or medical professional. Rest, drink plenty of fluids, take your medication and attend any necessary follow-up appointments.

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

How do you stop an asthma attack without an inhaler?

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 experience when you don’t have a reliever inhaler with you, there are practical 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 – 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.

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.

How long do asthma attacks last?

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

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

What triggers 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 then this can also trigger an asthma attack.

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

What are the most common triggers of asthma attacks?

Common asthma attack triggers include:

  • 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
  • Stress or extreme emotion

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, 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.

How to avoid asthma triggers

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

If there’s a particular allergen culprit 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’re not personally exposed to dust when cleaning.

It can be more difficult to avoid asthma triggers completely when you’re 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 isn’t always feasible.

Let your employer or the HR department know about your asthma. You should be able to discuss the options available for optimising your work environment to be more suitable to your needs.

Keeping on top of your asthma management plan, working alongside your doctor or asthma nurse and making sure you take your inhalers or other asthma medications should help to control your symptoms. Making practical lifestyle choices is important too, like eating healthily, exercising and not smoking.

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

Information and support

You will find a wealth of further information about allergies and asthma on our website, and we hope you will explore it. You can also get in touch with us – we would love to hear from you!

Link to section H2 What to do when having an asthma attack?