Is asthma the reason you’re finding it hard to breathe?

Asthma may be common, but can also be debilitating and even deadly. Yet with effective treatment, people can live and breathe freely. Here’s what you need to know.

Asthma is a chronic condition in which the airways narrow and swell and produce extra mucus, which can make breathing difficult.

Around 2.7 million  Australians live with the disease.

National Asthma Council Australia asthma and respiratory educator Narelle Williamson says common symptoms include:

• Wheezing
• Breathlessness
• Cough
• Chest tightness

The exact causes of asthma and triggers can vary for each person, but Narelle says may include respiratory tract infections; certain medications; allergic rhinitis (hay fever); allergens such as dust mites, pollen, moulds, perfumes/sprays, smoking, air pollution and dietary additives; some thunderstorms in Spring and early Summer.

• Protect yourself: How to safeguard against asthma during winter

How is asthma diagnosed?

There is no single test to diagnose asthma.

Diagnosis is based on a combination of personal and family history, physical examination and diagnostic testing, including spirometry.

Royal Australian College of General Practitioners respiratory medicine specific interests group chair Dr Kerry Hancock says asthma can be tricky to diagnose, especially in young children.

“Even though you might have inflammation in your airways all the time, you don’t necessarily have the symptoms all the time,” Dr Hancock says.

“Ideally we would like to have confirmation on a lung function test, that somebody does have obstructed airways and their condition is improved when they take medication.

“But often GPs have to diagnose asthma on the clinical presentation of symptoms or they might have a chance to listen to the patient’s lungs and hear the wheezing.”

How is asthma treated?

Narelle says medication is essential for managing asthma, along with having an up-to-date asthma action plan.

The three main types of asthma medications are relievers, preventers and combination medications.

“The best choice of treatment will depend on the person’s age, symptoms and also which type of inhaler they find easiest to use correctly,” Narelle says.

“Some medications should be used with spacers in order to deliver the medication to the small lower airways, where it is needed the most.”

• Maximum value: How spacers can improve delivery of your asthma medication

Can you develop asthma later in life?

Dr Hancock says people can get asthma later on in life, but adult on-set asthma is often overlooked or misdiagnosed.

She warns the symptoms of asthma when you are older can mimic other conditions, such as heart disease, so it is important to get a proper diagnosis.

Narelle says the reasons for developing asthma later in life are not always clear, but could be due to factors such as:

• Prolonged exposure to pollution or smoking.
• Hormonal fluctuations in women during or after pregnancy and menopause.
• Obesity.
• Viruses or illnesses.

What does it feel like to have asthma?

Narelle says symptoms can vary from person to person and may include a tight feeling in the chest, or being short of breath.

“They may have a recurrent cough and possibly may be able to hear themselves ‘wheezing’,” Narelle says.

“Often people have trouble speaking full sentences.”

Why is asthma often worse at night?

It is common for asthma to be worse at night, Narelle says.

But she warns if people suffer from night time symptoms, it can indicate their asthma is not well controlled.

She says there are a few reasons why symptoms may become worse at night, such as:

• Lying on your back puts extra pressure on your chest and lungs which makes it harder to breathe.
• Triggers in the bedroom, such as dust mites in the mattress, pillows, doona, soft toys, pet hair, or mould.
• If a person suffers from hay fever, they may find pollen affects them at night, because pollen levels are highest in the early morning and early evening.
• Hot or cold air can trigger asthma symptoms, so keeping heating on low/moderate settings in the bedroom can help.

What is thunderstorm asthma?

Certain types of thunderstorms in spring and early summer in regions with high grass pollen concentrations in the air can cause life threatening allergic asthma exacerbations, Narelle says.

“It’s thought to be triggered by exposure to rye grass pollen, fungi or dust, in wind gusts preceding a  thunderstorm, particularly in South Eastern Australia,” Narelle says.

“Thunderstorm-triggered asthma can occur in allergic individuals when they inhale air that contains a high concentration of pollen allergens, most often in microscopic particles.”

Narelle says people at risk of thunderstorm asthma include people with allergies to rye grass pollen,

seasonal hay fever, people with a history of asthma and those with undiagnosed asthma.

• Thunderstorm asthma: Why you need a plan now

Written by Bianca Carmona.