Asthma symptoms: patterns, triggers and warning signs

Symptoms may appear at night, with exercise, during a respiratory infection, or after exposure to smoke, dust, cold air, pollen or animals. Not everyone wheezes, and an examination can sound normal between episodes.

Clinicians look for symptoms that come and go, share recognisable triggers, disturb sleep, limit activity or improve after asthma medicine. Cough may be dry, while wheezing is often a musical sound heard mainly when breathing out.

Similar complaints can occur with infections, nasal allergy, reflux and other lung or heart problems. Symptoms indicate that assessment is needed; they do not confirm asthma on their own.

Note when each symptom starts, possible exposures, night waking, exercise limitation and how often prescribed reliever medicine is needed. If you have a peak-flow plan, record readings alongside symptoms because either may change first.

Follow your written asthma action plan and check inhaler technique with a clinician or pharmacist. Arrange a review if symptoms are recurring, waking you, restricting usual activity or requiring more reliever medicine than your plan allows.

Call emergency services if breathlessness is severe, speech is difficult, lips look blue or grey, you feel confused or faint, or prescribed reliever treatment is not helping. Quiet breathing in someone who is exhausted can be more concerning than loud wheezing.

Sit upright, follow the emergency steps in your action plan and do not remain alone while urgent help is being arranged.

Ask whether your pattern fits asthma, which breathing tests are appropriate, how to distinguish poor control from an emergency, and whether nasal allergy or workplace exposures may be contributing. Request a demonstration of your inhaler technique and a written action plan.