I have a wheezing sound when I breathe: what should I know?

A wheezing sound means air is moving through narrowed or irritated airways and needs context. It may be brief after an irritant or part of a significant breathing problem, so assess your breathing rather than the sound alone.

Wheezing can occur with asthma, acute bronchitis, COPD, allergic rhinitis or bronchiolitis. Anaphylaxis may cause sudden wheezing with swelling of the lips or tongue, hives, throat tightness, vomiting or dizziness after an exposure. A clinician may ask whether the sound is new, whether it is worse when breathing out, and whether cough, fever, chest tightness or breathlessness is present.

Sit upright, loosen tight clothing and move away from smoke, dust, strong fragrance or a known trigger. Use your prescribed reliever inhaler exactly according to your personal action plan. Do not borrow another person’s inhaler. Note when the wheeze began, what preceded it and whether speaking or walking is becoming difficult. A clinician may recommend inhaled treatment or nebuliser treatment after examining you.

Call emergency services if breathing is severely difficult, lips look blue or grey, you cannot speak in full sentences, you feel faint or confused, or swelling suggests anaphylaxis. Seek urgent assessment for a first episode, rapidly worsening wheeze, chest pain, fever with marked illness or poor response to your prescribed reliever. Arrange review when wheezing recurs, disturbs sleep or follows a pattern.

Could this be asthma, infection, allergy or another airway problem? How should I use my reliever and action plan? Do I need breathing tests, an inhaler review or a nebuliser? Which warning signs mean I should seek emergency help?