What should you know about severe asthma?

Asthma affects the airways, which can narrow when they become inflamed or react to triggers. Severe asthma describes asthma that remains difficult to control even when prescribed inhalers and other care are used correctly. Symptoms may include wheezing, cough, chest tightness, waking at night, or breathlessness that limits ordinary activity. A flare can develop after a viral illness, allergen exposure, smoke, exertion, or other trigger, but sometimes no clear trigger is found.

A clinician may review inhaler technique, adherence, lung function, symptoms, and previous attacks before deciding whether specialist assessment or additional treatment is needed.

Use your preventer and reliever exactly as prescribed, and keep an up-to-date written action plan. Check that you can demonstrate inhaler technique; a spacer may improve delivery for some inhalers. Record changes in night symptoms, activity tolerance, reliever use, and known triggers. Reduce exposure to smoke and avoid medicines or substances that your clinician has identified as triggers. Treating related problems such as allergic rhinitis can also be part of asthma care.

Seek emergency help if breathing is severely difficult, you cannot speak in full sentences, your lips look blue or grey, you become confused or unusually drowsy, or your reliever is not helping. Sit upright, follow your action plan, and use prescribed rescue medicine while waiting for help. Do not drive yourself if breathing is worsening. A severe attack can need oxygen, repeated inhaled medicine, steroids, or hospital monitoring.

Ask which symptoms mean your asthma is uncontrolled, how to adjust treatment during a flare, whether you need lung-function testing, and when specialist review is appropriate. Bring your inhalers and action plan so technique and instructions can be checked.