What should you know about severe persistent asthma?

Asthma narrows and irritates the airways, making it harder for air to move. In severe persistent asthma, symptoms may occur often, disturb sleep, limit activity, or remain difficult to control despite prescribed treatment. Wheezing, cough, chest tightness, and breathlessness can vary from day to day. Allergic rhinitis and house dust mite allergy may worsen airway irritation, while a chronic cough can have several causes. A clinician uses your symptom pattern, inhaler technique, lung tests, and treatment response to guide care.

Take controller treatment exactly as prescribed and keep a reliever available according to your action plan. Check inhaler technique regularly; a small technique error can leave medicine in the mouth instead of the airways. Track night symptoms, reliever use, exercise limits, and known triggers. Reduce smoke and other irritants, manage nasal allergy when advised, and attend planned reviews. Never change or stop long-term asthma medicine without clinical guidance. Ask what to do if symptoms begin increasing.

Follow your written asthma action plan when symptoms worsen. Seek emergency help for severe breathlessness, difficulty speaking in full sentences, blue or grey lips, confusion, exhaustion, fainting, or symptoms that are rapidly worsening or not responding to the prescribed reliever. Sit upright while waiting, use your reliever as directed in your plan, and do not drive yourself if breathing is seriously impaired. A nebuliser treatment may be used by a healthcare team when inhaled treatment needs supervised delivery.

Ask whether your diagnosis, inhaler technique, triggers, and treatment level have been reviewed. Request a written action plan, clarify your reliever instructions, and discuss lung testing, allergy control, night waking, exercise symptoms, and when to attend urgent care.