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5 Signs It's Time to Step Up Your Asthma Treatment

Severity and frequency of asthma symptoms can vary greatly among individuals. Asthma treatment is individualized and medications selected for therapy will vary based on the seriousness and regularity of asthma symptoms. In cases of severe asthma, you may need more intensive treatment than most asthma patients. It may take a few tries to identify the right treatment plan for you, so it’s important to monitor your symptoms and be able to determine if your asthma medications are keeping your condition controlled. Make sure you talk to a healthcare provider honestly about symptom severity and frequency so the correct treatment can be chosen for you.

If you’re still experiencing frequent asthma symptoms, you may need to try another medication. Asthma is typically treated with a variety of maintenance medications that act on different cells or chemicals in the body. These medications include long-acting beta agonists which relax tightened airway muscles and are administered via inhalers. Anti-inflammatory medications include leukotriene antagonists (given orally), inhaled steroids (given by inhaler or nebulizer), and oral steroids. These medications prevent and reduce inflammation in the lungs. Newer treatments for severe asthma include biologics, which block IgE (allergic) antibodies or eosinophils (inflammatory cells) in the body thus reducing asthma attacks. Biologics are administered by injection. Many asthmatics require a combination of medications to keep symptoms under control, but if these standard options don’t work, you may need a new plan.

If asthma is affecting your sleep, it may be time to step up treatment. Nocturnal asthma symptoms can include coughing during the night, shortness of breath while trying to sleep, wheezing, chest pain and chest tightness. These symptoms can occur while trying to fall asleep, or can cause you to wake up from sleep in the middle of the night. Experiencing these symptoms more than twice per month, twice per week, or an increase from your baseline symptoms may indicate that your asthma medications need to be increased.

Ideally, symptoms of asthma should be infrequent (e.g., less than twice per week). However, if you notice an increase in coughing, wheezing, chest tightness, or shortness of breath from your baseline, it may be time to step up treatment.

Often, poorly controlled asthma will cause interference in daily activities. Does asthma cause you to miss work or school? Have you noticed a decline in your ability to exercise or even just do housework or climb a flight of stairs? Are you socializing less because of your asthma symptoms? Have you needed to visit an emergency room or been hospitalized because of your asthma? Answering yes to any of these questions may indicate a need to step up asthma treatment.

Short-acting beta agonist inhalers, such as albuterol, provide quick relief from acute asthma symptoms. However, if you are using your inhaler more than twice per week (unrelated to exercise) or more than you previously have, it is time to visit your doctor to see if your asthma treatment plan needs to be stepped up.