Asthma is a disease that affects many people but has unique triggers and symptoms for every individual. Understanding these triggers and symptoms can help patients better manage their asthma and improve their quality of life.

What is asthma?

Asthma is a condition where breathing becomes difficult because your airway muscles tighten, swell up, and clog with mucus. There are many reasons a person may develop asthma including genetic factors, childhood respiratory infections, or the environment. Common symptoms include difficulty breathing, shortness of breath, wheezing, cough, or chest pain. These symptoms vary over time and from patient to patient and can be triggered by different factors which will be discussed below. It is important to note that a person can be sensitive to multiple asthma triggers and that triggers are specific to each patient. Identifying patterns in symptoms and triggers can be a key step in managing your asthma.

Common Asthma Triggers

Allergens: 

• Allergens are small protein substances that float in the air. 

• When a person is exposed to large amounts of an allergen they can have an asthmatic response that can last several hours to days or longer. The length of symptoms depends on the person and the amount of allergens in their environment. 

• Common allergens include animal dander, dust, pollen, and molds. 

• Skin testing can be used to detect a person’s sensitivity to specific allergens.

Irritants: 

• Irritants are components of the environment that people are not allergic to, but can still trigger asthma symptoms. 

• Examples of irritants include strong odors, smoke, and air pollution. Irritants can cause a quick onset of asthma symptoms but, once the irritant is removed, people usually experience a quick improvement of symptoms. 

• Skin testing can not be used to identify sensitivity to irritants.

Exercise: 

• For some people, physical activity can cause the onset of asthma symptoms within minutes of sustained exercise. 

• This type of asthma is commonly called exercise-induced bronchoconstriction (EIB).

Weather: 

• Weather, especially wind, cold air, and sudden changes can increase asthma symptoms. 

• Additionally, heavy rain can worsen symptoms by releasing and spreading more pollen into the air.

Emotions: 

• Strong emotions, such as laughter, fear, anger, etc., can cause breathing changes and may bring on asthma symptoms.

Daily (Diurnal) Changes: 

• Some people have worse asthma symptoms during the night than they do during the day. 

• While there is still uncertainty about the exact reasons for this, it is thought that allergens in bedding or acid reflux could be causes for these changes.

Reflux Disease

• Reflux disease is a condition where stomach acid is regurgitated into the esophagus.

• These small droplets of acid can be inhaled into the trachea worsening asthma symptoms.

• Patients are often aware of their symptoms, especially at night.

Viral or Sinus Infections: 

• Not all viruses cause asthma symptoms to get worse, however upper respiratory infections (URIs) can progress from a cough to asthma symptoms over the course of a few days. 

• Depending on the virus and the person, the severity of the symptoms can vary. Sinus infections have also been associated with worsening asthma symptoms.

Food Additives: 

• Sulfites, an additive commonly found in wine, can trigger asthma symptoms for some people. MSG and alcohol can also be triggers.

Medications: 

• Never stop taking a medication without talking to your provider first. 

• Some medications like aspirin, non-steroidal anti-inflammatory drugs (NSAIDs), beta-blockers (usually prescribed for heart conditions, high blood pressure, or migraines), and ACE inhibitors (usually prescribed for heart conditions and high blood pressure) can cause a cough or asthma symptoms. 

• For a list of brand and generic names of these drugs click here.

Other Health Conditions: 

• Asthma symptoms can also be affected by other health conditions such as chronic obstructive pulmonary disease (COPD), smoking, obesity, obstructive sleep apnea, nasal polyps, and pregnancy. 

• This list is not exhaustive, and you should discuss other pre-existing conditions with your asthma doctor.

When multiple triggers are present, they can weaken your lung function and make your asthma symptoms worse. Talking with a doctor and using tools such as symptoms scores and peak flow meters can help patients understand patterns in their asthma triggers. Identifying and understanding these triggers is a key to successful asthma care.