How can you tell if your asthma is getting worse. What are the key signs of worsening asthma symptoms. When should you contact your doctor about changes in your asthma. What steps can you take to better control worsening asthma.

Understanding Asthma Progression: Why Symptoms May Worsen Over Time

Asthma is a chronic respiratory condition that can evolve and intensify over time, even when patients diligently follow their treatment plans. Various factors contribute to this progression, including prolonged exposure to environmental triggers and the gradual buildup of inflammation in the airways.

Dr. Sharon R. Rosenberg, co-director of the asthma and COPD program at Northwestern University’s Feinberg School of Medicine, explains: “A number of factors can worsen asthma, including prolonged exposure to dust, pollen, mold, pollution, and other irritants in the air.” However, it’s crucial to note that some individuals may experience a gradual worsening of asthma symptoms without any apparent trigger exposure.

Dr. Guha Krishnaswamy, director of allergy and clinical immunology at Wake Forest Baptist, elaborates on the physiological changes that occur: “The mucus membranes become more swollen, smooth muscle becomes a little twitchier, and the airways produce thick mucus.” These alterations collectively lead to an exacerbation of asthma symptoms.

Recognizing the 6 Key Indicators of Worsening Asthma

Being vigilant about changes in your asthma symptoms is crucial for maintaining control over the condition. Here are six important signs that your asthma may be worsening:

1. Increased Difficulty Breathing

One of the most noticeable signs of worsening asthma is an increase in breathlessness during everyday activities. Dr. Krishnaswamy provides an example: “If you used to be able to carry a grocery bag from your car to your kitchen with ease and now you are huffing and puffing, that could be a sign of worsening asthma.” Pay attention to any changes in your breathing patterns during routine tasks.

2. Declining Peak Flow Meter Readings

A peak flow meter is an essential tool for monitoring asthma severity. Dr. Krishnaswamy compares it to “a blood pressure cuff for people with high blood pressure — it gives you an objective measurement of your condition.” If you notice a consistent decline in your peak flow meter readings, it may indicate that your asthma is deteriorating.

3. Limitations in Exercise Capacity

Changes in your ability to exercise or participate in physical activities can be a telltale sign of worsening asthma. This may manifest as:

• Decreased motivation to work out
• Reduced stamina during exercise
• Increased breathing difficulties during physical activity

If you find yourself struggling with activities that were previously manageable, it’s important to take note and consult your healthcare provider.

4. Increased Reliance on Quick-Relief Inhalers

Dr. Krishnaswamy shares a personal anecdote: “I saw this happen with my own mother. She was breathless and needing to use her rescue inhaler more and more frequently.” According to the National Heart, Lung, and Blood Institute, if you need to use your quick-relief medicine more than twice a week, it’s a sign that your asthma is not well-controlled.

5. Nighttime Awakenings Due to Coughing or Wheezing

Nocturnal asthma symptoms can significantly impact your quality of life and indicate poor asthma control. Dr. Krishnaswamy emphasizes: “Attacks at nighttime that wake you up at 2 in the morning with coughing and wheezing and reaching for your rescue inhaler are a sign your asthma is poorly controlled or getting worse.”

6. Disruptions to Normal Routine

If asthma symptoms are regularly interfering with your daily life, such as causing you to miss work or school, it’s a clear indication that your condition is worsening. While occasional flare-ups during high-stress periods are normal, frequent disruptions to your routine warrant medical attention.

The Importance of Monitoring Asthma Symptoms

Regular monitoring of asthma symptoms is crucial for maintaining optimal control over the condition. By staying attuned to changes in your breathing patterns, peak flow meter readings, and overall quality of life, you can detect early signs of worsening asthma and take proactive steps to prevent severe exacerbations.

Is there a recommended frequency for assessing asthma symptoms? While individual needs may vary, most healthcare providers suggest daily monitoring of peak flow meter readings and keeping a symptom diary. This consistent tracking allows for early detection of any concerning trends.

Strategies for Managing Worsening Asthma Symptoms

If you notice any signs of worsening asthma, it’s essential to take prompt action. Here are some steps you can take to manage your symptoms effectively:

1. Contact your healthcare provider immediately to discuss changes in your condition.
2. Review and update your asthma action plan with your doctor.
3. Be prepared to adjust your medication regimen as advised by your healthcare team.
4. Identify and minimize exposure to potential triggers that may be exacerbating your symptoms.
5. Consider additional lifestyle modifications to support better asthma control.

Dr. Rosenberg emphasizes the importance of having a comprehensive asthma management plan: “Your physician will make sure you are on an appropriate asthma management regimen and give you the right rescue medications to use when your symptoms get worse.” She also notes that medication adjustments, including changes in types, dosages, or frequencies, may be necessary to regain control over worsening symptoms.

The Role of Asthma Action Plans in Managing Exacerbations

An asthma action plan is a personalized guide that helps you manage your condition effectively, especially during flare-ups or exacerbations. These plans typically include:

• A list of your daily medications and dosages
• Instructions for recognizing and responding to worsening symptoms
• Guidelines for when to seek emergency medical care
• Contact information for your healthcare providers

The Centers for Disease Control and Prevention (CDC) offers sample asthma action plans online, which can serve as a starting point for creating your personalized plan with your healthcare provider.

How often should you review and update your asthma action plan? It’s recommended to review your plan with your healthcare provider at least annually or more frequently if your asthma is not well-controlled.

The Importance of Consistent Asthma Management

One common pitfall in asthma management is the tendency to reduce or discontinue controller medications when symptoms improve. Dr. Krishnaswamy cautions against this approach: “Too often, people will ease up on their controller medications and use their rescue inhaler instead. But if you have persistent asthma, you need persistent therapy.”

Maintaining a consistent treatment regimen is crucial for long-term asthma control, even during periods of symptom improvement. This approach helps prevent the gradual worsening of the condition and reduces the risk of severe exacerbations.

Understanding Severe Asthma Attacks: Symptoms and Response

While monitoring for signs of worsening asthma is crucial, it’s equally important to recognize the symptoms of a severe asthma attack. These episodes can be life-threatening and require immediate medical attention.

Symptoms of a severe asthma attack may include:

• Severe breathlessness, even at rest
• Inability to speak in full sentences
• Rapid breathing and heart rate
• Bluish tint to lips or fingernails (cyanosis)
• Chest pain or pressure
• Confusion or altered mental state

If you or someone you know experiences these symptoms, it’s crucial to seek emergency medical care immediately. Prompt treatment can prevent life-threatening complications and help restore normal breathing function.

Exploring the Underlying Causes of Asthma Progression

Understanding the factors that contribute to asthma progression can help patients and healthcare providers develop more effective management strategies. Some key elements that may influence the worsening of asthma over time include:

Chronic Inflammation

Persistent inflammation in the airways can lead to structural changes, making them more sensitive to triggers and potentially worsening asthma symptoms over time. Proper use of anti-inflammatory medications, such as inhaled corticosteroids, is crucial in managing this aspect of the condition.

Airway Remodeling

Long-term inflammation can result in permanent changes to the structure of the airways, a process known as airway remodeling. This can lead to increased airway hyperresponsiveness and potentially more severe asthma symptoms.

Environmental Factors

Cumulative exposure to environmental triggers, such as allergens, air pollution, or occupational irritants, can contribute to the progression of asthma. Identifying and minimizing exposure to these factors is an important aspect of long-term asthma management.

Comorbid Conditions

Certain health conditions that commonly co-occur with asthma, such as obesity, gastroesophageal reflux disease (GERD), or sinus problems, can exacerbate asthma symptoms and contribute to disease progression. Managing these comorbidities effectively is often crucial for maintaining optimal asthma control.

How can patients work with their healthcare providers to address these underlying factors? Regular check-ups, open communication about symptoms and concerns, and a willingness to adjust treatment plans as needed are all essential components of a comprehensive asthma management strategy.

Innovative Approaches to Asthma Management and Prevention

As our understanding of asthma continues to evolve, researchers and healthcare providers are exploring new ways to manage the condition and prevent its progression. Some promising areas of development include:

Personalized Medicine

Advances in genetic research and biomarker identification are paving the way for more personalized asthma treatments. By tailoring medications and management strategies to an individual’s specific asthma phenotype, healthcare providers may be able to achieve better control and potentially slow disease progression.

Biologics

For patients with severe or difficult-to-control asthma, biologic therapies targeting specific inflammatory pathways show promise in reducing exacerbations and improving overall asthma control. These treatments may be particularly beneficial for patients whose asthma continues to worsen despite conventional therapies.

Digital Health Technologies

The integration of smart inhalers, mobile apps, and wearable devices into asthma management plans offers new opportunities for real-time symptom monitoring and early intervention. These technologies can help patients and healthcare providers identify trends in asthma control and make timely adjustments to treatment plans.

Environmental Interventions

Recognizing the significant impact of environmental factors on asthma progression, there is growing interest in large-scale interventions to improve air quality and reduce exposure to common asthma triggers. This may include policy changes, urban planning initiatives, and public health campaigns aimed at creating healthier environments for individuals with asthma.

What role can patients play in advancing asthma research and treatment? Participating in clinical trials, sharing experiences with healthcare providers, and staying informed about new developments in asthma management are all valuable ways for patients to contribute to the ongoing efforts to improve asthma care.

As we continue to deepen our understanding of asthma and its progression, the importance of vigilant symptom monitoring and proactive management cannot be overstated. By recognizing the signs of worsening asthma early and taking appropriate action, patients can maintain better control over their condition and enjoy a higher quality of life. Remember, asthma management is a collaborative effort between patients and healthcare providers, and open communication is key to achieving the best possible outcomes.

6 Signs Your Asthma Is Worsening

Over time, asthma often progresses. Knowing the signs of worsening asthma is the first step to getting your condition under control.

By Elizabeth Shimer BowersMedically Reviewed by Lindsey Marcellin, MD, MPH

Reviewed: October 10, 2014

Medically Reviewed

If you have asthma, you know an attack can come on suddenly, literally taking your breath away. But asthma, a chronic lung disease that inflames and narrows the airways, can also gradually exacerbate over time — even if you’re avoiding triggers, following your treatment plan, and doing everything you’re supposed to do.

“A number of factors can worsen asthma, including prolonged exposure to dust, pollen, mold, pollution, and other irritants in the air,” says Sharon R. Rosenberg, MD, co-director of the asthma and COPD program at Northwestern University’s Feinberg School of Medicine in Chicago.

But for some people, asthma gradually worsens without any exposure to triggers. Symptoms get worse as inflammation builds over time, explains Guha Krishnaswamy, MD, director of allergy and clinical immunology at Wake Forest Baptist. “The mucus membranes become more swollen, smooth muscle becomes a little twitchier, and the airways produce thick mucus,” he says. These changes lead to worsening asthma symptoms.

Anyone who has asthma needs to be on the lookout for signs that the condition is getting worse. The reason is simple: Uncontrolled asthma can be a severe, life-threatening disease.

Signs of Worsening Asthma

Here are six signs your asthma may be getting worse:

1. Increased difficulty breathing.

“You may notice more shortness of breath during normal activities,” Dr. Krishnaswamy says. For example, if you used to be able to carry a grocery bag from your car to your kitchen with ease and now you are huffing and puffing, that could be a sign of worsening asthma.

2. A drop in peak flow meter readings.

“For people with asthma, a peak flow meter is like a blood pressure cuff for people with high blood pressure — it gives you an objective measurement of your condition,” Krishnaswamy says. Chronically lower peak flow meter readings can indicate that your asthma is getting worse.

3. Exercise limitations.

If you’re lacking the motivation you used to have for working out, or you’re experiencing decreased stamina or trouble breathing during exercise, your asthma may be getting worse.

4. Using a quick-relief inhaler more often.

“I saw this happen with my own mother,” Krishnaswamy says. “She was breathless and needing to use her rescue inhaler more and more frequently.” If you need to use quick-relief medicine more than twice a week, your asthma isn’t under control, according to the National Heart, Lung, and Blood Institute.

5. Waking up at night with coughing or wheezing.

“Attacks at nighttime that wake you up at 2 in the morning with coughing and wheezing and reaching for your rescue inhaler are a sign your asthma is poorly controlled or getting worse,” Krishnaswamy says.

6. Having to disrupt your normal routine because of asthma.

During times of high stress, you might experience a flare that causes you to miss school or work. “Maybe you’re having a stressful morning — your child is sick — and your asthma worsens, then it quickly reverses once the stress has passed,” Krishnaswamy says. But if your asthma symptoms are keeping you home from work or school on a regular basis, the condition is likely getting worse.

What to Do If Your Asthma Is Getting Worse

If you experience any of these symptoms of worsening asthma, call your doctor so he or she can make changes to your asthma management plan. “Your physician will make sure you are on an appropriate asthma management regimen and give you the right rescue medications to use when your symptoms get worse,” Dr. Rosenberg says. He or she may also change your medication types, dosages, or frequencies, as needed.

In addition, everyone with asthma should have an action plan for controlling flares and exacerbations, she says. The Centers for Disease Control and Prevention offers sample asthma action plans online.

Remember, if you have chronic asthma, it’s important to stick to your treatment regimen, no matter how good you feel. “Too often, people will ease up on their controller medications and use their rescue inhaler instead,” Krishnaswamy says. “But if you have persistent asthma, you need persistent therapy.”

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8 Signs Your Asthma Is Getting Worse

If you’re experiencing asthma symptoms regularly or your symptoms are getting worse despite treatment, you may need a more effective treatment method.

Severe asthma is often harder to control than mild to moderate asthma. It may require higher dosages and more frequent use of asthma medications. If you’re not managing it properly, severe asthma can be dangerous and even life threatening in some cases.

It’s important that you’re able to recognize when your condition isn’t properly managed. Doing so can help you take steps to find a more effective method of treatment.

Here are eight signs that your severe asthma is getting worse and what to do next.

If you’ve been having to use your quick-relief inhaler more often than usual, or you’ve started to feel like it doesn’t help as much when you do use it, your severe asthma may be getting worse.

It can be hard sometimes to keep track of exactly how many times you use your inhaler during a given week. If you suspect your usage is increasing, you may want to start keeping track in a journal or in a note-taking app on your phone.

Keeping a log of your inhaler usage can also help to identify what may be triggering your severe asthma symptoms. For example, if you mainly use your inhaler after being outdoors, an environmental trigger like pollen may be causing your asthma to flare up.

Another sign that your severe asthma may be getting worse is if you’re coughing or wheezing more often than usual.

Talk with your doctor about adjusting your treatment plan if you constantly feel like you’re about to cough. Also speak with them if you find yourself wheezing with a whistle-like sound more than once a day.

If you’re ever jolted awake in the middle of the night by a fit of coughing or wheezing, you may need to modify your asthma management plan.

Properly managed asthma shouldn’t wake you up from sleep more than 1 or 2 nights a month. If you’re losing sleep due to your symptoms more than this, it may be time to discuss treatment modifications with your doctor.

Your peak flow readings measure how well your lungs are functioning at their best. This is usually tested at home with a handheld device called a peak flow meter.

If you’re a peak flow meter user, and your peak flow levels drop below 80 percent of your personal best, it may be a sign that your severe asthma is poorly managed.

Another sign that your asthma is getting worse is if your peak flow reading varies greatly from day to day. If you notice low or inconsistent numbers, contact your doctor as soon as possible.

Another sign that your asthma is getting worse is if you start to feel out of breath even when you’re not doing anything strenuous.

It’s normal to feel winded after exercising or climbing more stairs than you’re used to. But stationary activities like standing, sitting, or lying down shouldn’t cause you to lose your breath.

Minor chest tightness is common for people with asthma. But frequent and intense chest tightness can mean your severe asthma is getting worse.

Chest tightness is often the result of the muscles surrounding your airways contracting in reaction to asthma triggers. It may feel as though there’s something squeezing or sitting on top of your chest. If you experience unusually intense chest tightness, particularly while sitting still, speak with your doctor.

If you find it difficult to speak a full sentence without pausing to take a breath, you should make an appointment with your doctor. Trouble speaking is usually the result of an inability to take enough air into your lungs to allow you to let it out at the slow, deliberate rate required for speech.

You may notice that you’re unable to keep up with any type of physical activity if your severe asthma symptoms are getting worse.

Talk with your doctor if you find yourself coughing or using your inhaler more often at the gym or during activities like jogging or playing sports.

If your chest tightens more often during everyday physical activities like climbing the stairs or walking around the block, you may need to change your medications to get your symptoms under control.

Am I having an asthma attack?

The signs of worsening asthma can be uncomfortable but should still be easy enough to manage until you’re able to see a doctor.

If you experience a more sudden and severe onset of symptoms that deviate from your normal symptoms, you may be having an asthma attack or exacerbation. This can include extreme difficulty breathing, wheezing, chest tightness, cough, and shortness of breath, among other symptoms.

If you or someone around you experiences symptoms of an asthma emergency, call 911 or your local emergency number, or go to the nearest emergency department.

Was this helpful?

If you think that your severe asthma is getting worse, the first thing you should do is make an appointment to see your doctor. Before your appointment, write down a list of the symptoms you’ve been experiencing and bring it with you to review together.

Your doctor will likely listen to your chest and check your peak flow levels to see how they compare with your previous readings. They may also ask you about your routine for taking your asthma medication. Plus, they may check to make sure you’re using the proper technique with your inhaler.

If you’ve been using your inhaler properly and still experience severe symptoms, your doctor may change your treatment plan. They may increase the dose of your inhaler or prescribe an add-on treatment like a leukotriene receptor antagonist (LTRA) tablet or biologic therapy.

In some cases, your doctor may also prescribe a short “rescue” course of oral steroid tablets. These can reduce the amount of inflammation in your airways.

If your doctor does change the dosage of your current medication or prescribe an add-on treatment, consider scheduling a follow-up appointment in 4 to 8 weeks to ensure that your new treatment plan is working.

It’s important to be able to spot the warning signs that your severe asthma is getting worse. This is a vital part of managing your symptoms and may help to prevent a potentially life-threatening asthma attack.

Do your best to avoid your asthma triggers, and don’t be afraid to contact your doctor if you think your current treatment isn’t working as well as it should be.

Bronchial asthma: how to avoid exacerbation

Bronchial asthma (BA) is one of the most common diseases affecting millions of people. It is manifested by wheezing, shortness of breath, a feeling of congestion in the chest, cough. These symptoms – asthma attacks – require immediate attention. As such help, many patients use short-acting bronchodilators in the form of inhalations, which, indeed, quickly eliminate attacks and alleviate symptoms, but do not cure the disease itself and even mask the worsening of its course.

Patients generally find that the ¹ emergency inhaler helps control their asthma, so they often do not see the need for additional treatment. However, the opposite happens: the number of symptoms and attacks increases, which means that bronchial asthma is not controlled ² and an exacerbation can develop – a condition when emergency inhalers and other conventional therapy no longer help to alleviate the patient’s condition. The severity of symptoms and the frequency of attacks is rapidly increasing, and the patient is forced to urgently consult a doctor, call an ambulance, and sometimes go to the hospital. Severe exacerbations can result in the death of the patient, even with enhanced therapy.
Thus, the use of an emergency inhaler more than twice a week is an alarm signal and a reason to evaluate your dependence on it in order to consult a doctor in a timely manner to select the appropriate modern therapy that will reduce the risk of severe exacerbations and death from bronchial asthma.

Why is emergency inhaler not enough anymore?

Previously, it was believed that the mechanism of development of bronchial asthma is based on bronchospasm, therefore, for 50 years, emergency short-acting inhalers were the basis of therapy. They quickly alleviate the symptoms, however, without having an anti-inflammatory effect, they do not affect the main cause of the development and progression of AD – chronic inflammation.
Now experts have concluded that monotherapy with short-acting emergency inhalers is dangerous ¹ for patients with bronchial asthma: the use of more than three short-acting emergency inhalers per year increases the risk of asthma exacerbations ³ , more than twelve is associated with an increased risk of death from this disease ³ .

Asthma care: a new approach

Since 2007, the Global Initiative on Asthma (GINA) has been actively seeking new ways to treat asthma in order to reduce the risk of asthma-related exacerbations and death.
Currently, the medical community has radically revised the principles of bronchial asthma treatment: modern therapy should not only eliminate symptoms, but also reduce the risk of exacerbations in the future . Now, for the basic therapy of patients with any severity of bronchial asthma, international and Russian clinical guidelines recommend prescribing anti-inflammatory drugs, primarily inhaled glucocorticosteroids (IGCS), using them as monotherapy or in combination with fast-acting bronchodilators of long or short action. For the relief of symptoms, it is primarily recommended to use fast-acting bronchodilators in combination with ICS (anti-inflammatory bronchodilators).

The current treatment of choice for asthma of any severity is an on-demand anti-inflammatory bronchodilator, with or without supportive care (depending on physician prescription). Exact adherence to all doctor’s recommendations reduces the risk of asthma exacerbations ^4.

Check if you are dependent on emergency inhaler

Sources :
1. Global Initiative for Asthma. GINA 2020. [Electronic resource], 08/21/2020. URL: https://ginasthma.org.
2. Schatz M et al. J Allergy Clinic Immunol. 2006;117:995-1000.
3. Stanford RH et al. Ann Allergy Asthma Immunol. 2012;109:403-407.
4. Beasley R et al. N Engl J Med. 2019 May 23;380(21):2020-2030
5. Partridge MR et al. BMC Pulm Med. 2006;6:13.
6. Chuchalin A. G. et al. International Journal of COPD, 2014:9963–974
7. Federal clinical guidelines for the diagnosis and treatment of bronchial asthma. 2019. Russian Respiratory Society. [Electronic resource], 08/21/2020. URL: http://spulmo.ru/obrazovatelnye-resursy/federalnye-klinicheskie-rekomendatsii/
8. Arkhipov V.V. et al. Pulmonology. 2011;(6):87-93.

Exacerbation of bronchial asthma

Asthma exacerbations are episodes of progressive deterioration characterized by cough, wheezing, feeling of heaviness in the chest, difficult breathing, weakness, tachycardia.

The causes of exacerbations are usually the ineffectiveness of the basic treatment or the impact of adverse factors. For any form of asthma other than very mild intermittent, inhaled glucocorticoids should be taken continuously daily until remission is achieved.

The dose of anti-inflammatory drugs should be selected by a doctor depending on the severity of asthma, the goal of treatment is to achieve a stable remission with minimal asthma symptoms and a qualitatively full life of the patient. If asthma treatment is chosen incorrectly, the doses of basic anti-inflammatory drugs are insufficient, or the patient inaccurately follows the doctor’s recommendations, independently reducing the doses of drugs or using the inhaler incorrectly, then stable remission will not be achieved, there is a threat of frequent exacerbations.

The following factors can provoke a worsening of asthma:

1. exposure to an allergen,
2. infection: viral or bacterial;
3. taking certain medications:
4. inhalation of chemicals that irritate the respiratory tract;
5. physical activity;
6. meteorological factors,
7. nervous stress.

Deterioration usually worsens over hours or days. Patients should know how to recognize an incipient exacerbation in order to consult a doctor in time and begin treatment. Symptoms of early exacerbation are: deterioration in sleep, irritability, decreased tolerance to physical exertion, the appearance of a cough, a feeling of heaviness in the chest. An important symptom of an incipient exacerbation is the appearance or increase in nocturnal asthma attacks, which indicates an increase in inflammatory changes in the bronchi. An important sign of deterioration is also an increase in the dose of inhaled bronchodilators. In some patients whose exacerbation is caused by the addition of an infection, signs of exacerbation may be an increase in the amount of sputum and a change in its color to yellow.

If the patient has a peak flowmeter and he regularly measures his indicator of bronchial patency – the peak exit rate, then it is possible to record a decrease in PEF below his individual norm, indicating the onset of an exacerbation of the disease. Here you can remind patients about the “zone system” and adequate correction of treatment.
“Yellow zone” means that an exacerbation may occur and you need to see a doctor to correct the treatment. The “red zone” indicates a more serious condition, this is an alarm signal. Frequent hitting the “yellow zone”, or getting into the “red zone” indicates the ineffectiveness of treatment in the “green zone”. After the exacerbation is eliminated, it is necessary
review the plan for basic drug treatment, as well as environmental control measures. Treatment of an exacerbation should be started as early as possible, under the supervision of a physician, and with regular examination of bronchial patency.

It is necessary to start treatment with an increase in the dose of the basic drug with preliminary inhalation of sympathetics. With insufficient effectiveness of such treatment, the doctor decides on the appointment of theophylline drugs.

If there is no improvement, the doctor prescribes tableted glucocorticoids or refers the patient to a hospital. If the patient has a severe course of asthma, and he constantly takes tableted glucocorticoids, then during the period of exacerbation their dose should be increased.

Causes of attacks in patients with asthma are not completely clear, these are activation of the inflammatory process at night, accumulation of sputum in the distal bronchi, increased tone of the vagus nerve at night, and contact with an allergen. The most common allergen – house dust – contains the remains of insects, bacteria, fungi, food remains, human and animal dander, as well as an important component – the house mite, which is the main allergen. Carpets, upholstered furniture, woolen things, pillow feathers contain a large number of mites. Studies have shown that adults and children with mild asthma improve after contact with house dust children is stopped.

The following rules should be followed to reduce the allergic reaction of an asthma patient:

• pack mattresses and pillows in allergen-impervious materials.
• bedding should be washed weekly at 55°C;
• During the day, the bed should be covered with a bedspread so that dust does not accumulate on the bed.
• do not sleep on upholstered furniture;
• carpets must be removed from walls and floors;
• reduce the humidity in the room to less than 50%;
• the bedroom should have a minimum of furniture and no bookshelves
• Curtains should be of lightweight material and washed frequently;
• Clothes must be put away in the closet with the closet doors closed tightly.
• it is necessary to carry out frequent wet cleaning in the bedroom, incl. and under the bed
• dust should be washed with a damp soft cloth that collects but does not disperse dust in the air;
• do not store children’s toys in the bedroom;
• Pets are not allowed in the bedroom.

For the prevention of nocturnal attacks, it is recommended to inhale an inhaled glucocoticoid at bedtime, if necessary in combination with a sympathomimetic.

Patients who have a large amount of sputum are recommended to inhale a bronchodilator before going to bed, then after 15-20 minutes, an expectorant solution should be inhaled using an ultrasonic home inhaler. It can be physiological saline, alkaline mineral water, 2% soda solution, etc. After that, take a drainage position and cough.

A patient with asthma who suffers from nocturnal attacks of suffocation should have a thermos filled with hot water or an infusion of expectorant herbs on the bedside table.