Asthma is a disease with many different symptoms that occur in many different ways and combinations. Some people with asthma only have symptoms periodically and they are generally mild. Others have symptoms more often and may also experience symptoms that are more severe. Others still have symptoms every day or symptoms that are so severe they are life-threatening.

The most common asthma symptoms include:

• Coughing, especially at night
• Wheezing
• Shortness of breath
• Chest tightness, pain, or pressure

The good news is, most people with asthma will begin to have these and other symptoms early enough to seek appropriate treatment and stop a severe attack from occurring. Symptoms that indicate the onset of an asthma attack include:

• Frequent cough, particularly at night
• Shortness of breath or easily losing your breath
• Tiring easily or feeling weak while exercising
• Wheezing or coughing after exercise
• Feeling tired, upset, moody, or grouchy
• Experiencing signs of a cold or allergies
• Sleeping difficulties
• Lung function changes as measured by a peak flow meter

When early symptoms occur, follow your doctor’s instructions for changing and/or increasing your medications. If your doctor has prescribed the proper medications, this will usually stop an attack from occurring or getting worse.

How can you know when an attack is approaching the danger zone? If you’ve had early symptoms of asthma and medication changes haven’t helped—or you have been unable to follow doctor's recommendations on adjusting your doses—you should seek further medical attention if any of the following occur:

• You have a day or nighttime cough that doesn't go away
• You can’t stop coughing
• You experience very rapid breathing
• Wheezing persists
• You experience tightness or pressure in your chest
• You experience ongoing shortness of breath
• The muscles in your neck and chest tighten
• You experience feelings of anxiety or panic
• Your face becomes pale or sweaty
• Your bronchodialator medications don’t provide immediate relief of symptoms
• Your peak flow readings drop markedly (usually less than 50 percent of predicted)

In extremely severe cases, you may also stop wheezing, a condition known as a “silent chest,” your lips or fingernails may turn blue, indicating a lack of oxygen, and you will find it difficult or impossible to talk. These severe symptoms occur when the airways are so tight that air cannot move back and forth and require immediate emergency medical care.