Asthma is a common, long-term condition that affects a person’s airways. The Centers for Disease Control and Prevention (CDC) estimate that 8.1 percent of adults and 8.4 percent of children in the United States have asthma.
This article explores the symptoms and treatments at each asthma stage.
What are the stages of asthma?
Asthma can be either intermittent or persistent. When symptoms arise occasionally, a person has intermittent asthma. Symptoms of persistent asthma occur more often.
The four main asthma stages are:
- intermittent
- mild persistent
- moderate persistent
- severe persistent
These classifications are for people with asthma who do not take long-term controller medication.
The symptoms of asthma are the same at every stage, but their frequency and severity differ.
The main symptoms of asthma include:
- coughing
- wheezing
- tightening of the chest
- breathing difficulties
We explore each asthma stage in detail below.
1. Intermittent asthma
This is the least severe type. Doctors sometimes call it mild intermittent asthma.
For a person with intermittent asthma:
- symptom frequency: Symptoms may occur about 2 days a week or less often.
- nighttime awakenings: Symptoms may wake a person two or fewer times each month.
- severity: Symptoms will not interfere with regular activities.
- lung capacity: The result of a forced expiratory volume (FEV) lung capacity test is usually 80 percent or more of normal values.
- inhaler use: A person will need to use a short-acting beta agonist (SABA) inhaler to control symptoms on 2 or fewer days each week.
Severe persistent asthma is the most serious form. For a person with this type of asthma:
- symptom frequency: Symptoms will arise throughout the day.
- nighttime awakenings: A person will likely be woken by symptoms every night.
- severity: Symptoms will significantly limit regular activities.
- lung capacity: The result of a forced vital capacity lung function test tends to be less than 60 percent of normal values.
- inhaler use: A person will need to use a SABA inhaler to control symptoms several times a day.
As symptoms of moderate persistent asthma become more severe, the preferred controller medications change.
Options for controller medications for moderate to severe persistent asthma include:
- a medium-dose ICS plus a LABA, which is the preferred method
- a medium-dose ICS plus an LTRA
- a medium-dose ICS plus theophylline, which is a less common, less effective choice
People can also use a SABA inhaler when needed to relieve symptoms.
Severe persistent asthma: Step 5
If step 4 medications do not reduce the symptoms of severe persistent asthma, the doctor may prefer to combine a high-dose ICS and a LABA.
They may also consider omalizumab (Xolair) for people with allergies.
Severe persistent asthma: Step 6
If symptoms of severe persistent asthma have not responded to the previous treatments, the doctor may prescribe a high-dose ICS alongside both a LABA and an oral corticosteroid.
They may also consider omalizumab for people with allergies.
Outlook
Asthma is a long-term condition that affects the airways. People can often manage symptoms well with the right treatments.
Doctors classify four main stages of asthma, and each has its own treatment options. These change as symptoms increase in severity. A good doctor will work with a person to find a treatment plan that manages their symptoms effectively.
Long-term asthma management also involves avoiding triggers and reducing exposure to allergens. Stress management techniques and regular exercise to strengthen the lungs can also help.
Smoking is a major asthma trigger, and quitting will improve a person’s symptoms. The doctor can provide support to anyone who wants to make this change.
Making lifestyle modifications and following a treatment plan are the best ways that a person with asthma can improve their quality of life.
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