Asthma – adults
Asthma is a common lung condition that affects the breathing tubes (airways) that carry air in and out of your lungs. Asthma causes wheeze and cough, and can make it difficult to breathe. New Zealand has one of the highest rates of asthma in the world, affecting up to 1 in 4 children and 1 in 6 adults.
This page focuses on asthma in adults. For information about children with asthma, see asthma in children.
- If you have asthma, your airways are sensitive and react to certain triggers such as allergens (substances that cause an allergic reaction), viruses, cold or humid weather, exercise and air pollutants such as cigarette smoke.
- These triggers cause your air passages to tighten up, swell on the inside (become inflammed) and produce more mucus.
- As a result, the airways become narrower, making it difficult for air to move into your lungs, and even more difficult for air to move out.
- Learning about asthma, what causes it and how it is treated can help you avoid triggers and keep your symptoms under control.
- Seek urgent medical help if you have severe asthma symptoms.
What causes asthma?
Asthma is thought to be caused by a combination of genetic and environmental factors.
Asthma and allergies are closely linked. About 70 to 80% of asthma in New Zealand is associated with allergies. Often people with asthma also have eczema (allergic skin rash) or hay fever, or have close family members who have asthma, eczema or hay fever.
- The tendency for these 3 conditions to occur together is known as atopy.
- If you are atopic, allergies can be a trigger for your asthma.
Factors in our environment thought to have a role in causing asthma include:
- air pollution (such as exposure to tobacco smoke)
- workplace chemicals.
What are the symptoms of asthma?
Asthma is ongoing and your symptoms may come and go.
Common symptoms of asthma include:
- difficulty breathing, feeling out of breath or as though you can't get enough air out of your lungs
- a tight feeling in your chest like something is squeezing or sitting on your chest
- wheezing (a whistling, musical or squeaky noise in your chest)
- a cough, which can be worse at night or in the morning.
If you have any of these symptoms, see your doctor so they can assess if this is due to asthma or something else.
Severe asthma symptoms
From time to time, your symptoms may get gradually or suddenly worse. Seek urgent medical help if you have any of these severe symptoms:
- it is difficult to talk
- your lips and/or fingernails have a bluish tinge
- your nostrils flare when you breathe
- the skin around your neck and/or ribs pulls in when you breathe
- your heart is racing
- it is hard to walk.
For severe asthma symptoms, you should use your reliever inhaler immediately and call an ambulance on 111 or go to your nearest Accident & Emergency clinic.
What triggers asthma symptoms?
Learning what triggers your asthma and finding ways to avoid or reduce the effects is an important part of managing your asthma.
Common asthma triggers include:
- house dust mite
- infections of the airways, such as colds and flu
- pollen or mould
- cigarette smoke
- weather, such as change in temperature, cold weather or humid weather
- stress and high emotion
- chemicals that irritate the airways, such as sprays, perfumes, cleaning fluids
- some medications.
How is asthma diagnosed?
In most cases, asthma can be diagnosed from:
- your history (describing your asthma symptoms now and in the past)
- listening to your breathing with a stethoscope
- checking how your lungs are working with breathing tests, such as a peak flow meter (a device that measures changes in your breathing over the day) and spirometry (a machine that measures lung function).
In some cases, more detailed testing may be required, such as a skin-prick test to test for allergens or, rarely, a chest x-ray to rule out other conditions.
Once a diagnosis is made, your doctor will prescribe the type of medicines you need to take and will set up an asthma action plan. This plan reminds you how to manage your asthma every day and how to recognise and manage your asthma when your symptoms get worse.
How is asthma treated?
While asthma cannot be cured, the correct use of medication combined with other self-care measures means that symptoms can be well controlled in most people.
The main aims of asthma treatment are to:
- keep symptoms under control
- prevent asthma attacks or exacerbations (sudden worsening of symptoms)
- keep lungs healthy as possible
- stop asthma from interfering with your daily activities
- help you enjoy a full and active life.
There are many different types of asthma medicines and sometimes you will have to take more than one. These are usually puffers or inhalers but may also be tablets.
The main groups of asthma medicines are:
- Symptom relievers
- These provide short-term relief by relaxing the muscles around your airways, opening up your airways and making it easier to breathe.
- Common relievers include salbutamol and terbutaline.
- Asthma preventers
- These are taken every day to prevent symptoms from developing.
- They do not provide quick relief of asthma symptoms.
- The two main types of preventers commonly used are:
- steroid preventers
- long-acting bronchodilator preventers.
- Prednisone (steroid tablets)
- These are usually taken for very severe episodes of asthma and work more intensely to reverse the swelling of the airways.
Read more about asthma medications.
- Keep an eye on your symptoms. If you are getting wheezy more than two times a week, it may mean your asthma is not well controlled. See your doctor for a check up.
- If you have symptoms of hay fever (allergic rhinitis), such as nasal congestion, runny nose, sneezing, itchy eyes, talk to your doctor about medication to treat these symptoms, such as antihistamines or nasal steroid sprays. Treating hay fever can improve your asthma symptoms.
What self-care can I do with asthma?
There are many things you can do to improve how well your asthma is controlled. By working with your doctor or nurse to create an asthma action plan, you can reduce how bad your asthma symptoms are and how often you have them.
- Understand your asthma and learn to recognise your symptoms and your triggers.
- Take your prescribed medication – especially your preventer – every day, regardless of whether you have asthma symptoms or not.
- If you smoke, try to quit. Try to keep clear of anyone else who smokes and of any other fumes.
- Ask your doctor about managing allergies if these are a known trigger for you.
- Use the asthma under control test to check if your asthma is well controlled or not.
- Use a peak flow meter to take and record regular readings to check that your asthma is under control.
- Keep active – physical activity improves how well your lungs work, and people who are fit usually find they have less asthma and cope better when they do have it.
- Visit your asthma team (your GP, your practice nurse and your pharmacist) regularly. They will review the medications you are taking and can teach you how to use your inhaler properly so you get the most benefit.
- Get a seasonal flu jab – see your doctor about a free flu vaccination each autumn to reduce your risk of flu. If you avoid the flu, it reduces your risk of serious asthma.
- Keep your dust-mite allergy under control.
Read more about an asthma action plan.
Living with asthma Asthma & Respiratory Foundation NZ
Breathe Better September Asthma & Respiratory Foundation NZ
Family health history Genetic Science Learning Centre, University of Utah, USA, 2015
Rhinitis and asthma – Combined allergic rhinitis and asthma syndrome World Allergy Organization
Tools and resources Centre of Excellence in Severe Asthma, Australia, 2018
Source: Health Navigator