Asthma

Asthma is caused by inflammation and increased sensitivity of the bronchi, the small tubes in the airways that carry air in and out of the lungs. When an irritant enters the lungs the airways become narrow, the muscles around them tighten and they produce more than usual sticky mucus.

Long-term inflammation of the airways can lead to more permanent or chronic asthma, and the condition is known to run in families.

Episodes of increased shortness of breath are often triggered by allergic reactions to irritants such as house dust mites, animal fur, pollen, tobacco smoke and often to particles and chemicals found in the work environment.

Other related allergic conditions such as eczema or a food allergy can also be to blame. Read more at allergy testing
Other triggers can include:

• Chest infections often caused by cold and flu viruses.
• Exercise.
• Emotional factors such as stress or laughing.
• The climate: cold air or a sudden change in temperature; a windy day; poor air quality; and hot, humid days.
• Some anti-inflammatory drugs such as aspirin and ibuprofen can trigger asthma for some people.

If the doctor thinks your symptoms indicate asthma, a number of tests can be carried out, the three main ones being:

• The peak expiratory flow rate test

This is used to measure how fast you can blow air out of your lungs in one breath. You may be given a small hand-held device called a peak flow meter to take home and a diary to record measurements of your peak flow morning and evening and symptoms to help you be aware of when your asthma is getting worse.

• Spirometer

This is a breathing test to assess how well your lungs work and show if your airways are obstructed. The spirometer is a machine that measures the volume of air you breathe out in one second, plus the total amount of air you breathe out whenever you exhale.

You are then given a medicine to open up your airways to see if this improves your breathing. If the reading after taking the medicine is much higher, this can confirm the asthma diagnosis.

• Airway responsiveness tests

Following an initial spirometer test, a common asthma trigger may be used to discover how your airways react. After exercising or breathing in a dry powder, the patient takes the spirometer test again to measure how the lungs have responded to the trigger.

If the measurements show a significant decrease, the diagnosis is likely to be asthma.

• When the doctor has made a diagnosis, other tests are usually made to identify triggers. Skin or blood tests can help discover whether specific allergies are responsible, and a sputum sample will check if you have inflammation in the lungs. Read more at Sputum

The treatment of asthma involves a combination of medicines, particularly inhalers (puffers). The various inhalers must be taken with the correct technique for the medicine to reach the lungs and be effective. When the medication is taken correctly and regularly, symptoms that are often worse at night, (such as coughing or a tight chest), can be effectively controlled, so you should breathe easier and sleep better.

However, identifying and then avoiding potential asthma triggers is important in preventing attacks: at the South West Sleep Clinic we offer advice on the lifestyle changes you can make to help prevent attacks and to help you sleep.

Giving up smoking and avoiding exposure to tobacco smoke significantly reduces the severity and frequency of asthma attacks. Smoking can also reduce the effectiveness of asthma medication.

Exercise is good for you

Giving up exercise would undoubtedly bring more health problems, but do plan your exercise in advance – use your inhaler 10-15 minutes before you exercise and again when you finish; warm up properly and plan short-burst activities rather than endurance exercises; exercise in warm environments, such as a swimming pool.

It is important that everyone with a long-term condition such as asthma should have a yearly jab each autumn to protect against flu, as well as a one-off vaccination to protect against the serious chest infection pneumococcal pneumonia.