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Controlling Severe Asthma

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8 Ways to Make Severe Asthma More Manageable

Doctor William C Lloyd Healthgrades Medical Reviewer
Medically Reviewed By William C. Lloyd III, MD, FACS
Written By Erin Azuse, RN on February 23, 2022
  • smiling female patient speaking with female doctor
    Take charge of your severe asthma.
    If you have severe asthma, you know it can be challenging. You may have a hard time keeping your asthma well-controlled, even when it seems like you’re doing everything right. But that doesn’t mean you should just throw in the towel and give up. There are things you can do to make living with severe asthma more manageable.
  • Woman and doctor
    1. Follow your asthma action plan.
    You should have a written plan that was developed with your doctor to help you manage your asthma. (If you don’t, ask your doctor for one!) Your plan should list all of your medications, explain what to do if you start to experience symptoms, and identify when you need to call your doctor or go to the emergency room. Understand the difference between your long-term “control” medications that should be taken daily versus your short-term “rescue” medication to be used when your asthma symptoms flare up. Sticking to your action plan is crucial, so ask your doctor if you have any questions.
  • woman-using-inhaler-outside
    2. Make sure you are taking your medications as directed.
    Don’t miss doses of your asthma medication. Place your daily control medications in a visible place so you don’t forget to take them, like next to your coffee maker or your toothbrush, and be certain to have your rescue inhaler on you at all times. It’s believed many people with asthma do not use their inhaler correctly, and therefore, do not get the full benefit of the medication. For this reason, consider demonstrating your inhaler use for your doctor. This also applies to the use of medical devices like spacers or nebulizers that might be used to administer asthma medication.
  • Woman taking pill
    3. Understand how systemic steroids may be used in severe asthma treatment.
    If you have a severe asthma attack, you may need to be treated with intravenous steroids in the hospital, or your doctor may prescribe a short burst of oral steroids, like prednisone, to help calm down the immune system and reduce swelling in your airways. Steroids can be very helpful when taken short term, but can cause side effects like fluid retention, high blood pressure, and high blood sugar. Long term use of steroids is generally avoided, but may sometimes be needed at a low dose. If you find you are needing oral steroids frequently, this may suggest your severe asthma is not being controlled.
  • dusting-near-bed
    4. Identify your triggers and find ways to avoid them.
    Certain things can “trigger” your airways to swell, leading to an asthma attack. This can include smoke, animal dander, dust, mold, weather changes, and even stress. With severe asthma, it’s important to identify your triggers so you can do your best to eliminate them. Think about your home and your day-to-day routine. For example, using a dehumidifier or running the air conditioner may help decrease mold; removing your carpet may help get rid of dust and animal dander.
  • Sick woman taking her temperature
    5. Keep illnesses at bay.
    When you have severe asthma, even a mild cold can cause your asthma to flare up. You are also more likely to develop complications, like pneumonia, if you get sick with a respiratory virus. While it’s impossible to avoid every virus and bacteria in the environment, you should try to minimize your risk. Simple things like washing your hands frequently and keeping your hands away from your eyes, nose and mouth can help. Talk to your doctor about getting a flu shot and possibly the pneumonia vaccine too. Try to avoid contact with anyone you know is sick. Help boost your immune system by eating a nutritious diet and getting plenty of sleep.
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  • woman-standing-on-weight-scale
    6. Monitor your overall health.
    Live a healthy lifestyle. Be aware that if you are overweight, asthma symptoms tend to be exacerbated. If your doctor approves, engaging in regular physical activity, like walking or swimming, can be beneficial for your lungs. Get regular check ups since certain medical conditions tend to occur along with asthma. Some common ones include: sinus infections, gastroesophageal reflux disease (GERD), depression, and sleep apnea. Often, when these co-existing conditions are properly treated, your asthma will improve as well.
  • writing-in-diary
    7. Write it all down.
    Our memories can play tricks on us, so the best way to keep track of how well your asthma is being managed is to put it down on paper. Keep track of when your symptoms appear and make a quick note when you reach for your rescue inhaler. Use a handheld peak flow meter to measure how well you are moving air out of your lungs and document those numbers. All of this will provide you and your doctor with a clear record of any improvements or worsening of your severe asthma.
  • Female doctor consoling a patient
    8. Talk to your doctor about new treatment options.
    According to a study done in Canada, many patients with severe asthma reported being unaware of some of the newest treatments available. Don’t be afraid to ask your doctor about other options for treatment if you aren’t finding the relief you need.  For example, biologics are emerging as a new form of treatment for severe asthma. They work on certain parts of the immune system that are involved in asthma attacks and can be very effective as an additional control medication for some people. Additionally, a recently approved procedure called bronchial thermoplasty reduces airway constriction and appears to provide significant relief for some severe asthma sufferers.
Severe Asthma Management | Asthma Tips

About The Author

Erin Azuse, RN, has been a registered nurse for 18 years, working in neonatal intensive care and pediatrics. She specializes in creating educational materials for patients, consumers, and other healthcare providers, as well as content marketing for private physicians’ practices, medical device companies, and nursing schools.
  1. Asthma- How is Asthma Treated and Controlled? National Heart, Lung, and Blood Institute.
  2. Asthma Triggers and Management. American Academy of Allergy Asthma and Immunology.
  3. Severe Asthma: The Canadian Patient Journey. Asthma Society of Canada.
  4. So You Have Asthma: A Guide for Patients and Their Families. National Heart Lung and Blood Institute. 
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Last Review Date: 2022 Feb 23
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