There are many different names used to describe types of asthma, some of these are also referred to as ‘asthma classifications’. They may be used to describe what triggers your symptoms, how often they occur, and how severe they are.
Asthma is a chronic disease which means it is a long-term condition, even if you don’t experience the symptoms all the time. Your symptoms, how bad they are, and how often they occur will determine your asthma management.
To learn the asthma basics, click here
To learn more about asthma symptoms, click here
To learn more about asthma triggers, click here
If you’re struggling with asthma symptoms – trouble breathing, a persistent cough, or tightness in the chest – we suggest you discuss asthma and allergies with your local doctor. They can assist with providing a diagnosis and identifying your triggers.
TYPES OF ASTHMA
When you are diagnosed with asthma, your treating health professional will not necessarily advise that you have a particular type of asthma. They may refer to it as a type of asthma, stage of asthma, level of asthma, or asthma classification – this usually relates to the frequency and severity of your symptoms. Below are four classifications your doctor might use:
- Mild intermittent. Many people have this level of asthma, which doesn’t interfere with daily activities. Symptoms are mild, lasting fewer than two days per week or two nights per month.
- Mild persistent. The symptoms occur more than twice a week — but not daily — and up to four nights per month.
- Moderate persistent. The symptoms occur daily and at least one night every week, but not nightly. They may limit some daily activities.
- Severe persistent. The symptoms occur several times every day and most nights. Daily activities are extremely limited. This is not a diagnosis of ‘Severe Asthma’ this is a different classification of asthma and very difficult to treat.
When you call Asthma Australia, we will look at your asthma in terms of how much it is impacting your life; is it well controlled? Or is it poorly controlled? We also take into account your overall health, lifestyle, other medical conditions which may impact asthma, allergy cross over and wellbeing, as these things can impact your asthma and asthma management. We will also review your medications and ensure you know how to use them and understand what they are for. We look for gaps in your treatment and help you fix them with your doctor’s help.
Most people with asthma should be able to gain and maintain good asthma control. Good asthma control means having all of the following:
- Asthma symptoms no more than twice per week
- Need for reliever medication no more than twice per week
- No night-time asthma symptoms
- No asthma symptoms on waking
- No need for reliever medication
- No restriction of day-to-day activities
- No days off school or work due to asthma
- No asthma attacks or flare-ups
You can check your level of asthma control with a questionnaire like the Asthma Control Test. If you have poorly controlled asthma, speak to your doctor.
Poorly controlled asthma
Poorly controlled asthma means you may be experiencing night-time asthma symptoms, asthma symptoms on waking, needing your reliever medication regularly, your asthma is restricting day-to-day activities; you require time off school or work due to asthma, and/or you have experienced an asthma attack.
If you have poorly controlled asthma, speak to your doctor for an asthma review.
You may have also heard these terms:
- Acute asthma. Acute asthma is often used in a clinical or emergency context to refer to an asthma flare-up or asthma attack when you are experiencing symptoms like shortness of breath, a tight chest, wheeze, or cough.
- Adult-onset asthma. People can be diagnosed with asthma at any age. It is not only a condition that is diagnosed in childhood. Adult-onset is a term sometimes used to refer to people who are diagnosed with asthma in adulthood.
- Allergic and non-allergic asthma. Some people may be diagnosed with allergic asthma, which means their asthma symptoms are caused by allergens (or triggers) such as pollen, dust, food chemicals, and mould. It is more likely if you also have an allergy. We know that up to 80% of people that have asthma also have allergies, learn more here. On the other hand, some people may have non-allergic asthma which means their asthma symptoms are caused by triggers like viruses, air particles from smoke, cleaning products, perfumes, and aerosol products. People with asthma do not have to have allergic or non-allergic asthma. Your triggers may be allergic and non-allergic, for example, both pollen and smoke.
- Asthma-COPD overlap. COPD stands for Chronic Obstructive Pulmonary Disorder. It is a term for a group of progressive lung conditions including bronchitis and emphysema. Some people, particularly older adults, show features of both COPD and asthma – this is referred to as the asthma-COPD overlap. It is more likely in current smokers or people with a smoking history and those over the age of 55. Your doctor may prescribe you different or additional medications.
- Chronic asthma. Asthma is a chronic (long-term) condition that affects the airways in the lungs. Sometimes this term is used to refer to a type of COPD, in this case you may be treated according to guidelines for Asthma-COPD overlap.
- Exercise-Induced Bronchoconstriction. Exercise-Induced Bronchoconstriction (EIB) (previously called Exercise-Induced Asthma (EIA), is a temporary narrowing of the lower airways, occurring after vigorous exercise. It may occur in people with asthma or in people without asthma. In people with asthma who experience EIB, exercise is an asthma trigger. This means that for some people during vigorous exercise the small airways in the lungs become red, swollen, and may become blocked with mucus. This narrows the airways and makes it more difficult to breathe. Not everybody that has asthma has EIB and some people with EIB may not have asthma. Find out more here.
- Occupational asthma. Occupational asthma refers to new-onset asthma, which is caused by workplace triggers such as chemicals, animal proteins, fumes, gases, dust, etc.
- Work-exacerbated asthma. Work-exacerbated asthma is when your asthma control worsens due to workplace triggers such as chemicals, animal proteins, fumes, etc.
- Bronchial asthma. Bronchial asthma, which is another common form is a pattern of periodic attacks of wheezing alternating with periods of quite normal breathing. However, some people with bronchial asthma alternate between chronic (long-term) shortness of breath and episodes in which they feel even more breathless than usual.
- Nocturnal asthma. Nocturnal asthma is when your symptoms worsen at night, possibly caused by triggers such as dust, dust mites, pet dander from mattresses, bedding, soft toys, or cold air at night time, etc. Nocturnal asthma can also be from heartburn or your sleep cycle.
- Cough-variant asthma (CVA). Cough-variant asthma (CVA) is where you have a persistent dry cough but very few other asthma symptoms. This is also often referred to as an ‘asthma cough’ but just because you may not experience other symptoms like shortness of breath or wheezing, does not mean that it is less serious. You can still experience an asthma flare-up or attack.
- Reactive airways. People with reactive airway disease have bronchial tubes that overreact to some sort of irritant. The term is mostly used to describe a person who is wheezing or having a bronchial spasm, but who has not yet been diagnosed with asthma.
- Seasonal asthma. When your asthma flares up due to seasonal triggers. For example, if you are only triggered by pollens in spring or colds and flu which are more present in winter months. If you have no asthma symptoms at all during other parts of the year, your doctor may prescribe a preventer medicine only to be taken daily during (and in the lead up to) these seasons.
- Viral asthma. When your primary trigger is having a virus such as a cold, upper respiratory tract infection or influenza.
- Thunderstorm asthma. You may have heard about thunderstorm asthma after the 2016 Epidemic Thunderstorm Asthma Event – during which, 10 people sadly lost their lives. Thunderstorm asthma refers to the phenomenon where large numbers of people experience asthma symptoms triggered by an uncommon combination of high grass pollen levels and a certain type of thunderstorm. The wind before the storm causes pollen grains from grasses to be swept up in the wind and carried long distances. Some pollens can burst open and release tiny particles that are concentrated in the wind just before the thunderstorm. These small particles get further into the airways and can trigger asthma symptoms. Thunderstorm asthma isn’t a specific type or diagnosis of asthma, but it is a trigger for some people with asthma and can be very serious. If grass pollen is a problem for you then thunderstorms in spring and summer may also affect you. Read more about thunderstorm asthma here.
- Diagnosed ‘Severe asthma’ People with severe asthma experience the same symptoms as people with mild to moderate asthma, however, these asthma symptoms may be more intense or occur more often. Severe asthma is a diagnosis made if your symptoms remain uncontrolled despite high-dose treatment or can only be controlled with continual high-dose treatment. Less than 4% of adults with asthma have severe asthma. Learn more about severe asthma here.
- Difficult to treat asthma: difficult-to-treat asthma is defined as asthma that remains uncontrolled despite continual high-dose treatment. People with severe asthma are a subgroup of those with difficult-to-treat asthma, but not all patients with difficult-to-treat asthma have severe asthma. Difficult-to-treat asthma includes asthma that is uncontrolled due to suboptimal adherence, inappropriate or incorrect use of medicines, environmental triggers, or comorbidities. Patients whose asthma control improves rapidly after such problems are corrected are not considered to have severe asthma.
- Refractory or “treatment-resistant” asthma. Refractory means “stubborn” or “unmanageable” and these terms are sometimes used to describe severe asthma. However, the introduction of monoclonal antibody therapies has demonstrated that significant improvements can be seen in asthma that was previously termed ‘refractory’.
- Brittle asthma. This term is another term sometimes used for severe asthma.
- Silent asthma: This term is sometimes used to describe people with asthma who do not tend to wheeze. It is not necessary to have an audible wheeze to be diagnosed with asthma. Note that during an asthma attack, a silent chest indicates that the episode is life-threatening as there is no longer enough air moving in and out to produce a wheeze
Page updated 29/3/21