I’ve been given a steroid inhaler for asthma last week. I did peak flow recordings for 2 weeks with a Salbutamol inhaler and the GP prescribed me the new inhaler based on the results.
I haven’t slept more than a couple of hours a night for the last 3 weeks because I keep being jolted awake gasping for air. It feels like I’m trying to breathe through a straw when I’m trying to sleep. Even when I prop myself up.
I’ve been on the steroid inhaler for 5 days now but I’m still needing to use the Salbutamol inhaler 3 or 4 times a day (2 puffs) because of chest tightness and shallow breathing. It doesn’t feel like it lasts long. I use a spacer and hold my breath for 10 seconds.
I honestly don’t feel any better. I’m exhausted, my chest feels tight and I’m struggling to get through sentences during the day often because of how breathless I am.
Should I expect to feel different by now? Should I be seeking more care or just keep going and hope the steroid inhaler actually helps soon?
Written by
FernLeaves
To view profiles and participate in discussions please or .
Thank you for your reply! I’ve got an appt with the GP tomorrow morning now, and I’ll ring 111/999 if it gets worse. It’s always mornings and night that the symptoms are awful. It’s really not too bad right now. So confusing! My peak flow reading was fine (though lower than my personal best) even when I felt really bad earlier. It’s the same now I’m feeling less bad. I don’t really understand any of this.
Peak flow can be confusing! Mine doesn't behave neatly either - I find it's more helpful to focus on how it responds to the salbutamol inhaler. I should be getting an increase after I use it. If I'm not getting much improvement, and/or it doesn't last, for me that's a sign something is up.
The pollen season has started and the levels of pollen tend to be higher in the mornings and evenings. I have asthma but it is aggravated greatly by allergies. I take and antihistamines and use a HEPA air filter as well as having steroid inhaler and Ventolin for use as needed. Your GP can arrange for you to be tested for allergies. Mention it when you speak to them.
I have nothing to add to Homely2's advice but wanted to reinforce it.
It's normal for a steroid inhaler to take a while to work, but that doesn't mean you should ignore it if you're really struggling meanwhile. Please do seek some help asap - if you can't get through to the nurse helpline right away then call your GP asap.
And as Homely2 says, if you're struggling to speak, eat, or sleep and getting no relief from the salbutamol inhaler then call 999 or go to A&E immediately.
I hope it goes well! Definitely come back here and ask any questions/ask the nurses if you're not sure about anything!
As you're new to it all, you might find these posts helpful - from a few years ago but still very relevant. You don't have to read them all in one go, but it may be useful to have a look before your appointment just so you can get a bit of a handle on how it's meant to work (sometimes GPs are good at telling you this, but sometimes they aren't and they're often pressed for time):
Hi, I had a similar experience, spent weeks on fostair 100/6 then 200/6 with little relief for barely a few hours at a time, ended up reliant on the blue salamol inhalers every 4 hours, 24 hours a day for what felt like an eternity, couldn't speak/sleep because I was so restricted for breath, it was horrendous, gp's had no ideas what was wrong with me to not be responding to so much inhaled steroid, prednisolone would give me immediate relief whilst on it, symptoms would come back immediately as soon as I finished a 5 day course, honestly I ended up sitting upright on my sofa 24/7 just trying to work out how to breath, it was terrifying and exhausting.Long story short turns out I have eosinophilic asthma, a blood test held all the information needed, my gp's have never heard of it 🤷♀️ and still don't understand it or have any interest in helping me manage it, a respiratory consultant referral saved me. Please ring asthma UK help line, I didn't know about them when I needed help, so was reliant on a&e etc but I'm sure they will give you some fantastic advice, you sound like you need some help asap xx N
Thank you for your reply, and what you went through sounds truly terrible (and not dissimilar to my symptoms except for me they let up a little in the afternoon/eve). You must’ve been absolutely exhausted.
Can I ask, did you have any trouble with swallowing along with your symptoms?
I hope things are better for you now that you’ve seen the respiratory consultant?
I’ll follow everyone’s advice and ring the helpline tomorrow as well, or maybe ask my kind husband to do that for me (I feel far too tired to talk right now).
All the best and thanks again for replying. It helps me see that I’m not getting quite what I need from the GP. My husband got me an appt tomorrow so hopefully I’ll get some more help then.
Hi, it's definitely worth talking to the nurses on the helpline, they will give you great advice on what to be asking/pushing your gp for x no, I didn't have any swallowing problems, and yes it was totally exhausting, and very frightening so I empathise with you completely, i really hope you get some help, relief and rest very soon, don't be afraid to push for referrals, they don't offer them without being pushed x sounds like we're also similar in having a great husband helped me too 😊 take care Nicola
To add: I'm not suggesting you have the same, just that you have to go and find the help when your desperate, it won't come to you if your gp's are short of ideas, they aren't respiratory experts x N
I'd give it more time to become effective.have u tried using salbutamol before sleep?I'd sleep well propped up.ALUK website have lots of useful info including on inhaler technique.as homely says,do ring helpline open 915-5pm mon- Fri. I'd make a bullet point list of what u want to mention to gp as easy to get sidetracked.id ask for chest to be listened to& perhaps ask if course of steroids( predniisolone) may help x
One other suggestion to add to the advice given above; this may help or it may not and you may already be doing it anyway. Don’t eat (or drink) anything within four hours of going to bed and try to ensure that that last meal of the day is something light (as in not fatty or spicy) and not large. If you can, have your main meal at midday.
As others have suggested, ringing the AsthmaUK helpline is a good idea. I’ve had excellent advice from them in the past myself.
My experience was that the GPs / asthma nurse initially prescribed the lowest dose of the steroid inhaler and they sent me away with a ‘come back in 6 months’. They all rather assume that this will work and they’ve done their job. But if it is not working after a week you should go back. Much later, I discovered I was fine if I took the maximum number of puffs of the steroid inhaler (8 rather than the initial 2). But the GP never even mentioned there is a minimum and a maximum dose. I also found myself taking that much salbutamol and I started having mini fainting moments as a result. They say it takes a month to have a full effect but you should get a pretty good idea far quicker than that. Obviously, only increase dosages with medical supervision.
My GP prescribed the lowest possible dose for me, which did nothing. Fortunately, the asthma nurse tends to focus on what I actually NEED, so she upped the level and told me to come back in a week if I didn't notice any improvement - because although it can take weeks to get the full benefit, she said if you're not noticing SOME change after that long, there's likely to be an issue.
I'm glad you have the doctors appointment, I was in a similar situation, I had very poorly controlled persistent asthma that came on quickly after being sick. If you can remove all irritants and possible triggers, things like laundry detergent, dryer sheets, scented candles, air fresheners, hand cleaners, Soaps, lotions, perfumes, anything with a fragrance, anything with chemicals, household cleaners, dust, mold, Stay away from dishwasher vapors, shower vapors. lint from shedding blankets, flowers, plants, etc. Until you get a handle on it.
I also learned how to sit down, keep from hyperventilating and remember to breathe out fully, stay calm and keep my anxiety from ramping up, which can trigger an attack for me by itself, its not easy but I got a lot of practice.☺️ breathing wrong was a big one for me because I was gasping for air, and I was breathing in but not breathing out fully, which is called air stacking, Not good because it traps the co2 and naturally makes you sob, independent of the attack.
I found that once I learned to control the anxiety, and keep my breathing as normal as possible, the attacks were much easier to handle.
Once you get it under control it won't seem so overwhelming, and you should be better able to figure out what helps and what are your big triggers to avoid. 🧡🌞
Thank you for these tips, I will keep all of this in mind! I’ve been doing box breathing to help because breathing out felt too restrictive but it is letting up the past couple of days. I really appreciate you taking the time to write this out for me ❤️
Hi, sorry for the delay in replying, I've been wiped out by all of this!
Tbh, the appt was useless… I turned up and the nurse said, ‘I see you’re here for an asthma review, but you don’t have asthma, is that correct?’ She took all my stats and said there’s no wheeze so I don’t need anything else.
The GP I saw before that said I did have asthma so it’s all very confusing.
After pushing the day after with my husband to the practice manager, I’ve been given Fostair, and booked in for a Spirometry halfway through June.
I’m absolutely exhausted. I haven’t been able to swallow solid food without choking since this all started just over a month ago now, and I still haven’t heard anything about a date for an endoscopy to look into this aspect.
Ugh that is so unhelpful!! Why is there still this myth that you have to wheeze to have asthma and the idea that's all you need for diagnosis? And the lack of understanding that asthma is variable so even if you did wheeze sometimes, you won't always.
I'm glad you and your husband were able to push them a bit. I would go back to the GP you saw before next time and avoid this nurse who sounds very unhelpful.
Also very frustrating re the swallowing aspect. Have you already been referred for the endoscopy or are you waiting for the referral? I'm wondering if chasing with the hospital directly might be helpful there.
I told her I was wheezing at that point when I was walking up the stairs but I don’t think she noted that anywhere because when we went back later and spoke to the practice manager they were asking me if I was wheezing with it.
My husband is planning to go in later and ask for an update and push again re. the endoscopy because I looked after posting this and it’s been 2 weeks since they agreed to refer me for it. I don’t know where I would be referred to for the procedure, but hopefully we will get some info today/tomorrow on this aspect.
They really seem hung up on the wheezing! They need some education on asthma and diagnosing asthma, I think. It seems as if they've decided a wheeze is the only way they can tell if you have asthma and need treatment.
It does sound as if you need to know if they've even done the referral - good luck!
Hi, I'm sorry you're still so unwell and the help you need is so unhelpful and slow, have you managed to speak to the ALUK helpline??? Everyone on here raves about how fabulous they are at listening and giving good helpful advice to go back to health professionals with, I haven't used them myself, but have been in your situation and know how desperate it can become just to find someone to listen and actively help, it's worth a try x N
I have and the nurse I spoke to was amazing, she recommended a combination therapy inhaler and that’s what I pushed for with the practice manager. Talking to the nurse at ALUK made me wish she was at my GP practice to help me. So thorough and encouraging and she actually cared about what’s been happening for the last few weeks.
I got Fostair after crying and saying I need help because at first the practice manager and nurse at my surgery were saying I don’t have asthma so they can’t prescribe me any medication for it (even though I’d already been on the steroid one for days at this point and had Salbutamol). So bizarre. Of course, I don’t know if I have asthma or not at this point but I’d rather try some kind of treatment rather than wait around unable to breathe properly or eat or sleep or go outdoors for a short walk!
It's positive the ALUK nurses we're so fabulous, keep leaning on them for support and advice, they seem to get the gp's moving with the advice they give x I wish I had known they existed when in your shoes. I hope the fostair helps give you some relief whilst you're waiting on referrals, are you using it as a preventer, so morning and evening? I found it helped, at least to aid some sleep x Nicola
Content on HealthUnlocked does not replace the relationship between you and doctors or other healthcare professionals nor the advice you receive from them.
Never delay seeking advice or dialling emergency services because of something that you have read on HealthUnlocked.
Low peak flows in morning, is this normal ?
Chest Clinic
Why is 2 puffs of my Salbutamol inhaler not always working?
Asthma misery
not sure on advice
