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Levels of control

Hey,So I'm feeling a bit confused about what 'controlled' asthma really means and wondered if you guys could help. Are there different grades of control you would expect to reach depending on the severity of your asthma? Or is there just one gold standard of control = no symptoms for the majority of the time?I ask beacuse having previously being very good at denial and ignoring symptoms unless they gave me no option I now feel much more aware and am aiming for a better overall fitness too - *but* my last asthma review made me I think I was being unrealistic?? At the review (due to night time symptoms being on the up and days that have been really up and down too) my peak flow was and has been sitting at the 320 mark (with best of 450) so not fab, but the nurse was just happy that I have avoided A&E for most of this year (touch wood). She advised me not to push myself hard and expected that my symptoms were just due to the change in air temp and as long as my reliever was working etc it should settle. Whislt she might be right I left feeling like if the cough etc doesn't go away, I would just need to put up with the symptoms and deal with it. Sorry, I've rambled, but what do you think, should I expect more?Thank you x

5 Replies

Hi Lee

You are pretty much right, the goal for asthma is control with minimal or no symptoms, on the correct medication. Both the mildest and severe asthma can be controlled (difficult and brittle asthma are seperate issues all together, although some level of control is still attainable) so that the sufferer experiences very few or no night time symptoms, attacks, or symptoms on exposure to a trigger.

Your asthma nurse was also probably right by saying that the change in air at this time of year may be making you chesty - it certainly does me. However, that is not to say that more optimal control can't be achieved - this may include increasing or adding in medications. If I were you, I would see my GP and mention that my asthma is unstable. It isn't something that you should have to put up with, especially if your asthma is normally well controlled and you are (mostly) symptom free.

Feel free to PM me for more info, hope this helps



Hey lee

That is a really good question, you have got me thinking.

When my asthma is controlled i do not wake up in the night coughing or with a tight chest or needing my reliever but when i start coughing or waking in the night reguarly i know i need to up something or at least ring my resp nurse for advise.

It all depends on your asthma, if it is mild or moderate you should only be using your reliever 3 times weekly, but if you are like me and use your reliever 4 times every day all the time, then go by if you are waking at night or if you needing your reliever more than the standard control dose (ie me more than four times daily) as this would indicate your control is not as good as it could be.

Thank you for raising that question it helped me to relate to how controlled my asthma is. Hope my woffle helps you to decide how well controlled you are and if you need to seek advise.



Thank you crazybaby and plumie for your replies :) Both really helpful and clear. I think that I will make an appt to go back. I need more sleep if nothing else and as it's likely to get colder not warmer as winter goes on I need to feel like there are more things I can do to get sorted. I've been tempted to up my symbicort (400/12) but having looked at the leaflet I am on the max dose already so probably shouldn't!

Thanks again

Lee x


Hello there, i have just read youre post and i agree with what you are saying. My son, who turned 5 last week has had a constant cough for the past 4 weeks( he is asthmatic and has had many attacks) and his reliever inhaeler isnt really doing the job as he is restrricted to what he can and cant do. His cough is keeping him awake and cannot sleep very well but the last 5 or 6 days has gradually got worse. I took him to see the gp yesterday as his appointment with the asthma nurse isnt until next week, and the gp said his chest is fine just to come back in 2 weeks if no better!!! Anyway to cut a long story short he had 2 asthma attacks yesterday had to rush him to a&e where he had a nebuliser and was put onto steroids, yet again. So my advice to you is if you are still coughing to demand that the docs do something about it and maybe up youre preventor inhaeler which might help, thanks for reading.


Hi Lee.

You don't say how many puffs of symbicort you use, but it is possible to use two puffs a day of the 400/12, but not long term.

As has been said below, I find if I wake at night and always 3.30, this is a few days before I get symptomatic and falling PF readings, I just up my preventer meds until things settle down. The aim of control is dependant on your perception of how much medication you wish to take, and the side effects, and how much the symptoms affect your daily life. Some wish to have no symptoms, and use as much medication as required. The standard is really no symptoms at all, but very rarely totally achievable.

I consider my asthma to be well controlled, but even then will still get mild symptoms some days, but can live with it, and adjust the medication as and when I see fit.


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