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Knowing and Treating Your Early Warning Asthma Signs Can Reduce the Need for Emergency Room Visits


Did you know you may be able to tell when an asthma episode or attack is about to start before you have trouble breathing? Knowing your early warning signs (or mild symptoms) can be helpful so you can begin asthma treatment as soon as possible.

Early warning signs are different for everyone and can vary for each asthma episode. But if you track your symptoms in an asthma diary, you may notice that you experience some of the same mild symptoms before an asthma episode occurs.


This list includes some common early warning asthma signs. Have you, or people you spend time with, noticed these signs before your asthma episodes?

  • Changes in breathing
  • Changes in your mucus (sputum)
  • Runny/stuffy/congested nose
  • Sneezing
  • Itchy/sore/scratchy throat
  • Itchy neck or chin
  • Itchy/watery eyes
  • Dark circles under eyes
  • Feeling tired, weak or have no energy
  • Feverish
  • Moodiness
  • Restless
  • Not sleeping well
  • Hoarse voice or dry mouth
  • Paleness
  • Difficulty speaking/talking in full sentences
  • Raised shoulders/slouching
  • Clammy skin
  • Sweating
  • Chest pain
  • Tight chest
  • Anxious
  • Excitable
  • Withdrawn/quiet mood
  • Faster heartbeat
  • Headache
  • Poor tolerance for exercise

Make a list of your early warning signs so you can treat future asthma attacks and episodes before symptoms get worse. Talk to your doctor about what to do when you notice these signs. They may have you follow the Yellow Zone treatment on your Asthma Action Plan. In this zone, your doctor may have you take a quick-relief medicine, such as albuterol.

The earlier you can recognize breathing problems, the earlier you can, and should, start treatment. When you treat early, you can reduce the need for an emergency department visit.

Signs of an asthma emergency (Red Zone on your Asthma Action Plan):

  • Asthma is getting worse fast
  • Severe shortness of breath
  • Skin is sucked in around neck or ribs (chest retractions are rare in adults)
  • Trouble walking or talking due to shortness of breath
  • Breathing is hard and fast
  • Lots of coughing
  • Shoulders hunched over
  • Asthma quick-relief (rescue) medicine not helping
  • Nostrils open wide/flare (may be rare in adults)
  • Lips or fingernails are blue (may be visible on light-pigmented skin)

If you have any of these signs, seek immediate medical attention. Asthma can be life-threatening.

Medical Review August 2018.

Knowing how to manage asthma is important for better health and quality of life. We also offer an online course called ASTHMA Care for Adults. This comprehensive program covers a full range of topics everyone with asthma needs to know. This FREE self-paced online course is presented in different formats, such as videos, animations, handouts and more.


The Asthma and Allergy Foundation of America (AAFA) is the largest and oldest nonprofit patient organization dedicated to asthma and allergies. Our online community includes public blogs. To post a comment, you will need to register or sign in.

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Comments (3)

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Good reminders of some of the common early warning signs before an asthma episode.  Some, like these specifically, 

  • Hoarse voice or dry mouth
  • Difficulty speaking/talking in full sentences
  • Raised shoulders/slouching

are ones I need to pay more attention to since I know for a fact that they are early warning signs for me.

Good article and reminder!  Thanks AAFA!!  


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