Here are 8 Asthma Symptoms in Adults You Should Know
A lingering cough, feeling run down, and shortness of breath aren't things you should brush off—they can be symptoms of asthma in adults.
What does asthma look like in adults?
Asthma is often thought of as a childhood condition, but while children are more likely to get diagnosed, more adults live with the chronic respiratory disease.
Nearly 10 percent of American adults, about 20 million people, have asthma, according to the Asthma and Allergy Foundation of America (AAFA).
“While adult and childhood asthma are classified as different types of asthma, it is actually very similar in terms of symptoms, management, triggers and even medications used,” says Purvi Parikh, MD, an allergist with Allergy & Asthma Network and a clinical assistant professor in the departments of medicine and pediatrics at New York University School of Medicine.
However similar the two conditions, the consequences can be worse for adults. The respiratory disease causes an economic loss of $81 billion per year, a result of medical costs and missed work.
Worse, an average of 3,500 people a year die from it, and adults are five times more likely to die from asthma than children, according to the AAFA.
This is why it’s so important for you to get assessed for asthma if you have any symptoms. The goal: a proper diagnosis and treatment. Unfortunately, that may be easier said than done.
Getting diagnosed as an adult can be more difficult
There are several reasons that adults may be less likely to receive an accurate diagnosis, says pulmonologist Anthony Gerber, MD, a professor of pulmonary, critical care, and sleep medicine at National Jewish Health and an associate professor of medicine at the University of Colorado Denver.
Some adults believe that they can’t get asthma if they’ve never had it before and so may be more prone to ignore or write off symptoms. It’s not uncommon for adults to have a chronic cough for months without considering it could be asthma, says Dr. Parikh.
Adults are also more likely to have other underlying conditions that can mask or complicate asthma symptoms. Those include heart disease, diabetes, and chronic obstructive pulmonary disease, also known as COPD.
It’s not just the adults who are confused, though; doctors often miss asthma symptoms in adults or misdiagnose other conditions as asthma.
“About one-third of the patients I see who have been diagnosed with severe asthma don’t really have asthma,” says Dr. Gerber. “Their symptoms are being caused by a different condition.”
For example, chest pain could be from gastroesophageal reflux disease (GERD, which causes heartburn) or heart disease. A chronic cough could be due to vocal cord dysfunction.
“This leads to asthma being misdiagnosed in adults,” says Dr. Gerber. “I always recommend adults get diagnosed by a specialist.”
The three types of asthma that can occur in adults
There are three main ways that people get asthma as adults, says Dr. Gerber.
You had it as a child but it went away—than came back
There is no cure for asthma, but the condition’s symptoms can come and go.
It’s not uncommon for someone who was diagnosed as a child to get a break throughout young adulthood and then have the symptoms flare back up in middle age.
You had it as a kid but were never diagnosed
Were you chronically sick as a child? Did you quit sports when your cardiovascular fitness never seemed to improve? Did you hate gym class because it made your chest hurt?
Plenty of children with asthma fly under the radar and don’t realize that’s what their symptoms were until they are diagnosed as adults.
You developed it for the first time in adulthood
Sometimes adults who have never had any symptoms before will develop asthma, and it can happen in your 40s, 50s, 60s or any age.
Known as adult-onset asthma, it may have no known cause, but most of the time the new asthma is triggered by an environmental irritant (air pollution or mold, for instance), a viral infection (a cold that really never goes away), or an allergy.
Women are more likely to develop asthma in adulthood, and there are certain things, like obesity, smoking, and stressful life events that are known risk factors for adult-onset asthma.
Symptoms of adult-onset asthma
The main symptoms of asthma are the same in adults and children: chronic cough, wheezing, shortness of breath, and chest tightness, says Dr. Parikh.
However, there are some signs and symptoms that are more likely to be found in adults than children.
A noticeable change in lung function
Is it becoming harder to catch your breath after your run? Are you having coughing attacks? Are you exhausted more often than you used to be?
A decrease in lung function is one of the hallmark signs used to diagnose asthma and doctors test lung function to see if treatment is working over time.
Children tend to experience symptoms that flare up or get worse after exposure to an allergen or during a viral infection. Adults, on the other hand, may be more likely to experience persistent symptoms that require daily medication to control.
For children, asthma may feel “normal” because that’s all they know. Adults, however, can remember how they used to feel “before” and have benchmarks they can use to compare their lung fitness over time.
(Here’s what asthma feels like from people who know.)
Shortness of breath or wheezing while exercising
Exercise is supposed to be hard, but it should be tolerable.
Adults are more likely to get exercise-induced asthma (EIA), a condition in which exercise triggers symptoms. Because of underlying conditions like heart disease, adults may also feel the effects of EIA more.
If you have shortness of breath or wheezing when you exercise, you may have adult-onset asthma.
Night waking or insomnia
Do you wake up in the middle of the night in a panic? There are several causes of night waking, but asthma is an oft-overlooked one, says Dr. Gerber.
You may be struggling to breathe in your sleep and your body wakes you to get more air. Because you feel panicked when you wake, it may make it harder for you to fall back asleep.
A dry cough, especially at night or in response to certain triggers, can be a sign of asthma.
Perhaps it’s because children generally have higher energy levels, but adults with asthma usually experience more fatigue than children with the respiratory condition.
You may not recognize asthma as the reason, but if you are working harder than normal to breathe—all day, every day—it really takes a toll.
Asthma can be triggered by a viral infection, but it can also worsen colds and cases of the flu.
You may get a respiratory infection and find that the cough lingers indefinitely.
Or you may notice that it takes you weeks to recover after a cold, far longer than the rest of your family.
If your asthma is triggered by something in your environment or an allergy, your disease severity may wax and wane depending on the seasons.
This can be true for kids as well, but adults often are better at spotting patterns and identifying their triggers.
About 30 percent of cases of asthma in adults are due to allergies.
The workplace makes you sick
There is a type of asthma triggered by things related to your job, and it’s called occupational asthma.
Some adults may find that their symptoms revolve around their work schedule, or could be triggered by workplace exposure to irritants like chemicals, dust, or mold.
You may feel sick during the workweek but the symptoms may go away on the weekends or when you are not at work. However, prolonged exposures may also cause asthma symptoms that don’t necessarily resolve when you leave the workplace.
Problems concentrating, mental fogginess, and even adult attention deficit hyperactivity disorder (ADHD) symptoms can be due to asthma.
When you don’t have enough oxygen going to your brain, it doesn’t function at its best.
Find the right treatment for your lifestyle
Asthma treatment usually starts with using medication, like steroid inhalers and/or other prescription medications, to control daily symptoms and trigger management to reduce the number of attacks, says Dr. Parikh.
One way adult asthma treatment differs is in how much control you have over deciding when and how much treatment you need.
Children’s asthma treatment generally needs to be managed by their doctors and caregivers, but when it comes to adults, the medical community is moving toward a more patient-managed strategy, says Dr. Gerber.
You make a treatment plan with your doctor, but you’re allowed to administer your own medications as needed. In general, low-dose inhaled steroids are used to control the underlying inflammation in the lungs, and bronchodilators—sometimes called rescue medications—are used to address symptoms like shortness of breath.
After medications, treating asthma is less about what you add and more about what you remove.
Dr. Gerber recommends identifying your personal asthma triggers and adjusting your lifestyle to avoid those.
This may include staying indoors on days when pollution is high, banning fragrances in your home, buying hypoallergenic bedding, or hiring a house cleaner to take care of the dust and mold.
Asthma doesn’t go away on its own
It can be tempting to ignore these symptoms and hope it goes away on its own, but this isn’t something you should ignore, says Dr. Gerber.
Acute asthma attacks can damage the lungs over time, and can even be potentially life threatening
Therefore, it’s important to do everything you can to control asthma.
This starts with getting an accurate diagnosis, making a treatment plan with your doctor, and then doing your best to structure your daily life to avoid triggers and manage your symptoms.
Next, learn strategies to manage allergy-induced asthma.
- Asthma and Allergy Foundation of America: "Asthma Facts and Figures"
- Anthony Gerber, MD, PhD, a pulmonologist; professor of pulmonary, critical care, and sleep medicine at National Jewish Health; and an associate professor of medicine at the University of Colorado Denver
- Purvi Parikh, MD, allergist with Allergy & Asthma Network and a clinical assistant professor in the departments of medicine and pediatrics at New York University School of Medicine
- American College of Allergy, Asthma, and Immunology: "Adult Onset Asthma"
- Asthma and Allergy Foundation of America: Adult Onset Asthma
- Mediators of Inflammation: Phenotypes, Risk Factors, and Mechanisms of Adult-Onset Asthma