Asthma Diagnosis Print Understanding Asthma Classification By Pat Bass, MD | Medically reviewed by a board-certified physician | Updated January 04, 2019 Universal Images Group/Getty Images More in Asthma Diagnosis Symptoms Treatment Triggers Living With Prevention Asthma in Children Asthma classification is an important part of your asthma care plan. By categorizing your asthma, you can get an idea of your asthma control. You can also take specific steps to improve your asthma. Your asthma classification will change over time. There are a number of different ways you can think about your asthma classification. Asthma Severity Asthma severity describes an intrinsic intensity of your asthma. The table below outlines several different ways to look at asthma severity. Your doctor will generally place you into one of the following asthma classifications based on your worst symptoms. For example, if most of your symptoms are “Mild Persistent” but you have one symptom that is in “Moderate Persistent,” you will be classified as “Moderate Persistent.” The different asthma severity classifications based on the NHLBI Expert Panel Report 3 (EPR3): Guidelines for the Diagnosis and Management of Asthma include: IntermittentMild PersistentModerate PersistentSevere Persistent In order to be able to provide you an asthma classification, your doctor will need to ask you a number of different questions. Some questions might include: How many days per week do you experience asthma symptoms?How many nights per week does your asthma wake you up?How often do you need to use your rescue inhaler?Does your asthma interfere with your regular activities? Answers to these questions will help your doctor determine your asthma classification. Asthma Symptoms Symptoms are another important part of your asthma classification. Classic asthma symptoms include: WheezingChest tightnessCoughShortness of breath In general, the more symptoms you have the more severe your asthma classification will be. Additionally, the following symptoms indicate poorer control and a worse asthma severity: Frequent coughing at nightCoughing or wheezing with exercise or physical activityGetting tired with activities that you would normally complete easilyDecreases in your peak flowRestless sleep or waking up tiredWorsening allergy symptoms like a persistent runny nose, dark circles under your eyes or itchy, inflamed skin Rescue Inhaler Use Your goal should be to not need to use your rescue inhaler very often. If you are using it every day or even more than a couple of times per week, your asthma is not optimally controlled. Frequent rescue inhaler use will lead to a worsening asthma classification. Expect your doctor to ask you questions like “How many times did you use your rescue inhaler last week?” FEV1 and Peak Flow Peak flow demonstrates how quickly you can blow air out of your lungs and is determined by using a peak flow meter. Doctors usually compare your number now to your personal best. Forced expiratory volume is the maximal amount of air you can forcefully exhale. It is generally measured at one second (FEV1) and used to be only available in a specialist’s office. Now it is available in some home pocket spirometers. While there is some debate as to whether asthma classification and treatment should be based on the hard numbers these devices produce, or off your symptoms, much of that depends on you. Additionally, there is also no reason why you could not base your asthma action plan off of numbers from these devices for 3 months and then repeat using an asthma action plan for symptoms for the next 3 months. You can then see which one you think leads to better overall control of your asthma. Final Thoughts How you and your doctor choose to classify your asthma in the long term probably matters less than making sure you know your asthma classification (however you and your doctor define) and how it affects your treatment. If you are not familiar with your asthma classification and are not able to take specific actions based on it, talk to your doctor soon about what your asthma classification is and what you need to do to get your asthma under control. Asthma Severity Intermittent Mild Persistent Moderate Persistent Severe Persistent Symptoms 2 or less days per week More than 2 days per week Daily Throughout the day Nighttime Awakenings 2 X's per month or less 3-4 X's per month More than once per week but not nightly Nightly Rescue Inhaler Use 2 or less days per week More than 2 days per week, but not daily Daily Several times per day Interference With Normal Activity None Minor limitation Some limitation Extremely limited Lung Function FEV1 >80% predicted and normal between exacerbations FEV1 >80% predicted FEV1 60-80% predicted FEV1 less than 60% predicted Was this page helpful? Thanks for your feedback! Sign up for our Health Tip of the Day newsletter, and receive daily tips that will help you live your healthiest life. Email Address Sign Up There was an error. Please try again. Thank you, , for signing up. What are your concerns? Other Inaccurate Hard to Understand Submit Article Sources National Asthma Control Initiative- National Institutes of Health. Asthma Severity: Know Where to Start. Continue Reading Determining Your Asthma Severity An Overview of Intermittent Asthma How Is Intermittent Asthma Diagnosed? Medication Guide for the Albuterol Inhaler 5 Things To Do For Better Asthma Control An Overview of Asthma Treatment Overview of Forced Expiratory Volume (FEV1) Symptoms and Treatment of Nocturnal Asthma Persistent Asthma Classifications Mild Persistent Asthma Diagnosis and Treatment Options How Asthma Is Diagnosed Do You Have These Asthma Symptoms? Vital Capacity Can Show Decreased Lung Volumes With Diseases Budesonide For Your Asthma What Is an Optimal Peak Expiratory Flow Rate (PEFR)? When Will My Doctor Prescribe a Therapeutic Trial for Asthma?