Asthma Diagnosis Understanding Asthma Classification By Pat Bass, MD Pat Bass, MD LinkedIn Twitter Dr. Bass is a board-certified internist, pediatrician, and a Fellow of the American Academy of Pediatrics and the American College of Physicians. Learn about our editorial process Updated on March 17, 2021 Medically reviewed by Sanja Jelic, MD Medically reviewed by Sanja Jelic, MD Sanja Jelic, MD, is board-certified in sleep medicine, critical care medicine, pulmonary disease, and internal medicine. Learn about our Medical Expert Board Print 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. Universal Images Group / Getty Images Asthma Severity Asthma severity describes the intrinsic intensity of your asthma. The table below outlines several different ways to look at asthma severity. Your healthcare provider 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: Intermittent Mild Persistent Moderate Persistent Severe Persistent In order to be able to provide you an asthma classification, your healthcare provider 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 healthcare provider determine your asthma classification. Asthma Symptoms Symptoms are another important part of your asthma classification. Classic asthma symptoms include: Wheezing Chest tightness Cough Shortness 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 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 healthcare provider to ask you questions like “How many times did you use your rescue inhaler last week?” Peak Flow Peak flow demonstrates how quickly you can blow air out of your lungs and is determined by using a peak flow meter. Healthcare providers usually compare your number now to your personal best. You should monitor your peak flow daily and discuss with your healthcare provider action plan if the peak flow is decreased. 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 A Word From Verywell How you and your healthcare provider choose to classify your asthma in the long term probably matters less than making sure you know your asthma classification (however you and your healthcare provider 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 healthcare provider soon about what your asthma classification is and what you need to do to get your asthma under control. Sources Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. National Asthma Control Initiative National Institutes of Health. Asthma Severity: Know Where to Start. By Pat Bass, MD Dr. Bass is a board-certified internist, pediatrician, and a Fellow of the American Academy of Pediatrics and the American College of Physicians. See Our Editorial Process Meet Our Medical Expert Board Share Feedback Was this page helpful? Thanks for your feedback! What is your feedback? 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