Mild Persistent Asthma Diagnosis and Treatment

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Children and adults who experience asthma symptoms more than twice a week—but not daily— might be classified as having mild persistent asthma. Mild persistent asthma is one of the four classifications of asthma that are defined by the National Asthma Education and Prevention Program. Several criteria, including symptoms and breathing tests, are used to help classify your asthma.

Your asthma classification can change over time and it can help guide the type and dose of medication you may need for managing your symptoms.

Classification

Asthma is classified is based on several factors, including the frequency, severity, and impact of the symptoms. To determine which classification of asthma your condition falls into, your doctor will consider your medical history, perform a physical examination, and order diagnostic tests.

Symptoms

In placing your asthma into a classification, your doctor will ask how often you experience the effects of the disease as well as the degree to which your asthma interferes with your activity level.

Your asthma symptoms may include difficulty breathing, wheezing, chest tightness, and coughing. Your medical team will also assess your symptom severity by tracking how often you need to take short-acting inhalers to treat acute symptoms.

Pulmonary Function Tests (PFTs)

Your asthma classification also involves an assessment of your pulmonary function tests (PFTs). These tests require your cooperation as you breathe into a mouthpiece. Diagnostic PFTs measure the volume of air your lungs can inhale and exhale over a given amount of time (such as a second). Your values are compared to standard values.

Key measures in asthma classification include forced expiratory volume in one second (FEV1), which is how much air you can expire after taking in a deep inhalation. Another key measure is the ratio of FEV1 to forced vital capacity (FCV)—which is reported as FEV1/FVC.

With asthma, PFT values are decreased. Severe asthma is associated with a more substantial decrease in comparison to normal values.

Categories

Of the four categories of asthma, mild persistent asthma is the second mildest. Your asthma can improve or worsen over time, so you may experience more than one category throughout the years if your disease changes.

It's a good idea to know what differentiates your asthma classification from the others so that you can talk to your doctor if your symptoms (and classification) seem to be changing.

Because your asthma classification is based on your symptoms, factors like frequent exposure to asthma triggers or skipping your medications can worsen your asthma severity—and push you into a more severe classification.

Intermittent Asthma

Intermittent asthma is the mildest form, with infrequent symptoms and no interference with normal activity.

Criteria used to classify asthma as intermittent asthma include:

  • Asthma symptoms do not interfere with normal activities
  • Symptoms occur two days per week or less
  • Nighttime symptoms occur two days or less per month
  • Short-acting inhalers are rarely or never used
  • FEV1 is 80% of normal values or better
  • FEV1/FVC is 85% of normal values or better

Mild Persistent Asthma

Mild persistent asthma causes some limitations of physical activity and the symptoms occur at least once per week.

Intermittent asthma criteria include:

  • The effects of asthma pose minor limitations on normal activities
  • The occurrence of symptoms is more than two days per week but not every day
  • Nighttime symptoms occur three to four times a month
  • Using short-acting inhalers less than once per week
  • FEV1 is between 80% to 100% of normal values
  • FEV1/FVC is between 80% to 100% normal values

Moderate Persistent Asthma

Your asthma would be classified as moderate persistent asthma if it affects your daily activities and requires daily use of short-acting inhalers.

Criteria used to classify asthma as moderate persistent include:

  • The effects of the condition interfere with daily activities
  • A daily occurrence of symptoms
  • Nighttime symptoms occur more than once per week, but not every day
  • Need to use a short-acting inhaler every day 
  • FEV1 is between 60% to 80% of normal values
  • FEV1/FVC is between 75% to 80% normal values

Severe Persistent Asthma

If you experience symptoms throughout the day, you may be diagnosed with severe persistent asthma.

You can be diagnosed with severe persistent asthma if:

  • Your asthma severely limits your daily activities
  • Your symptoms occur multiple times each day
  • Nighttime symptoms occur often, sometimes every night
  • You use a short-acting inhaler several times per day
  • FEV1 is below 60% normal values
  • FEV1/FVC is below 75% of normal values

Asthma Types

In addition to asthma classifications (which are based on severity), there are also several types of asthma, such as allergic asthma and exercise-induced asthma (which are based on triggers).

You will have a diagnosis of an asthma type and an asthma classification.

Treatment

Your asthma treatment is tailored to your asthma classification and asthma type. There are several asthma medications, including oral pills, inhalers, and nebulizer treatments.

Asthma treatments used for mild persistent asthma include quick-relief rescue medicines (used for immediate relief when an asthma attack begins) and long-term control medicines, which are taken every day to prevent symptoms and asthma attacks. The idea behind taking long-term medications is to avoid having to experience asthma attacks that necessitate rescue medications or other urgent treatment.

Over the years, the severity of your asthma may fluctuate, which means that your medication may need to be adjusted over time.

Keep in mind that anyone who has asthma can experience a life-threatening asthma attack, even if the asthma is classified in one of the milder categories. Be sure that you are prepared to deal with an asthma attack—that means being ready to call for emergency help and having your medication and a list of all of your allergies with you at all times.

A Word From Verywell

If you have been diagnosed with mild persistent asthma, make sure to have an asthma action plan in place. Medications can help keep treating mild persistent asthma under control, but this is just one step in caring for your health. Make sure you are familiar with your asthma triggers because avoiding an attack is better for your overall health than having a sudden attack (even if it is treated in time).

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