Determining Your Asthma Severity

Measure Your Asthma Level to Gain Control

Man fatigued from exercise
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Understanding your asthma severity has implications for your asthma control. Severity is linked to the asthma treatment and monitoring your healthcare provider will recommend.

Without measuring your asthma regularly, you will have difficulty knowing if interventions are improving your asthma or if your asthma is worsening. As a result, asthma may be limiting your day-to-day activities and you might not even realize it.

By reviewing the table below, you can classify your asthma severity based on the National Heart, Lung, and Blood Institute's (NHLBI) guidelines as either:

  • Intermittent
  • Mild persistent
  • Moderate persistent
  • Severe persistent

Your asthma severity is based on the criteria described below. You classify yourself based on your worst symptom. For example, if you are waking up two nights per month with a cough or feeling short of breath, your asthma is in the intermittent asthma severity classification.

If you have symptoms two days per week, use your rescue inhaler two times per week, have a normal FEV1 between exacerbations, but wake up at night three times per week, your asthma severity is moderate persistent. Your asthma treatment will, in part, be based on your asthma severity.

Progressive, moderate to severe, persistent, or recurrent symptoms can be a sign of a serious medical condition. Anyone with symptoms such as these should seek medical attention immediately.  

Asthma Severity

Severity is based on symptoms associated with poor asthma control. The table uses the following criteria to determine asthma severity:

  • Symptoms: How many days in the past week have you experienced chest tightness, cough, shortness of breath, or wheezing?
  • Nighttime awakenings: How often do you wake up at night with chest tightness, cough, shortness of breath, or wheezing?
  • Rescue inhaler use: How many times in the last week have you used your rescue inhaler?
  • FEV1: What is your current lung function measured with spirometry? Unlike the other above symptoms, your FEV1 will not be readily available at home; you will need to ask your healthcare provider when pulmonary function tests are performed.
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 2X per month or less 3-4X 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

There is some debate among experts today whether asthma action plans based off of symptoms are more effective than plans based off of peak flow or even home FEV1. You can talk with your healthcare provider and determine which one they recommend and which one might be best for you.

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.

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.