Signs and Symptoms That Your Asthma Is Not Well Controlled

These indicate your treatment plan may need changing

Asthma can cause significant changes in the lungs over the short and long term. This can lead to a ​worsening of symptoms and an increase in their frequency. The first step to avoiding the complications of asthma and maintaining your respiratory health is learning to read the signs that your asthma is not well controlled.

This article reviews what those signs are and how to recognize an asthma emergency.

Person using asthma inhaler at home

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Reasons for Poor Asthma Control

Asthma is caused by a sudden tightening of airway passages and the overproduction of mucus in the lungs. It is characterized by the following symptoms:

Asthma control has three goals:

  • Avoiding an attack
  • Minimizing the severity of an attack
  • Preventing long-term damage to the lungs

When asthma is not well controlled, it is often because the prescribed treatment plan is not being closely followed.

It can also be because that plan needs to be adjusted or because you have been exposed to triggers you previously avoided.

What to Look Out For

If your asthma is not well controlled, you can expect to experience one or more of the following:

  • Greater awareness of your wheezing
  • A cough that won't go away
  • More frequent coughing at night or in cold weather
  • Coughing or wheezing with physical activity
  • Less relief from your inhaler or a more frequent need to use it
  • Asthma symptoms that wake you at night
  • Quick onset of fatigue while doing tasks you used to complete without issue
  • Worsening of allergy symptoms like runny nose, itchy eyes, or skin
  • A reduced ability to identify when an attack is about to begin
  • A downturn in your peak expiratory flow rate (PEFR), a measurement that indicates how quickly you can expel air from your lungs after a deep breath

What Is a Peak Flow Meter?

A peak flow meter is a handheld device that measures your PEFR. You can use it at home to help identify triggers, predict attacks, and know when to seek emergency care. Your healthcare provider can also use your results to decide if you need changes in your treatment plan.

If you have any of these symptoms, see your healthcare provider. You need to be evaluated for any significant changes in your respiratory health.

Spirometry is a healthcare practitioner-administered test that helps measure the function of your lungs. This and other tests can help determine the extent of any changes and how your treatment might need to be revised.

Signs of a Possible Asthma-Related Emergency

Worsening asthma symptoms can impact your quality of life, and you should be sure to make an appointment with your healthcare provider if you experience any of the above.

But there is a big difference between symptoms like asthma-related fatigue or increased coughing and an asthma-related emergency.

Seek emergency care at once if you have:

  • Severe wheezing while breathing in and out
  • Tachypnea, or extremely fast breathing
  • Shortness of breath while talking or trouble talking
  • Labored breathing paired with excessive sweating
  • Cyanosis, a bluish tinge to your fingertips or lips
  • A peak flow result that is in the "red zone, indicating you are at less than 50% of your normal peak flow
  • A feeling of impending doom or panic

Left untreated, respiratory distress can lead to serious complications and even death. Don't take chances. If you experience any of these symptoms, seek care at once.


The goals of asthma control are to prevent and reduce the severity of attacks, and prevent long-term lung damage. If you have symptoms like persistent cough, wheezing with physical activity, and getting easily tired, your asthma may not be well-controlled.

Seek emergency care if you have severe wheezing, fast breathing, shortness of breath while talking, or blue lips or fingertips. These are signs of an asthma-related emergency that must be addressed without delay.

A Word From Verywell

An asthma action plan is a personalized record of your symptoms and medications, drafted with the advice of your healthcare provider.

Your action plan will help you become aware of your triggers and the warning signs of an asthma attack. It should also include a note of your ideal PEFR and what to do when you have moderate or severe symptoms.

Keep in mind that changes to your action plan may be necessary over time.

7 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.
  1. Asthma and Allergy Foundation of America. What are the symptoms of asthma?

  2. NIH National Heart Lung and Blood Institute. Asthma care quick reference. Diagnosing and managing asthma.

  3. American Lung Association. Assess and monitor your asthma control.

  4. American Lung Association. Measuring your peak flow rate.

  5. American Lung Association. What are lung function tests and why are they done?

  6. D’Amato G, Vitale C, Lanza M, et al. Near fatal asthma: treatment and prevention. Eur Ann Allergy Clin Immunol. 2016;48(4):116-22.

  7. Centers for Disease Control and Prevention. Asthma acton plan.

Additional Reading
  • Krishnan J, Lemanske R, Canino G, et al. Asthma outcomes: symptoms. J Allergy Clin Immunol. 2012;129(3):S124-35. doi:10.1016/j.jaci.2011.12.981

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.