Medical News Today: What to know about intermittent asthma

Intermittent asthma is a type of asthma wherein a person has symptoms on no more than 2 days per week and nightly flares on no more than 2 nights per month.

If a person experiences asthma symptoms more frequently, they may receive a diagnosis of persistent asthma. Intermittent asthma can range in severity and is usually treatable with medications.

Read on for more information about intermittent asthma and how it differs from persistent types of asthma.

How it affects the respiratory system

Intermittent asthma
A person with intermittent asthma has symptoms for a maximum of 2 days per week.

The key difference between intermittent asthma and persistent asthma is timing.

A person with intermittent asthma does not experience the regular breathing difficulties a person with persistent asthma might. A person with intermittent asthma may only have a flare-up of symptoms once every few months.

Although most episodes of intermittent asthma are mild, this is not always the case. It is possible for a person with intermittent asthma to have an asthma attack with symptoms that are mild, moderate, or even severe.

In 2007, the National Heart, Lung, and Blood Institute (NHLBI) released their guidelines for the diagnosis and management of asthma. These guidelines are the most recent from the NHLBI.

According to these guidelines, the following factors can help a doctor classify asthma by type:

Intermittent asthma

A person with intermittent asthma has symptoms on fewer than 2 days per week, does not usually wake up with asthma symptoms, and requires treatment with short-acting inhalers on 2 days per week or fewer.

They also have symptoms that a doctor can treat with steroids once per year or not at all.

Persistent types of asthma

It is possible for a person to first have intermittent asthma symptoms and then progress to persistent asthma.

The classifications for persistent types of asthma include:

Mild

A person with mild persistent asthma can have asthma symptoms on more than 2 days per week and nighttime awakenings once or twice each month.

These people require their short-acting inhaler more than 2 days per week, but not every day.

Moderate

People with moderate persistent asthma tend to experience symptoms on a daily basis and nighttime awakenings with symptoms three to four times each month.

They may use their short-acting inhaler daily and may have to limit their activities due to their symptoms.

Severe

A person with severe persistent asthma has symptoms throughout the day. They usually wake up with nighttime symptoms once per week or more and use their short-acting inhaler throughout the day.

Because of their asthma, their daily activities tend to be severely limited.


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Symptoms

Intermittent asthma out of breath
Asthma symptoms include coughing after exercise.

Asthma symptoms, whether they are intermittent or persistent, have several characteristics that differentiate them from those of other respiratory-related conditions.

These symptoms include:

  • Airflow obstruction: Asthma causes changes in the lungs that make it difficult for a person to breathe in and out as easily as they normally would.
  • Inflammation: Asthma triggers lead to airway inflammation that makes it harder to breathe.
  • Hyperresponsiveness: Asthma causes the lungs to shrink and spasm more easily than those of a person who does not have asthma.

These factors can cause asthma symptoms that include:

  • coughing, usually at night or after exercise
  • problems breathing
  • shortness of breath
  • tightness in the chest
  • wheezing

If a person experiences these symptoms, it is important to talk to a doctor to determine whether or not asthma is the cause.

Treatment

Because people with intermittent asthma do not have frequent symptoms, they usually require fewer treatments to control their condition.

Doctors will usually prescribe a short-acting beta agonist to treat intermittent asthma. These medications relax and open up the airways, making it easier for a person with the condition to breathe.

One example of this type of medication is albuterol (Ventolin, Proventil). A person can use these inhalers every 4–6 hours to reduce symptoms such as wheezing and difficulty breathing.

If a person experiences a moderate to severe episode of intermittent asthma, their doctor may prescribe a short course of oral corticosteroids such as prednisone.

A person may find that they require oral corticosteroids during or after an upper respiratory infection. Prednisone can reduce inflammation in the airways, making it easier to breathe.


Living with intermittent asthma

A person with intermittent asthma should be able to control their symptoms with occasional inhaler use and nothing more.

They should discuss any symptoms that might indicate the presence of moderate to severe asthma with their doctor. This is because they may require emergency medical attention.

A doctor can work with a person to create an asthma action plan that includes how to avoid potential triggers that could worsen symptoms and how to manage their breathing.

Avoiding triggers

Intermittent asthma wood-stove
Exposure to wood-burning stoves may trigger symptoms for people with intermittent asthma.

People with intermittent asthma often find that their symptoms become worse following exposure to specific triggers.

Common examples of intermittent asthma triggers include:

  • exposure to very cold air
  • exposure to noxious fumes or chemical irritants
  • exposure to wood-burning stoves, fireplaces, or kerosene heaters
  • pet dander
  • pollen
  • smoke
  • viruses that cause upper respiratory infections

A person can try to avoid these triggers to prevent the symptoms of intermittent asthma from reoccurring.

Management

As well as avoiding triggers that cause symptoms to develop, a person may wish to consider keeping their inhaler in a convenient location where they can access it easily.

If allergies trigger a person’s asthma, a doctor may recommend additional treatments. These may include allergy injections, which involve the person having exposure to a small amount of an allergen to make them less sensitive to it the next time they have exposure.

Also, seeking treatment during an upper respiratory infection and when asthma symptoms worsen can help a person manage intermittent asthma.

If a person finds that they start requiring their inhaler more often than twice each week, they should talk to their doctor. This could indicate that their asthma has transitioned from intermittent to persistent.


Summary

Intermittent asthma is a treatable form of the condition that causes symptoms to develop on fewer than 2 days per week.

The symptoms can range in severity but are usually mild.

If a person starts to have more frequent symptoms or experiences a moderate to severe asthma attack, they should talk to their doctor.

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