Adult-Onset Asthma: Symptoms, Causes, Diagnosis, And Treatment

If you receive an asthma diagnosis later in life, you may not know what this means for your overall health and lifestyle moving forward.

Asthma is a chronic disease that you will always need to manage, but you can live a healthy, happy life with adult-onset asthma.

Understanding what asthma is and how to manage it can help you keep your symptoms under control and prevent potentially dangerous asthma attacks.

Here’s everything you should know about asthma in adults, plus how the condition is diagnosed and treated.

What is asthma?

Asthma is a long-term condition that impacts the airways that bring air in and out of your lungs. With asthma, these airways can become inflamed and constrict periodically, making it more challenging for your lungs to take in the oxygen they need.

Around one in 12 people¹ in the US have asthma. Asthma can affect anyone, regardless of their age or medical history. It often begins during childhood.

Asthma symptoms usually begin or worsen in response to triggers, such as physical activity or pollen.

You may have an asthma attack when your asthma symptoms progress. Attacks range from mild to severe, but you should always take asthma attacks seriously and seek treatment right away.

Currently, there is no cure for asthma. Working with your doctor to create a personalized treatment plan can help manage your symptoms and prevent asthma attacks.

What are the different types of asthma?

Not all asthmas are the same. While all forms of asthma cause inflammation in your airways that makes it harder for you to breathe, some asthma types have different triggers, symptoms, and treatments.

The most common types of asthma are:

• Allergic asthma: This is the most common type that occurs in response to allergens, such as pet dander or dust mites. It often begins during childhood and is connected to other familial allergic conditions.

• Non-allergic asthma: This type of asthma is usually triggered by stress, viral infections, or extreme weather rather than allergens.

• Exercise-induced asthma: This type occurs when your airways constrict in response to physical activity.

• Job-related asthma: Also called occupational asthma, this type of asthma occurs in response to work-related exposures, such as chemical fumes or irritants in your workplace.

• Eosinophilic asthma: This type is severe and difficult to control. People with this type of asthma have a high level of white blood cells called eosinophils, which can cause inflammation.

What is adult-onset asthma?

While asthma usually occurs during childhood, it can also develop during adulthood.

Some children experience asthma symptoms early in life that eventually go away. In some of these cases, symptoms return later in life.

Symptoms of asthma in adults

Symptoms of asthma in adults can vary from person to person. Your experiences may be completely different from another person with asthma. However, some common symptoms of asthma in adults include:

• Difficulty breathing

• Coughing, especially after exercising, laughing, at night, or in the morning

• Chest tightness

• Wheezing

• Shortness of breath

• Difficulty sleeping due to shortness of breath or coughing

Adult versus childhood asthma

When a child is diagnosed with asthma, they typically experience symptoms intermittently. They might develop symptoms when exposed to specific triggers or a respiratory infection.

In contrast, adults diagnosed with asthma later in life usually have persistent symptoms.

Asthma in adults can also be more challenging to manage. This is because it’s more common for adult asthmatics to experience faster lung function decline than children. Likewise, adults are more likely to die from an asthma attack than children.

3,524² people (most of whom were over the age of 18) died from asthma in 2019. As a result, it’s common for adult asthmatics to regularly take preventative asthma medications or have other asthma medications on hand to treat symptoms when they develop.

What causes asthma in adults?

No one knows what exactly causes asthma or what leads people to have different experiences.

The condition exhibits recurring episodes, also referred to as attacks or flare-ups. During an asthma attack, a number of things take place, including:

• Your airway lining swells

• The muscles in your chest tighten

• More mucus is produced in your airway

The combination of these events makes breathing more challenging and can lead to symptoms such as wheezing and coughing.

You may discover particular triggers that cause your asthma symptoms and episodes, such as:

• Allergens, like pollen, pet dander, dust, and food

• Viral infections

• Cigarette smoke

• Cold, dry air

• Stress

• Physical activity

Hormonal changes can also influence adult-onset asthma, particularly in women. For instance, some women may develop asthma for the first time during or after pregnancy. The same is true for menopause.

Risk factors

Anyone can develop asthma, but certain risk factors could make you more likely to experience symptoms of asthma as an adult. These include:

• Being overweight or obese

• Being female and over the age of 20

• Smoking cigarettes

• Having another allergic reaction, such as hay fever

• Exposure to pollution, secondhand smoke, or exhaust fumes

• Exposure to occupational triggers, such as farming or hairdressing chemicals

• Having a parent or sibling with asthma

Diagnosis

If your doctor suspects you have asthma, they will perform a series of tests to determine what is causing your symptoms. This will start with a thorough examination of your medical history.

Be sure to share details of your symptoms with your doctor, including when they started, how long you have been experiencing them, and any triggers you have noticed.

Tell your doctor about any current medications you’re taking, other medical conditions you may have, and any family history of asthma.

Following your medical history review, your doctor will perform a physical exam that could include tests to observe your lung function and breathing. These are called pulmonary function tests (PFTs).

Examples of PFTs include:

• Spirometry: You will be asked to breathe into a handheld device to determine how much air you can breathe in and exhale and how quickly you can do so.

• Peak expiratory flow rate (PEFR): This measurement shows how strongly you can exhale air. If your PEFR is greater than or equal to 80%, it may be considered normal.

• Bronchodilator responsiveness test: You will be asked to inhale medication using a bronchodilator. This will expand your airways. You will undergo a second spirometry test after 15 minutes which will be compared to the first one.

• Bronchoprovocation challenge test: This test will require you to perform an activity that could cause asthma symptoms, such as exercising or breathing in cold air.

• Fractional exhaled nitric oxide (FeNO) testing: This test can show if you have inflammation in your lungs. It is used when other diagnostic tests come back inconclusive.

Management and treatment

Asthma is a lifelong condition, but it can be managed.

After you have been diagnosed, you should work closely with your doctor to find a management and treatment plan that suits your lifestyle and needs.

Your doctor may prescribe medications to help prevent your asthma symptoms and treat them when they occur. Asthma medicine is usually inhaled using an inhaler or nebulizer. However, you can take some asthma medications by mouth.

Common asthma medications include:

• Bronchodilators: These are used to relax the muscles in your airways, allowing them to move air and mucus more efficiently. You can use a bronchodilator to ease intermittent and chronic asthma when you experience symptoms.

• Anti-inflammatory medications: These drugs make it easier for you to breathe by reducing swelling and the production of mucus in your airways. Your doctor may recommend taking them every day to prevent symptoms of chronic asthma.

• Allergy medications: These are used to manage your asthma symptoms if a specific allergen triggers them.

Other factors that can help keep your asthma under control are:

• Quitting smoking

• Maintaining a healthy weight (losing weight if you are overweight)

• Bringing a rescue inhaler with you wherever you go

• Following the personalized treatment plan created by your doctor

• Avoiding triggers, including pets with dander and cigarette smoke

• Use your air conditioner to lower the humidity and pollen levels in your home

• Clean your house regularly to prevent mold spores

• Decontaminate areas of your home that may contain allergens, such as your pillowcases and curtains

• Cover your mouth and nose with a mask in cold weather

• Talk to your doctor about keeping your heartburn and gastroesophageal disease (GERD) under control

Complications of asthma in adults

You should work closely with your doctor to keep your asthma symptoms under control. Untreated asthma can lead to a number of complications. Asthma complications can disrupt your day-to-day life or be life-threatening.

Common complications from adult-onset asthma include:

• Difficulty sleeping due to asthma symptoms, such as coughing or wheezing

• Fatigue from poor sleeping habits

• Physical inactivity due to asthma symptoms, such as shortness of breath, or a lack of energy from not sleeping well

• Side effects from asthma medications such as weight gain, insomnia, high blood pressure, infections, and/or bruising

• Gastroesophageal disease (GERD)

• Pneumonia

• Hospitalization

• Asthma attack and respiratory failure

• Mental health concerns, such as anxiety and depression

When to see a doctor

Asthma is a lifelong condition that should be taken very seriously. Even if you have never experienced an asthma attack, schedule an appointment with your doctor as soon as you notice the symptoms of adult-onset asthma. These may include shortness of breath, wheezing, coughing, and chest tightness.

Asthma symptoms may start as minor but can quickly become severe or life-threatening if you don’t treat them quickly. Work closely with your healthcare team and follow the individualized treatment plan they provide you to prevent your asthma symptoms from getting worse.

If you do experience asthma symptoms that worsen or don’t respond to treatment, seek emergency medical attention right away.

The lowdown

Asthma often develops during childhood, but it can also occur during adulthood.

If you experience any asthma symptoms, including difficulty breathing, coughing at night or in the morning, chest tightness, or wheezing, be sure to schedule a check-up with your doctor as soon as possible.

To diagnose adult-onset asthma, your doctor will review your medical history and perform a physical exam using pulmonary function tests.

If you are diagnosed with asthma as an adult, managing your symptoms is key to preventing asthma attacks and improving your quality of life. You should avoid triggers, take your medications as prescribed, and follow your doctor’s specific instructions.

Seek urgent medical attention if your asthma symptoms continue or worsen, even with treatment.