What is asthma?
Asthma is a chronic inflammatory disease of the airways — the tubes that carry air in and out of the lungs. In someone with asthma, the airway walls are persistently inflamed and easily irritated. When triggered, they swell, the muscles around them tighten, and they fill with mucus. The result is wheezing, coughing, chest tightness and breathlessness.
Unlike a one-off chest infection, asthma is lifelong, but with proper treatment most people live entirely normal lives — playing sport, having children, sleeping through the night.
Common triggers
Triggers vary from person to person, but common ones include:
- Pollen, dust mites, mould and pet dander
- Cold or dry air
- Smoke (cigarette, wood, vehicle exhaust)
- Respiratory infections
- Exercise — particularly in cold weather
- Strong emotions and laughter
- Certain medications, including aspirin in sensitive individuals
In the Eastern Mediterranean, Saharan dust events are a recognised seasonal trigger. Cypriot residents with asthma should pay attention to air quality alerts.
Symptoms
The four classic symptoms are:
- Wheezing — a whistling sound when breathing out
- Cough, often worse at night or in the early morning
- Chest tightness, a band-like sensation
- Shortness of breath, especially with exertion
Symptoms often come in flare-ups (exacerbations) separated by good days. Children may simply be described as "always catching a cold" before a diagnosis is made.
Diagnosis
A pulmonologist or general practitioner makes the diagnosis with:
- A careful history of symptoms and triggers
- Spirometry — a breathing test measuring how much air you can exhale and how fast
- A bronchodilator test — repeating spirometry after an inhaled medication, to show whether the airways open up
- Sometimes peak flow diaries, allergy testing, or fractional exhaled nitric oxide (FeNO) testing
Treatment
Modern asthma care is divided into two pillars:
Controllers — daily inhalers, usually low-dose inhaled corticosteroids, often combined with a long-acting bronchodilator. They calm the underlying inflammation.
Relievers — short-acting bronchodilators (e.g. salbutamol) used during a flare-up to open the airways quickly.
Modern guidelines now favour combination inhalers used both daily and as needed, replacing the older "blue inhaler only" approach for most adults and adolescents.
In severe cases, biologic therapies (targeted antibodies given by injection) have transformed outcomes.
Living well with asthma
Good control means:
- Symptoms less than twice a week
- No night-time waking from asthma
- Reliever inhaler used less than twice a week
- Normal daily activities, including exercise
If you do not meet these markers, your treatment plan needs review.
When to seek emergency care
Asthma can be life-threatening. Seek immediate care if:
- The reliever inhaler is not working
- You cannot speak in full sentences
- Lips or fingertips turn blue
- You feel exhausted or confused
Otherwise, schedule a routine consultation with a pulmonologist or general practitioner to build a written asthma action plan.