Exercise-induced asthma

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Exercise-induced asthma

An asthma attack is a short period when breathing becomes difficult, sometimes along with chest tightness, wheezing, and coughing. When this happens during or after exercise, it is known as exercise-induced asthma or exercise-induced bronchospasm. About 70% to 90% of people with persistent asthma and about 10% of the population without asthma have exercise-induced asthma.^{1, 2} Exercise-induced asthma develops most often in athletes, especially those who train or perform in cold air. Swimming appears to cause the fewest problems for children with asthma; it may even help reduce the severity of exercise-induced asthma.³

For most people:

• Shortness of breath may occur early in an exercise period. Some people get worse 5 to 10 minutes after exercise stops.
• Difficulty breathing usually goes away within 20 to 30 minutes after stopping exercise.

Exercise-induced asthma is often not diagnosed, especially in children. Most experts agree that a medical history and a physical exam are not accurate tools for diagnosing exercise-induced asthma. If you notice the symptoms of asthma (such as wheezing or shortness of breath) after your child exercises, it is important that you bring this to the attention of your health professional. However, children with asthma should still be encouraged to exercise and should not be excused from exercise unless really necessary.

For people with asthma symptoms during exercise, using asthma-controlling medication before exercise may help reduce symptoms, especially in cold, dry weather. For these people, some asthma experts recommend the following:⁴

• Take your medication daily, if needed, to decrease airway inflammation and decrease the overreaction (hyperresponsiveness) of the airways that carry air to the lungs (bronchial tubes).
• Use an inhaled bronchodilator (beta₂-agonists), cromolyn, nedocromil, or leukotriene pathway modifier before exercising.
• Warm up before exercising.

Other steps you can take to decrease asthma symptoms when you are exercising include the following:

• Avoid exposure to air pollutants and allergens whenever possible. Exercise indoors when air pollution levels are high.
• Wear a mask or scarf wrapped around your nose and mouth if you are exercising in cold weather. This may help warm and moisten the air you breathe in.
• Exercise slowly for the first 10 to 15 minutes.

If your child has exercise-induced asthma, be sure his or her teachers and coaches know when your child's daily medications should be given and what to do if your child has an asthma attack, especially before and during physical exercise. Your child's daily treatment and asthma action plans provide this information. School officials need to know the early warning signs of an asthma episode, how your child's medications are used, and how to give the medications. School personnel also should know how to contact your child's health professional.

References

Citations

1. Sheth KK (2003). Activity-induced asthma. Pediatric Clinics of North America, 50(3): 698–715.

2. Mickleborough TD, Gotshall RW (2003). Dietary components with demonstrated effectiveness in decreasing the severity of exercise-induced asthma. Sports Medicine, 33(9): 671–681.

3. Rosimini R (2003). Benefits of swim training for children and adolescents with asthma. Journal of the American Academy of Nurses, 15(6): 247–252.

4. National Institutes of Health (1997). Expert Panel Report 2: Guidelines for the Diagnosis and Management of Asthma. Clinical Practice Guidelines (NIH Publication No. 97-4051). Bethesda, MD: U.S. Department of Health and Human Services.

Credits

Last updated:	May 15, 2007
Author:	Maria G. Essig, MS, ELS
Reviewed By:	Caroline S. Rhoads, MD - Internal Medicine, Harold S. Nelson, MD - Allergy and Immunology
Editors:	Susan Van Houten, RN, BSN, MBA, Pat Truman