14 June

Intermittent Asthma: What Is It and How Do I Treat It?

When it comes to asthma, there is no “one size fits all” version. Asthma severity can differ across individuals, from those with mild symptoms to those that are severe and life-threatening.

Asthma can also occur at various ages and for various reasons. Developing asthma can in early life can cause childhood asthma, while others have adult onset asthma or even occupational asthma. Therefore, doctors may prescribe different courses of action and treatment based on different asthma cases.

You may know a severe asthma sufferer who does not leave home, under any circumstances, without an inhaler in case of a severe asthma attack. On the other hand, you may also have a friend or family member who has flareups related to seasonal allergies, using an inhaler only occasionally. This person would be described as a patient with “intermittent asthma.”

To understand what intermittent asthma means and how it is treated, we will explain the different ways asthma is classified. These categories are defined by not only the severity of the asthma symptoms but also how often the symptoms occur.

What is Asthma?

Asthma describes a condition where an individual’s airway is narrowed and/or swollen and may include the production of extra mucus. All of this results in difficulty breathing, which can be mild or severe, and anywhere in between.

When asthma occurs, patients may also cough, wheeze, and feel general shortness of breath. Wheezing can be accompanied by a sort of whistling or rattling sound in the chest, and some people also experience an odd metallic taste in their mouths during an asthma attack.

lungs copd disease

Asthma Classifications

Because asthma does not affect all individuals the same way, we consider four different classifications to categorize the way patients experience symptoms.

  • Mild Intermittent Asthma
  • Mild Persistent Asthma
  • Moderate Persistent Asthma
  • Severe Persistent Asthma

Mild Intermittent Asthma

As the name implies, mild intermittent asthma would be considered the least serious of the four categories. The symptoms are mild, occur infrequently, and are non-life threatening. This also means asthma management is generally easier.

This category includes people who experience symptoms no more than two days per week and no more than two nights per month. Individuals with mild intermittent asthma can typically go about their normal routines without disruption, and it has a fairly low impact on quality of life.

In some cases, mild intermittent asthma is induced by an asthma trigger such as exercise. It can also occur in conjunction with seasonal allergies, which lead to asthma exacerbation.

Symptoms of mild intermittent asthma may include coughing, wheezing, swelling, and mucus in the airways.

Mild Persistent Asthma

The next classification of asthma is defined as mild persistent, which covers a group of people who experience asthma symptoms more than twice weekly, but still not to the point that it occurs more than once every day. Their nighttime flareups would happen up to (but not more than) once per week.

Mild persistent asthma could have a few causes or triggers, including smoking (or exposure to second-hand smoke), allergies, a family history of asthma, and exposure to pollution or chemicals. Mild persistent asthma can also be linked to an individual being overweight.

As this is mild asthma, the symptoms are the same as those with mild intermittent asthma, they just occur more frequently.

Moderate Persistent Asthma

Those with moderate persistent asthma typically experience daily symptoms and will have lung function in the 60 to 80% range. Flareups can last for days, with persistent coughing and wheezing. Nighttime symptoms can happen every week, and the development of mucus in the airways will make breathing difficult.

Moderate persistent asthma can have a distinct impact on daily quality of life. In these cases, the asthma patient will require consistent asthma medication and treatment.

Severe Persistent Asthma

The most serious category and classification is severe persistent asthma. This is the least common type of asthma, and it means the individual’s lung function is at 60% or less.

This type of asthma brings with it symptoms so severe that quality of life is diminished and the individual struggles with daily activities and sleep.

girl speeping peacefully

The airway inflammation and mucus associated with the other types of asthma occur to the extent that the individual feels chest pain and tightness. Symptoms occur daily (and sometimes nightly) and do not respond to medication as quickly or easily as the other types of asthma.

Severe persistent asthma requires a consistent level of monitoring from medical professionals like an asthma nurse and may mean the individual has to try several different therapy options and medications to try and reduce symptoms.

Asthma Treatment: What Treatment Works for Mild Intermittent Asthma?

Now that you understand the four different categories of asthma, we will look specifically at the treatment associated with mild intermittent asthma.

The first thing we should clear up is a common misconception: If my asthma is only mild and intermittent, I don’t really need treatment, do I?

The answer is yes, you still need treatment even with mild intermittent asthma. By working with your doctor to determine the best course of action, you can reduce your symptoms and keep them at bay.

Mild intermittent asthma does not have a massive impact on quality of life in the same way severe asthma does, but this does not mean it is not bothersome.

Consider the fact that your occasional flareup could appear at the worst possible time. An airway obstruction could happen during a job interview, as you walk down the aisle, or even as you board a plane to go on vacation. There's never a good time to lose pulmonary function.

If you manage both asthma symptoms and your exposure to triggers, you can reduce the likelihood of an intermittent flareup slowing you down on big days. Your main treatment will involve the use of a short-acting inhaler.

Short-Acting Inhalers for Mild Intermittent Asthma

A short-acting inhaler works to accomplish two things: to reduce the severity of the flareup and to shorten the duration of the flareup as well.

The phrase “short-acting” is often followed by beta-2 agonist, and you are not alone if you have no idea what this means. As your health professional may explain in layman’s terms, the beta-2 agonists basically travel to your lungs to send a message.

They hit receptors that tell the airways to widen with an inhaled steroid. These inhalers are also referred to as a rescue inhaler, due to their fast-acting nature.

The beauty of short-acting inhalers is how quickly they work, increasing airflow within five minutes. After the initial widening of the airways, the effects of these inhalers can last another three to six hours.

While some patients are a little bit apprehensive about using an inhaler (especially kids), it is incredibly easy and painless. Perhaps the only unpleasant part is a slightly funny aftertaste you may experience, but it diminishes quickly.

Albuterol side effects are minimal, and more information about managing them may be found here.

Tips for Using a Short-Acting Inhaler

Always follow your doctor’s specific instructions regarding any medicine or treatment. These tips should help you ensure you use your inhaler correctly:

  • Make sure you prime a new inhaler before you use it. Priming ensures that the medicine is coming out (and not just air). When you first remove it from the packaging, take the cap off your short-acting inhaler, shake it a few times, and then spray it (holding it away from your face). After 2 or 3 times you will see the mist coming out, and you know it is working correctly.
  • Always keep the cap on the inhaler when you are not using it to ensure the mouthpiece stays clean.
  • Take your time and relax to ensure you get a deep breath in as you spray the inhaler in your mouth. Then as you slide the mouthpiece out close your lips together and hold them for 10 seconds. Then you can exhale.
  • A deep inhale and exhale will make the medicine that much more effective.
  • Your doctor may suggest you only use one spray, but in some cases, the recommendation may be to repeat the process with a second spray. Always consult your physician regarding the number of sprays and frequency of use.

cough inhaler patient

Will I Need to Take Other Medicine to Treat Mild Intermittent Asthma?

Generally, with mild intermittent asthma, where patients are using a short-acting inhaler only twice a week at most, a doctor will not prescribe additional medications as they might with chronic asthma.

However, you should always inform your doctor if your flareups are increasing and you are using the inhaler more often. If your asthma progresses to one of the “persistent” categories, you may need to try different medications alongside your inhaler to manage your asthma symptoms.

What Else Can I Do to Manage Mild Intermittent Asthma?

To avoid asthma flareups, you should also avoid environmental triggers as much as possible to gain asthma control. These vary among individuals, but some of the most common triggers are:

  • Smoke
  • Pollen
  • Cold Air
  • Pet Dander

By limiting your exposure to the triggers that worsen your asthma, you can reduce the frequency of flareups and the severity of symptoms.