How to Know if Your Seemingly Harmless Cough Is Actually Asthma
Having a cough is a clear sign that something just isn’t right in your lungs. It can be easy to chalk it up to something like a lingering cold, your partner’s smoking habit, or another obvious culprit, but sometimes a cough can actually point to a sneaky health condition like asthma.
For the record, you don’t just have to live with a constant cough, even if it feels like yours has been with you since birth. “I have patients who come in and say, ‘I don’t have any problems, but I have a cough,’” Raymond Casciari, M.D., a pulmonologist at St. Joseph Hospital in Orange, California, tells SELF. “But a cough is never normal.”
If you’re coughing, it means your lungs are trying to eject irritants or goopy fluids like mucus, the Mayo Clinic explains. With that in mind, it makes perfect sense that coughing happens to be a hallmark of asthma, which messes with the tubes that carry air in and out of your body. Under normal circumstances, these airways do their job with no trouble. But if you have asthma, your airways overreact to triggering substances by tightening, swelling, and pumping out too much mucus. All that adds up to having more trouble breathing than usual. You may also experience symptoms like wheezing (a whistling noise when you breathe), chest pain or tightness, and yup, a cough, according to the National Heart, Lung, and Blood Institute (NHLBI).
So, how do you know if your hacking might indicate that you have asthma? Here are signs to keep in mind.
1. Your cough never really goes away.
In most cases, a “regular” cough from something like a cold will annoy the crap out of you for a week or so and then recede. But an asthma cough “tends to be more severe and last longer than a normal cough with illness,” pulmonologist Ryan Thomas, M.D., director of the Multidisciplinary Severe Asthma Team at Michigan State University, tells SELF. A chronic cough like the one that often signals asthma lasts for eight weeks or more, the Mayo Clinic explains. “If the cough is always there, there’s a reason for that,” Dr. Casciari says. “It’s probably not going to go away on its own.”
2. It’s usually a dry cough, too.
Asthma typically causes a dry, non-productive cough (meaning you don’t expel substances like mucus), according to the American College of Allergy, Asthma & Immunology (ACAAI). It’s a little confusing that asthma can cause you to have a dry cough even though you may produce more mucus than usual, but it’s usually because that extra mucus is in the smaller parts of your airways deep in your lungs, so it’s harder to get it all the way up to your mouth, Dr. Casciari explains.
Since few things in life are black and white, it’s still possible to have a wet asthma cough, especially if you have an infection like bronchitis, Dr. Casciari says.
3. The cough gets worse when you’re exposed to certain triggers.
If you have asthma, your symptoms will typically flare up in the face of triggers, although the connection might be so subtle you don’t realize it at the time. While everyone’s triggers can be different, some of the most common ones are pollen, animal dander, dust mites, mold, smoke, air pollution, cold air, exercise, and stress, the ACAAI says.
4. You have other asthma symptoms, like wheezing.
“Wheezing … happens when air is moving through narrowed passages,” Dr. Casciari says. “That is exactly what asthma is—the airways are narrowed, and air is trying to get through there.” So, if your cough comes along with evidence of compressed airways such as trouble breathing, wheezing, and chest discomfort, it’s pretty likely you’re dealing with asthma, Dr. Casciari says.
With that said, it’s possible to have a form of this health condition called cough-variant asthma in which your only symptom is a persistent cough that arises when you’re exposed to a trigger. Asthma with a single symptom is peak sneakiness, but it can happen.
5. You cough a ton at night.
Asthma coughs tend to get worse at night. It’s not really known why this happens, but it might be due to the fact that your body can release higher levels of the stress hormone cortisol while you sleep. This may cause more inflammation in your body (and your airways), setting you up for more coughing, Dr. Casciari says.
If triggers like dust mites and animal dander are all over your bed and pillows, that might be a factor, too. Here are some changes you can make in your bedroom to cut back on asthma disrupting your sleep.
6. Over-the-counter cough medications aren’t doing jack.
These drugs are usually designed to decongest you or suppress your cough, but they won’t really help if you have asthma, the ACAAI says. “They may cause a temporary change in a situation like an upper respiratory infection, but they’re not effective in something like asthma, which is an intrinsic condition,” Dr. Casciari says. Translation: They don’t interrupt asthma’s pathophysiology in your body, so you’re not going to get relief.
If you have a cough and you suspect it’s due to asthma, it’s time to talk to your doctor and try to get diagnosed.
They’ll probably want to put you through some lung function tests, like a spirometry (which measures how much air you can blow out after taking a deep breath along with how fast you can expel it), the Mayo Clinic says. Other options include a peak flow test, which measures how hard you can breathe out, and exposing you to methacholine, a mild asthma trigger, to see if your airways narrow.
If your doctor diagnoses you with asthma, they may recommend long-term preventive medications, like allergy drugs to control your response to triggers and corticosteroids that cut down on inflammation, the Mayo Clinic says. Your doctor may also suggest you try quick-relief treatments like an inhaler with short-acting beta agonists to help relax your airways during an asthma attack.
It may take some time to nail down your exact course of treatment (which you should then detail in an asthma action plan), but do your best to stick with it. Life is so much better without an ever-present cough as your annoying sidekick.
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