How Severe Is Your Asthma?

Measure Your Asthma Level to Gain Control

Man fatigued from exercise
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Understanding your asthma severity has implications for your asthma control. Severity is linked to the asthma treatment and monitoring your doctor will recommend. Without measuring your asthma regularly, you will have difficulty knowing if interventions are improving your asthma or if your asthma is worsening. As a result, asthma may be limiting your day-to-day activities and you might not even realize it.

By reviewing the table below, you can classify your asthma severity based on NHLBI guidelines as either:

  • intermittent
  • mild persistent
  • moderate persistent
  • severe persistent

Your asthma severity is based upon the criteria described below. You classify yourself based on your worst symptom. For example, if you are waking up two nights per month with a cough or feeling short of breath, your asthma is in the intermittent asthma severity classification.

If have symptoms two days per week, use your rescue inhaler two times per week, have a normal FEV1 between exacerbations, but wake up at night three times per week, your asthma severity is moderate persistent. Your asthma treatment will, in part, be based on your asthma severity.

Asthma Severity

 IntermittentMild PersistentModerate PersistentSevere Persistent
Symptoms2 or less days per weekMore than 2 days per weekDailyThroughout the day
Nighttime Awakenings2X per month or less3-4X per monthMore than once per week but not nightlyNightly
Rescue Inhaler Use2 or less days per weekMore than 2 days per week, but not dailyDailySeveral times per day
Interference With Normal ActivityNoneMinor limitationSome limitationExtremely limited
Lung FunctionFEV1 >80% predicted and normal between exacerbationsFEV1 >80% predictedFEV1 60-80% predictedFEV1 less than 60% predicted


Interpreting the Asthma Severity Table

Severity is based upon symptoms associated with poor asthma control. The table uses the following criteria to determine asthma severity:

  • Symptoms: How many days in the past week have you experienced chest tightness, cough, shortness of breath, or wheezing?
  • Nighttime awakenings: How often do you wake up at night with chest tightness, cough, shortness of breath, or wheezing?
  • Rescue inhaler use: How many times in the last week have you used your rescue inhaler?
  • FEV1: What is your current lung function measured with spirometry? Unlike the other above symptoms, your FEV1 will not be readily available at home; you will need to ask your doctor when pulmonary function tests are performed.


There is some debate among experts today whether asthma action plans based off of symptoms are more effective than plans based off of peak flow or even home FEV1. You can talk with your doctor and determine which one they recommend and which one might be best for you.


National Heart, Lung, and Blood Institute. Accessed: May 20, 2010. Expert Panel Report 3 (EPR3): Guidelines for the Diagnosis and Management of Asthma

Clinical Pulmonary Function Testing, Exercise Testing, and Disability Evaluation. In Chest Medicine: Essentials Of Pulmonary And Critical Care Medicine. Editors: Ronald B. George, Richard W. Light, Richard A. Matthay, Michael A. Matthay. May 2005, 5th edition.

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