Topic Overview

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 who have 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, be sure to bring this to the attention of your doctor. Children who have asthma should still be encouraged to exercise. And they should not be excused from exercise unless that is really necessary.

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

• Take your medicine daily, if needed, to decrease airway inflammation and decrease the overreaction (hyperresponsiveness) of the airways that carry air to the lungs (bronchial tubes).
• Warm up before exercising.
• Use a beta2-agonist inhaler about 10 to 30 minutes before exercising. Examples of beta2-agonists used for exercise-induced asthma include albuterol (such as Proventil) and levalbuterol (Xopenex). The effect of the short-acting beta2-agonists lasts several hours. Using a cromolyn inhaler shortly before exercise also helps some people.

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 medicines should be given and what to do if your child has an asthma attack, especially before and during physical exercise. Your child's asthma action plan provides this information. School officials need to know the early warning signs of an asthma episode, how your child's medicines are used, and how to give the medicines. School personnel also should know how to contact your child's doctor.