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With your next breath … rethink your asthma control

If your symptoms are persistent, your asthma may be severe or may not be as well controlled as you think it is. That’s why it’s important to know about the latest asthma research, which identifies inflammation deep inside the lungs as asthma driven by type 2 inflammation.

See what uncontrolled asthma feels like

“Sure, it’s hard taking
the stairs with my
asthma … but that’s
normal, right?”

A man on stairs
A man on stairs

Asthma, uncontrolled asthma
and severe asthma


It’s time to bring more awareness to severe asthma
and its impact.

It is estimated that severe asthma represents about 5% to 10% of asthma cases. It can be harder to control, disrupting day-to-day lives even when multiple controller medicines are used. People with severe asthma may not realize that their asthma falls into this category.


According to Asthma Canada, “severe” and “uncontrolled” asthma can be recognized as follows:

Patients with severe asthma:

  • Have more difficulty achieving control of their disease
  • Need a greater number of medications and often at higher doses
  • Require more medical care than patients with mild-to-moderate disease

Asthma is considered uncontrolled if a patient experiences one or more of the following signs or symptoms:

  • Frequent visits to the ER, or a stay in the hospital
  • Using 3 or more pulls of their rescue inhaler per week (excluding use before exercise)
  • More than 2 courses of steroids in a year
  • A feeling that asthma is controlling their life and nothing seems to work
  • Frequent flare-ups, asthma attacks and severe symptoms
  • A feeling that their condition is life-threatening
  • Regular absences from work, school or other activities
  • A feeling of wanting to withdraw

of people with self-reported severe asthma indicate that their asthma is controlled


Some people living with severe asthma experience symptoms as part of everyday life, despite the use of multiple medicines. When asthma is uncontrolled, serious asthma attacks requiring emergency hospitalizations can occur.

Asthma can be recognized by symptoms such as coughing, wheezing and difficulty breathing.
Your level of asthma control can be assessed based on how often these symptoms:

  • Сough

    Occur during the day

  • Bed

    Wake you in the night

  • Outside

    Restrict daily activities such as sports, socializing and going outside

  • Inhaler

    Cause you to use quick-relief rescue inhalers

It is easy for a person to overlook the severity of their asthma, and in some cases, experiencing everyday symptoms can start to feel normal.


say the ability to function normally is very important for their asthma management


The symptoms of severe asthma that are not well controlled can be ever-present and impact the everyday lives of those living with the condition and their loved ones.

  • Heart pulse

    Severe asthma can interfere with physical activity and make routine tasks like climbing stairs, doing chores and running errands feel exhausting. In a 2021 survey, 81% of people living with severe asthma said their condition limited physical activities and 67% had to miss work or school because of their symptoms.

  • Productivity

    In a 2021 survey, 85% of respondents said severe asthma affected the quality of their social interactions. The symptoms of severe asthma can keep people from doing what they love with friends, and misperceptions about the condition can make people feel misunderstood or embarrassed.

  • Group of persons

    Severe asthma can cause people to have lower productivity or miss school and work.

  • Respondents

    It is common for people with severe asthma to experience anxiety and panic attacks due to the unpredictability of their symptoms. It is estimated that 30% to 50% of asthmatics experience symptoms of depression.

  • Mood

    The impact of severe asthma goes beyond the person living with it. It can also affect relationships with parents, partners and friends – as well as trigger stress and anxiety. In a 2021 survey, 80% of respondents reported feeling stressed due to their asthma.


of people with asthma had an open discussion with their healthcare provider about how asthma affects their daily lives

Societal impact

The societal and economic impact of asthma is often under-estimated.

  • Costs

    Asthma is associated with direct costs (e.g., hospitalizations, healthcare professional services, medications) and indirect costs (e.g., missed days of work or lower productivity). In Canada, the direct costs of asthma are estimated at $2.1 billion annually, and the indirect costs to the economy are expected to be $4.2 billion annually by 2030.

  • Costs increase

    It is estimated that severe asthma represents about 5% to 10% of asthma cases. It is also estimated that 50% of all annual healthcare costs for asthma come from the most severe asthmatic population. The costs associated with uncontrolled asthma can be more than 2x those of well controlled asthma.

What are the symptoms
and triggers of asthma?

Wheezing, shortness of breath, cough and/or chest tightness are typical symptoms of asthma. There is an increased probability that a patient has asthma if these symptoms are triggered by:

Environmental triggers:
Factors such as pollen, smoke, weather changes, and exercise.
Immune system:
An overactive immune system response can lead to excessive inflammation in the airways, causing them to narrow and making it harder to breathe.


If asthma is holding your child back, know that there may be ways to help them. Scientific research has shown that type 2 inflammation may play a role in some forms of asthma in children.

Is your child’s asthma well controlled?

It may be hard to know how well your child’s asthma is controlled on a day-to-day basis. But there are a few signs that may indicate that better control is needed, including:

  • Difficulty with symptoms during everyday activities or exercise
  • Trouble sleeping because of symptoms
  • Cold or chest infection
  • Need for reliever medications 3 or more times a week
  • Missing school due to asthma symptoms

If you’ve noticed these signs, your child’s asthma may not be well controlled – and it may be time to talk to your healthcare provider about what steps can be taken.

New research shows that a specific type of inflammation called type 2 inflammation may occur in 85% of children with asthma.

Type 2 inflammation makes your child’s immune system overreact to environmental triggers, like dust and pollen. Keep reading to learn more.

Type 2 Asthma and Type 2 Inflammation

Type 2 inflammation is a particular type of inflammation that can take place deep within your lungs. In two studies, this type of inflammation was found to be present in 50 to 70% of people with asthma. There are often higher levels of type 2 inflammation in the airways of people with severe asthma.

In some cases, asthma is linked to type 2 inflammation. The asthma subtypes driven by type 2 inflammation are called “eosinophilic”, “allergic”, or “mixed” (i.e., a combination of eosinophilic and allergic).

Take action and
rethink your asthma

Could it be asthma driven by type 2 inflammation?

The best way to find out is to ask your healthcare provider. You may already be using inhaled corticosteroids, corticosteroids taken by mouth or given by an injection, and drugs called “bronchodilators” that help open up your airways to manage symptom relief. If you have asthma driven by type 2 inflammation, there are also drugs called “biologics” that may be added to other treatment options to help reduce the number of asthma attacks you experience.

Since all treatment options can cause side effects and may not be suitable for everyone, it is important to have a conversation with your doctor.


The science of asthma and its management is evolving.

If you are living with asthma symptoms and are ready to rethink your management of it – including learning about type 2 inflammation – talk with your healthcare provider.

Be open and honest with your doctor about your asthma and how it makes you feel and impacts your life.

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Additional Resources

Download the Rethink Your Asthma Magazine Series – 5 magazine-style issues to help you manage your asthma, one step at a time.

  1. Issue 001:
    Understanding Asthma Control
  2. Issue 002:
    Knowing Your Asthma Type
  3. Issue 003:
    Talking with Your Doctor
  4. Issue 004:
    Making an Asthma Plan
  5. Issue 005:
    Staying on Track

Frequently asked questions

There is no such thing as “just” asthma. There are many different types of asthma with different causes, and people with any type of asthma may experience their symptoms to different degrees.

New understanding has identified a particular type of inflammation called type 2 inflammation. Type 2 inflammation occurs deep in the lungs in some asthma patients. In two studies, it was found that 50-70% of participants had asthma driven by type 2 inflammation.

People with severe asthma often have higher levels of type 2 inflammation in their airways. To determine a treatment that is right for you, your doctor may run some tests to see which asthma subtype you are affected by. If you have asthma that’s driven by type 2 inflammation, there are options that can be used in addition to other asthma medications to help block the activity of certain substances involved in the inflammatory process. This can help decrease the number of asthma attacks you experience.

Learn more about severe asthma

It is important to know that having asthma symptoms as part of your everyday life does not need to represent “normal” life with asthma. If your symptoms keep you from doing the things you want to do, and keep coming back, it may be time to rethink your asthma control.

Your level of asthma control can be assessed based on how often these symptoms:

  • Occur during the day
  • Wake you at night
  • Cause you to use your asthma rescue (reliever) medications
  • Restrict your activities

If you experience any of these conditions, talk to your healthcare provider to see if your asthma is well controlled.

Be honest with yourself and with your healthcare provider about the impact asthma has on your life. Even if you’ve learned to live with your asthma, you should talk to your healthcare provider if you find it difficult to:

  • Climb stairs
  • Sleep at night
  • Own pets
  • Be around smokers
  • Feel independent
  • Do your job well
  • Do household chores
  • Keep up with your kids
  • Leave your home
  • Catch the train or bus
  • Exercise regularly
  • Experience the outdoors

Your doctor or healthcare team are there to help you better understand and manage your asthma.

Many people with asthma accept their symptoms as normal and do not expect additional help from their doctor, which can prevent them from getting optimal asthma management. Working with your doctor and maintaining an ongoing dialogue can help you better manage your asthma.

Your healthcare team can keep you up to date about the latest asthma research and can also point you to other resources that can help with your asthma management plan, including online communities, patient support groups, and mental health professionals to help manage the emotional impact of your condition.

Talking to your healthcare provider and asking questions about your asthma is important to achieving better outcomes. Here are some questions that could help you start the conversation:

  • What kind of asthma do I have?
  • Can lifestyle changes help with my asthma management?
  • What things in my environment are triggering my asthma symptoms?
  • Are there support groups for people living with asthma?
  • Should I keep a journal to track my symptoms?

Type 2 inflammation can be involved in other conditions throughout the body, such as atopic dermatitis, eosinophilic esophagitis, Aspirin Exacerbated Respiratory Disease (AERD), and chronic rhinosinusitis with nasal polyposis (CRSwNP). In fact, about 1 in 2 people with asthma also have CRSwNP. Learn more about CRSwNP >

Although you may sometimes feel like dealing with severe asthma creates a barrier between you and your family, friends or colleagues, it’s important to know that you never have to feel alone. Talk to your healthcare provider about creating a personalized plan.

A good asthma management plan can help you achieve success in managing your symptoms and help you establish positive habits that last a lifetime.

As you know, it is important to take your prescribed medication to stay ahead of your asthma, even on days when you are feeling good. Your asthma plan will help you cover the different ways you can optimize your asthma care and improve your success.

The best asthma management plan is tailored specifically to you. Whether it is a checklist or a worksheet, your Personalized Asthma Action Plan should be action-oriented and include things like:

  • Your individual asthma triggers
  • A daily journal to track your progress
  • Emergency contact numbers of family, friends, and healthcare providers
  • A personal “green/yellow/red” system to help you identify and track your symptoms

The more involved you are in creating your asthma plan, the more likely you are to stay on track.

Having an asthma plan also means planning ahead. Your asthma can be unpredictable, and you might feel like avoiding things because of the possibility of a serious attack. The following 3 steps can help you prepare and move ahead with your plans:

  • What do you want to do? Identify the activity/event you are thinking about skipping because of concern about an asthma attack
  • Why do you want to do it? Think about why you would like to participate in this activity
  • What can you do to prepare? Write down any ideas you can think of that could help you plan for unexpected asthma symptoms during your activity