What is asthma?

While the severity of asthma differs from person to person, it generally causes your airways to narrow and produce extra mucus. This causes difficulty breathing and can cause wheezing, coughing, shortness of breath, etc.

Your asthma is not considered well-controlled if:

  • You need to use a fast-acting “rescue” inhaled medicine more often than three times a week or
  • If your symptoms wake you up at night or
  • If your symptoms interfere with your normal activities

Symptoms of an asthma attack:

  • Symptoms like coughing, shortness of breath, etc. are getting worse
  • You’ve taken your rescue inhaler and it is not helping
  • You cannot sleep or eat due to being out of breath
  • You are breathing fast and cannot catch your breath
  • Kids having an asthma attack sometimes complain of chest or stomach pain
  • Sit up straight
  • Stay calm
  • Take your rescue inhaler (1 puff every 30 to 60 seconds, up to 10 puffs)
  • If you do not feel better after 10 puffs, call 911

Reduce stress and anxiety

Stress can worsen all medical conditions, especially asthma. Symptoms of stress can even mimic asthma or trigger an attack. If you have untreated depression, consider seeking care to help manage your asthma and improve your quality of life.

Eat healthy

There are links between obesity and lung disease. Eating healthy and minimizing the consumption of junk food can help you stay a healthy weight and minimize the complications of your asthma.

Reduce indoor pollutants

  • Air quality in your home can trigger your asthma
  • Eliminate cigarette smoke and consider having your home inspected for mold
  • Consider seeing an allergist that can identify your asthma triggers e.g.,
    • dust mites
    • pollen
    • mold
    • animals
  • Consider purchasing an in-home purifier
  • Don’t smoke or vape indoors, and consider quitting smoking/vaping

If you have asthma, we recommend you seek this treatment every year. All of these recommended treatments are covered by AHDI in our Standards of Care.

  • Visit your doctor twice a year
  • Take one spirometry (breathing test) per year (for patients 10 years of age or older)

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Sleep Apnea

What is Sleep Apnea?

Sleep apnea is a potentially serious sleep disorder in which breathing repeatedly stops and starts while you’re asleep. If you snore loudly and feel tired even after a full night’s sleep, you might have sleep apnea.

Obstructive sleep apnea

The more common form that occurs when throat muscles relax.

Central sleep apnea

Occurs when your brain doesn’t send proper signals to the muscles that control breathing.

Complex sleep apnea syndrome

Also known as treatment-emergent central sleep apnea, complex sleep apnea syndrome occurs when someone has both obstructive sleep apnea and central sleep apnea.

The main cause of Sleep Apnea is being overweight. Other possible causes are:

  • A narrow throat
  • A round head
  • Hypothyroidism (Link to hypothyroidism page)
  • Excess growth due to hormones (acromegaly)
  • Allergies
  • Deviated septum (problem with nose structure)
  • Medical conditions that congest upper airways
  • Smoking
  • Alcohol or drug abuse

If you think you may have Sleep Apnea, contact your primary care physician immediately. You might be immediately referred to a sleep specialist for evaluation.

Early warning signs and symptoms that can indicate the need for assessment by doctors include:

  • Loud snoring
  • Episodes in which you stop breathing during sleep—which would be reported by another person
  • Gasping for air during sleep
  • Awakening with a dry mouth
  • Morning headache
  • Difficulty staying asleep, known as insomnia
  • Excessive daytime sleepiness, known as hypersomnia
  • Difficulty paying attention while awake
  • Irritability

Factors that increase the risk of this form of sleep apnea include:

Excess weight

Obesity greatly increases the risk of OSA. Fat deposits around your upper airway can obstruct your breathing.

Neck circumference

People with thicker necks might have narrower airways.

A narrowed airway

You might have inherited a narrow throat. Tonsils or adenoids also can enlarge and block the airway, particularly in children.

Being male

Men are 2 to 3 times more likely to have sleep apnea than are women. However, women increase their risk if they’re overweight or if they’ve gone through menopause.

Being older

Sleep apnea occurs significantly more often in older adults.

Family history

Having family members with sleep apnea might increase your risk.

Use of alcohol, sedatives or tranquilizers

These substances relax the muscles in your throat, which can worsen obstructive sleep apnea.


Smokers are three times more likely to have obstructive sleep apnea than are people who’ve never smoked. Smoking can increase the amount of inflammation and fluid retention in the upper airway.

Nasal congestion

If you have trouble breathing through your nose—whether from an anatomical problem or allergies—you’re more likely to develop obstructive sleep apnea.

Medical conditions

Congestive heart failure, high blood pressure and type 2 diabetes are some of the conditions that may increase the risk of obstructive sleep apnea. Polycystic ovary syndrome, hormonal disorders, prior stroke and chronic lung diseases such as asthma also can increase risk.

Risk factors for this form of sleep apnea include:

Being older

Middle-aged and older people have a higher risk of central sleep apnea.

Being male

Central sleep apnea is more common in men than it is in women.

Heart disorders

Having congestive heart failure increases the risk.

Using narcotic pain medicines

Opioid medicines, especially long-acting ones such as methadone, increase the risk of central sleep apnea.


Having had a stroke increases the risk of central sleep apnea.

It can be difficult to know if you are experiencing symptoms of Sleep Apnea, since you are asleep when most of these clues would present themselves. However, Sleep Apnea can cause you to feel the following when you are awake:


Waking up feeling tired no matter how much sleep you’ve had, feeling sleepy during the day and dozing off behind the wheel while driving.


Very loud snoring that wakes up your bed partner.

Gasping and choking

Waking up feeling short of breath, gasping for air or with the sensation that you’re choking.

Feeling bad when you wake up

Morning headaches, dry throat and mouth, and a severely sore throat in the morning.

Difficulty sleeping

Waking up frequently, feeling restless at night and insomnia. This is especially a presenting symptom in women.

Cognitive and mood changes

Memory problems, anxiety, depression and loss of interest in sex.

If you experience the following, call 911 or visit the emergency room:

  • Chest pain or pressure
  • Difficulty breathing
  • Profuse sweating
  • Numbness on one side of the body
  • Weakness (loss of strength) on one side of the body
  • Lose weight if you’re overweight
  • Exercise regularly
  • Drink alcohol moderately, if at all, and don’t drink several hours before bedtime
  • Quit smoking
  • Use a nasal decongestant or allergy medications
  • Don’t sleep on your back
  • Avoid taking sedative medications such as anti-anxiety drugs or sleeping pills

If you have Sleep Apnea, we recommend you see your doctor every year. Recommended treatments are covered by AHDI in our Standards of Care.

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