Breathlessness perception in asthmatic patients--clinical implications

Dyspnoea perception in patients with asthma bronchiale varies considerably in the course of their disease intra- and interindividually. The variability tends to be age dependent, elderly patients being less aware of even severe obstruction. Blunted perception of progressive airway narrowing has been identified, as an independent risk factor of severe asthma attacks or even asthma induced death. Such patients should be provided with a peak flow meter for home objective monitoring of airway obstruction. Simultaneously, a written action plan of how to manage an impending asthma attack should be available. A small number of asthmatics has been shown demonstrate excessive dyspnoea perception when no or minor airway obstruction could be established objectively. These patients could also profit from offering them a home peak flow meter due to the calming of their distress when no airway obstruction was measured and avoiding them of drug overuse.