People with moderate persistent asthma may experience difficulty breathing and coughing every day. These symptoms may affect and impede their daily activities.

Doctors rank asthma into four classifications according to their intensity and frequency of symptoms. To make a diagnosis, they consider a person’s previous and current symptoms and the results from lung function tests.

The symptoms of asthma can occur occasionally or persistently. Around 64.8% of American adults with asthma have a persistent form of this condition. Doctors subdivide persistent asthma into mild, moderate, or severe.

This article explores moderate persistent asthma, the causes, symptoms, treatments, and lifestyle changes. It also discusses the classification of asthma stages.

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Asthma is a chronic condition that affects the airways of the lungs, causing them to narrow and produce excessive mucus. As a result, a person with asthma may have difficulty breathing.

The condition may trigger coughing and shortness of breath, and individuals may also have chest pain and produce wheezing sounds as they breathe.

Learn more about asthma.

How is it diagnosed?

To diagnose asthma, a doctor will ask about people’s family history and medical conditions to understand the symptoms and what causes them.

This diagnosis stage also includes questions about people’s lifestyle, such as whether they usually smoke or exercise, their environmental conditions, and the presence of other medical conditions, such as hives and eczema.

If a doctor suspects asthma, they will perform a physical exam and order tests. These screenings may include lung function tests such as spirometry and a peak flow test.

The doctor may also request a chest X-ray, a blood test, or other tests to confirm their diagnosis and rule out other conditions.

What it means

Doctors will classify a person’s asthma according to the results they gather. However, healthcare professionals do not use these stages as a rigid definition of the disease. People may switch between stages depending on their response to treatment and other factors.

Medical practitioners generally use the classifications to:

  • choose the most appropriate treatment, dose, and treatment schedule
  • monitor responsiveness to treatment
  • adjust the treatment to keep asthma under control

They also use it as a guideline to communicate if a person’s symptoms are better or worse at a given time.

Learn more about what an asthma diagnosis means with our Asthma & allergies hub.

The Global Initiative for Asthma (GINA) guidelines divide asthma into three categories according to their severity.

Previously, the National Asthma Education and Prevention Program classified asthma into four stages: intermittent, mild, moderate, and severe.

Based on new data, GINA assesses asthma by mild, moderate, and severe and does not distinguish between intermittent and mild persistent asthma. GINA considers this an arbitrary and nonevidence-based distinction.

This classification is for individuals who are not currently taking any long-term medications to control their asthma.

People with moderate persistent asthma exhibit symptoms daily, which can hinder their everyday activities. They typically use short-term medications more than twice a week to relieve symptoms.

A person with moderate persistent asthma will show symptoms, including:

In addition, they may:

  • wake up at nighttime once a week but not daily
  • use short-term beta-agonists daily, which are medications that relax airway muscles
  • have a Forced Expiratory Volume 1 score — a measure of the air they can force from their lungs in 1 second — above 60% but lower than 80% of the expected value
  • have a peak flow score — a measure of how quickly they can blow air out of their lungs — that varies by more than 30%

Learn more about the stages of asthma.

Healthcare professionals do not know the exact cause of moderate persistent asthma, and it may vary from person to person. However, experts agree that genetics and environmental exposure play a crucial role.

As moderate persistent asthma occurs daily, exposure to allergens and irritants can trigger these symptoms. These may present at home or in certain environments with airborne allergens and irritants such as pollen or dust.

Common asthma triggers include:

Asthma affects people of all ages but often starts during childhood. There are differences in the diagnosis and treatment of this condition depending on when it occurs.

Although many people first develop asthma during childhood, asthma symptoms can occur at any time. If it occurs during adulthood, doctors refer to this as adult-onset asthma.

Adults with newly-diagnosed asthma generally have persistent symptoms, and doctors recommend daily medications to keep symptoms under control. In contrast, children often experience intermittent asthma symptoms.

Learn more about the differences in asthma by age group.

For people with moderate persistent asthma, a doctor may recommend a combination of treatments to handle daily symptoms.

A healthcare professional will create a treatment plan to manage persistent asthma symptoms. The plan may include one or more of the following treatments:

Preventers or controller medications

These are the primary treatment for asthma. This treatment aims to prevent asthma attacks by treating the underlying airway changes, such as excessive mucus. A person needs to take them daily, even when they do not have symptoms.

Other long-acting treatments include inhaled corticosteroids, leukotriene receptor antagonists, and theophylline.


These short-acting inhalers act within minutes to relieve asthma attacks or ease worsening symptoms. Treatment typically starts with a low dose of corticosteroid inhaler plus a short-acting bronchodilator.

Combination inhalers

These medications combine reliever and preventer inhalers to provide long lasting relief from symptoms. A person needs to take them every day.

Allergy medications

If a person has allergies that increase or worsen asthma symptoms, doctors may prescribe allergy medications.


This type of treatment prevents swelling in the airways by targeting specific cells or pathways. They are for people with moderate-to-severe asthma. Doctors administer them through injection or infusion.

Learn more about asthma medications.

Adopting specific lifestyle changes may also help some individuals avoid having asthma attacks, especially in cases where persistent symptoms occur daily. These include:

  • Recognizing triggers: Discovering what causes asthma attacks can help people avoid future asthma attacks. Daily triggers include weather, air pollution, pet dander, and intense emotions.
  • Exercising: Daily exercise can improve overall health, including lung health and lung capacity. This can reduce flare-ups and help manage symptoms over time.
  • Avoiding tobacco: Smoking is a common asthma trigger, especially if someone smokes daily, as it irritates the lining of the airways. A 2020 study found that smokers have decreased lung protection function.
  • Breathing exercises: These exercises may improve a person’s overall lung health, capacity, and strength. It can improve quality of life and reduce hyperventilation symptoms, according to a 2020 study.
  • Getting vaccinations: Asthma can be due to common respiratory conditions such as the flu and pneumonia. Receiving seasonal vaccinations can help prevent a person from developing them. People with asthma may also have a higher risk of illness from COVID-19, so they should receive COVID-19 vaccination.
  • Following a healthier lifestyle: A 2019 study found that following a nutritious diet improves asthma control and airway inflammation and reduces the risk of worsening asthma.
  • Maintaining a moderate weight: People with obesity have an increased risk of asthma. A 2018 review found that children and adults with obesity who lose weight showed improvements in asthma-related quality of life and, in some, asthma control.
  • Getting enough sleep: Not getting enough sleep can affect a person’s immune system, which plays a significant role in lung health. A 2020 study also found that people who get insufficient sleep are at risk of frequent asthma attacks, increased healthcare needs, and poorer quality of life.

A person with moderate persistent asthma can keep their symptoms under control.

When people manage their symptoms, they can lead an active and productive life, including participating in sports.

Moderate persistent asthma is a relatively advanced type of asthma that requires treatment. A person will have daily symptoms and may find it challenging to perform day-to-day activities.

However, this condition still responds to treatment. Doctors can help manage the condition with a treatment plan specifically designed for the individual.

Avoiding triggers, making lifestyle changes, and taking medications can help control asthma symptoms.

A person’s asthma classification can go a stage higher or lower depending on their response to treatment. Therefore, individuals with the condition need to follow their doctor’s advice and treatment plan and stay in touch with them to keep track of their progress.