New to asthma: what comes next, what to ask and what to write down in the first four weeks

After an asthma diagnosis your doctor or nurse keeps clarifying things, you get to know your inhaler, and you can ask for a written action plan. For the first four weeks you note how your days and nights go, on paper or in Sam, where sleep and respiratory rate from Apple Health sit next to your entries. Your doctor decides the treatment plan.

This text is for you if a doctor has already diagnosed asthma. If you only suspect it, your doctor is the next step. There is no self-test here.

What does the diagnosis mean?

The NHS calls asthma a common condition that affects your breathing. The main symptoms are wheezing, coughing, shortness of breath and a tight chest. They come and go, and they are often worse at night or early in the morning. Common triggers include exercise, cold air, air pollution and allergens such as pollen, dust or pet dander.

Asthma is common. Asthma and Lung UK says about 8 in 100 people in the UK have it.

Many people ask at once whether asthma can be cured. The NHS says not currently, but if it is well treated you should not have problems with symptoms. How your own course looks is for your doctor to say.

What checks come next?

The NHS describes the steps. A GP or nurse asks questions and listens to your chest. A simple breathing test may follow, and sometimes blood tests. You may also use a peak flow meter at home for several weeks. Asthma can take time to diagnose, because symptoms vary and breathing problems can have different causes. Doctors sometimes try asthma medicines to see whether they relieve your symptoms.

Some of this may already have happened. Ask what is still open and when you will discuss the results.

Who decides which inhaler I use?

Your doctor does. The NHS says inhalers are the main treatment and describes a reliever inhaler used when you have symptoms, a preventer used every day, and combined approaches. This text recommends no medicine and no dose.

Ask your doctor or nurse to write down which device you use for what. Ask them to watch you use it, and bring your own devices. The NHS says annual asthma reviews check your inhaler technique and whether your treatment works.

What is an asthma action plan and how do I get one?

An asthma action plan is a written guide you agree with your doctor or nurse. Asthma and Lung UK describes three parts: the medicines you take routinely, the steps when symptoms get worse, and what to do in an emergency, including when to call for help. The CDC says everyone with asthma needs their own plan, made together with your health care provider.

Ask for it at the next appointment. If your service offers an asthma course or education session, ask about that too.

What do I write down in the first four weeks?

Four weeks give your doctor numbers instead of guesses. The GINA questions that doctors use to rate asthma control also look at the last four weeks. One line per event is enough. This is a good set:

• Reliever: the day, number of puffs, the reason (symptoms, or before exercise as your plan says) and whether it helped.
• Nights: whether asthma woke you.
• Attacks: date, how bad it felt, whether the reliever helped, whether you needed extra medical help or steroid tablets.
• Before it: pollen, cold air, a cold, smoke or dust, exercise or stress. These are your notes, not proof of a cause. See asthma triggers: exercise, sleep and stress.
• Preventer: whether you took it as prescribed. Gaps belong in the record too. In Sam you can tick off doses and set reminders.
• Peak flow: only if your doctor asks you to measure it.

A line can look like this (invented example): "Tue, 2 puffs reliever after the stairs in cold air, helped, did not wake at night."

In the asthma program you enter reliever uses with puffs and reason. Attacks have their own entry with strength, whether the reliever helped and a switch for night waking. Sleep and respiratory rate from Apple Health sit next to them. You enter only what you know yourself. Peak flow values are not entered in Sam.

At the end of each week, count the days with reliever and the nights you woke. What those two numbers mean for you is a topic for your doctor. Our guide to asthma diary with Apple Watch and Sam shows the setup.

Which questions do I bring to the next appointment?

Bring your record and your inhalers. Then ask:

• Is my asthma allergic, non-allergic or both?
• Which checks have been done and which are still planned?
• Can you watch my technique and write down which device is for what?
• Do I get a written action plan, and what should I do if things get worse?
• Is there an asthma course or education session I can attend?
• Should I measure peak flow, and how do I note it?
• When is my next review?

What can an Apple Watch do, and what can it not?

An Apple Watch does not measure lung function. For that you need a spirometer at the clinic or a peak flow meter.

What the watch gives you is context. Apple says the Vitals app needs you to wear the watch to sleep for 7 days to establish your typical range. It shows overnight metrics such as respiratory rate. Apple states that these measurements are not intended for medical use. A respiratory rate is a note for the conversation, not a finding. In Sam it appears as a number next to your entries, without interpretation. More in respiratory rate, sleep and asthma.

When should I not wait for the appointment?

Severe breathing trouble is not a topic for a blog post, and a diary does not replace an emergency call. The NHS says to call the emergency number if you have an asthma attack and you feel worse at any time, do not feel better after the maximum dose of your reliever inhaler, or do not have your inhaler. Use your local emergency number (112 in the EU, 999 in the UK, 911 in the US). Do not drive yourself to hospital. After any attack, the NHS advises seeing your GP within 2 days.

What counts as getting worse for you, and what to do before calling, belongs in your written action plan. Ask for it. This text does not replace a medical assessment.

Log your first four weeks in Sam and take them to your appointment

You go to the appointment with a record, and you do not have to piece four weeks together from memory.

• Attacks (date, strength, whether the reliever helped) and reliever uses (puffs, reason) go into the asthma program in a few taps. Instead of loose notes, everything sits in one place with a date.
• Sleep and respiratory rate come from Apple Health, and on request pollen and air quality for your approximate location. You add only what you know yourself.
• The doctor report (PDF) shows days with reliever and nights woken for the last 28 days, plus attacks and steroid courses. You print it or show it on your phone.

The program starts after your doctor has diagnosed asthma, and Sam has no peak flow entry and no action plan.

Try Sam Health

Sam is a wellness companion, not a medical device. The app does not diagnose, treat, cure or prevent any condition or health state. Always consult qualified professionals for medical decisions.

Related reading

• Asthma or COPD? Understanding the key differences
• Asthma not well controlled? What that means
• Doctor visit checklist for a chronic condition

Sources

Updated: October 2026

• NHS: Asthma, Diagnosis (last reviewed 7 April 2025), Treatment, Living with asthma and Asthma attack
• Asthma + Lung UK: What is asthma? (last reviewed 31 May 2024)
• Asthma + Lung UK: Personal asthma action plans (last reviewed 11 January 2026)
• CDC: Living with asthma (last reviewed 28 August 2026)
• Global Initiative for Asthma: 2026 GINA Summary Guide, Table 2, assessment of asthma control
• Apple Support: Track overnight and daytime vitals with Apple Watch