About this symptom
Wheezing is a high-pitched whistling sound when you breathe. It is caused by air moving through narrowed airways, and is heard most when breathing out, though it can also happen when breathing in. It usually comes from the small airways deep in the lungs, but a block in a larger airway can cause it too.
Asthma and COPD are common causes, along with bronchitis and other chest infections. It can also come from heart failure, acid reflux, an allergic reaction, smoking, or something breathed in. In babies and young children it is often triggered by a viral infection. Wheezing is a sign, not a disease, so the cause needs to be found.
Possible causes
This is not a diagnosis. These are the causes doctors think about, with the ones that are most urgent to rule out first.
- Severe allergic reactionWheezing with swelling of the lips, mouth, tongue or throat, a tight throat or fast breathing, often soon after a sting, a food or a medicine.
- ChokingWheezing and coughing that start suddenly after something may have been breathed in or swallowed, mostly in a young child.Read about it
- Heart failureSometimes called cardiac asthma. Wheezing with breathlessness lying down or on effort, and swollen ankles.Read about it
- PneumoniaWheezing with a cough, a high temperature, breathlessness and tiredness, and chest pain when breathing in or coughing.Read about it
- AsthmaWheezing with a cough and chest tightness that come and go, often worse at night or in the early morning, or after dust, smoke, cold air or exercise.Read about it
- COPDOngoing wheezing with a long-lasting chesty cough, breathlessness and frequent chest infections, mostly in people who smoke or used to smoke.Read about it
- BronchitisWheezing with a cough that brings up phlegm, usually after a cold or flu, sometimes with a sore throat and a high temperature.Read about it
- Acid refluxWheezing with heartburn or a sour taste, often worse after meals or when lying down.Read about it
When to get help
Also get emergency care for:
- An asthma attack that gets worse at any time, does not improve with the reliever as your doctor's plan says, or when there is no inhaler
- Sudden wheezing and coughing after something may have been breathed in, especially in a child
See a doctor soon if you have:
- Wheezing for the first time
- Wheezing that keeps coming back or has no clear reason
- Wheezing that is getting worse, or usual medicines no longer control it
- Wheezing with a cough that has lasted more than two to three weeks
- Wheezing with fever and yellow or green phlegm
- Wheezing with breathlessness lying down or swollen ankles
If you have asthma or COPD and mild wheezing settles with the medicines and plan your doctor gave you, it can be managed at home. Tell your doctor if it is coming back more often.
What you can do at home
With any emergency sign, do not stay at home: call for an ambulance first and follow any advice the operator gives.
Do
- Sit upright and try to stay calm
- Take your prescribed asthma or COPD medicines as your doctor has told you, and follow your asthma action plan if you have one
- Keep away from smoke, dust and anything you know sets it off
- Warm, moist air, such as in a steamy bathroom, may ease it for some people
Do not
- Do not smoke or stay in smoky air
- Do not wait at home if an attack is getting worse
- Do not drive yourself to hospital
What the doctor will do
The doctor will ask when the wheezing started, how long it lasts, when it is worse and what seems to set it off, such as dust, smoke, cold air, exercise or an infection. They will ask about asthma, allergies, smoking, heartburn and medicines, and listen to your chest. In a child they will ask whether something may have been swallowed or breathed in.
Tests may include:
- A pulse oximeter, a clip on the finger that shows the oxygen level in the blood
- A chest X-ray
- Breathing tests () that show how well the lungs work
- Blood tests
Treatment depends on the cause. If breathing is very difficult, a stay in hospital with oxygen and medicines through a drip may be needed.
Myths and facts
Things people often say about this. Open each one to see what is true.
Myth“Wheezing always means asthma.”What is true?
Fact
Asthma is a common cause, but COPD, bronchitis, chest infections, heart failure, acid reflux, allergies and something breathed in can cause wheezing too. Only a doctor can tell which, so have new wheezing checked.
Myth“Wheezing will pass on its own, so there is no need to see a doctor.”What is true?
Fact
Wheezing that is new, keeps coming back or has no clear cause needs a doctor's check. Warm, moist air may ease it for a while, but it does not treat the cause.
Myth“During an asthma attack, keep using the inhaler and wait it out at home.”What is true?
Fact
If an attack gets worse at any time, does not improve with the reliever inhaler as your doctor's plan says, or you have no inhaler, call for an ambulance. Do not drive yourself.
Questions to ask your doctor
Tick the ones you want answered and take them with you.
Common questions
Does wheezing always mean asthma?
No. Asthma is common, but COPD, bronchitis, chest infections, heart failure, acid reflux, allergies and something breathed in can also cause wheezing. A doctor can tell which with an examination, a breathing test and sometimes a chest X-ray.
Why is my wheezing worse at night?
Asthma symptoms are often worse at night or in the early morning. Acid reflux and heart problems can also bring on breathing trouble when lying down. Tell your doctor if wheezing or breathlessness wakes you at night.
Why does my child wheeze?
In babies and young children wheezing is often triggered by a viral infection. It can also come from asthma or from something breathed in. Take a wheezing child to a doctor, and get emergency help if the child is grunting, sucking the tummy in under the ribs, or has pale, blue or grey lips.
What can I do at home to ease wheezing?
Take your prescribed medicines as your doctor has told you, keep away from smoke, dust and other triggers, and sit upright. Warm, moist air may help some people. These ease symptoms but do not replace a doctor's check, especially for wheezing that is new or getting worse.