'Now ... because of better understanding of the disease, better preventive education and better medicines, most people with asthma don't have to have any symptoms.'

"We have known for a long time that asthma can be controlled better, that it is not being controlled as well as it can be, and that we ought to do something about it," said Dr. Norman Edelman, a professor of medicine at the State University of New York at Stony Brook and a medical consultant to the American Lung Association.

Approximately 20 million Americans have asthma and at least half are not as controlled as they could be -- suffering needlessly from interrupted sleep, lost days at work or school, and inability to exercise, Edelman said.

Perception vs. Reality

A recent poll taken by the Asthma and Allergy Foundation of America (AAFA) found that 88 percent of nearly 600 adults who have asthma reported managing their symptoms well. But that may not be the case: In that same group, 61 percent said they had to catch their breath while running up the stairs, 48 percent have been woken in the night as a result of asthma symptoms and 50 percent have had to stop exercising in the middle of their regimens.

Among 118 respondents whose children have asthma, 89 percent felt their children's symptoms were being well-controlled, yet half of the children had missed days of school and or work, half were unable to complete their exercise programs, and 45 percent were awakened in the night because of asthma symptoms.

"This was an interesting study of perception versus reality," said AAFA spokesman Mike Tringale. "These people have learned to live with compromised lives."

He added, "Now, however, because of better understanding of the disease, better preventive education and better medicines, most people with asthma don't have to have any symptoms."

'It Changes Who You Are'

The implications of poorly managed asthma are numerous, including physical problems such as weight gain from not exercising. "Weight gain is terrible for asthma, because it exacerbates the symptoms," he said.

And there are more subtle psychological changes.

"People's personalities are affected. Even though you are going about your daily activities, like going to work, you are still disabled because you are not functioning at your maximum. It changes who you are," Edelman said.

To close the knowledge gap, both the American Lung Association and AAFA have started programs to alert asthma sufferers that most can control their asthma more effectively.

Talking the Same Language

Last spring the American Lung Association introduced a five-question online test on its Web site for asthma sufferers over the age of 12.

Questions include asking if and how seriously within the last four weeks asthma symptoms prevented asthmatics from completing work at school or in the office, if those with asthma are kept awake at night because of their illness and how often asthmatics have experienced shortness of breath.

"About 100,000 people have taken the test online, and two-thirds of them have found that they don't have their asthma under control," said Edelman.

The test's success has spurred the Lung Association to develop another quiz designed for children under 12, to be answered by their parents.

The AAFA's program called Sleep Work Play also helps asthma patients better recognize their symptoms so they can talk to their doctors about controlling them.

"People haven't been talking in the same language. Doctors don't probe deeply enough in patients' symptoms, parents don't question their kids," said AAFA's Tringale.

Online Questionnaires

The program includes a Web site questionnaire that asks asthma patients about their sleep, work and play habits. It also encourages users to take the completed questionnaire to their doctor, so that the two of them can discuss how to better manage asthma symptoms.

The questions -- for example, "Do you have to stop and do things differently because of your asthma? Please be specific: even little things like walking through a park, petting a dog, going on vacation, etc." -- help people to think about how asthma symptoms are really affecting their lives, Tringale said.

More information: For adults, the asthma control questionnaire can be found at the American Lung Association. The kids-oriented quiz is at the Asthma and Allergy Foundation of America.