Imagine what it would be like if you woke up one night, alone in bed, and started to take a breath but nothing happened. You had to fight to get any air into your lungs.

It may sound like a nightmare, but those of you with asthma know all too well what I'm describing. Asthma attacks are terrifying, with their coughing, choking and wheezing.

Those of you with asthma, and those who take care of them, must remember the key to helping avoid attacks is to watch out for triggers -- things that bring on an attack -- and to recognize the symptoms of an attack coming on so you can treat them quickly.

Many of you have worked out an asthma action plan in advance so you know how to manage it everyday, including when the first signs of an attack appear. But too many of you have plans you don't follow, or have no plan at all.

Asthma is treatable, not curable. Even if your asthma has been under control for years you could still have an attack, given certain triggers. The best way to stay healthy is to stay away from them:

  • Don't smoke and avoid secondhand smoke, including from fireplaces and wood stoves. Need help to quit smoking? Contra Costa residents can call the Tobacco Cessation Program at 925-431-2666 for help.

  • Keep air ducts and heating filters clean, and remove household triggers such as pet dander, pests, mold and dust. Even some perfumes or household chemicals can trigger attacks.

  • Get your flu and pneumonia vaccinations -- respiratory infections are common triggers.

  • Control your weight with good eating habits. Several small meals are easier to digest than a couple of large ones. Remember how it's harder to breathe after a big meal?

  • For exercise you don't necessarily have to go to the gym. You can walk or dance.

    If you have asthma, but are not sure what makes it worse, talk to your doctor. Some foods and anti-inflammatory medicine, such as aspirin and ibuprofen, may cause an attack.

    Make a list of your activities or food that you ate before your attack and take it to your next appointment.

    Understanding how and when to use your medication is another important skill. You should follow the advice of your medical practitioner.

    As you age, your medication may need to be changed, so don't get hung up on what you used to take.

    Many of you rely too much on quick-relief or "rescue" medicines, the ones that work fast and open your airways within minutes. These medicines are good for short-term relief, but it's the long-term asthma control medications that have the greatest impact over time.

    When you use your long-term medicine correctly you should have less need for rescue medicines.

    Even if you don't feel your heart race or "taste" the medication, as many who use rescue inhalers do, it doesn't mean the long-term medication is not working. It is made to work over time -- so take your medicine!

    Are you doing a good job of controlling your asthma? If you use a rescue inhaler or wake up due to shortness of breath more than twice a week, you probably are not.

    Remember, you can't cure asthma, but you can always manage it better. Ask your health care provider, or call Contra Costa Health Services Asthma Educators Line at 510-231-8640.

    Janyth Bolden is the director for the Cardiopulmonary Services at Contra Costa Regional Medical Center & Health Centers. Healthy Outlook is written by the professional staff of the county health department. Send questions to series coordinator Dr. David Pepper at theairdoctor@gmail.com. For more health information, go to www.cchealth.org.