Do you know what to do if your asthma symptoms are waking you up at night or when you're very short of breath and your quick-relief medicines don't help? If you are not completely sure, you're likely to benefit from an asthma action plan -- a key feature of newly updated guidelines issued by the National Asthma Education and Prevention Program (NAEPP).

In addition to having an asthma action plan, the guidelines stress that it's also important to keep track of how you're feeling, to take steps to avoid asthma triggers, and to see your doctor regularly -- even when you're not sick. By being proactive, you'll be better able to control your asthma instead of having it control you.

Step 1: Develop an Asthma Action Plan.
This plan is a one-page reference guide to the medications and other steps you should take to manage your asthma based on whether you're feeling well, your asthma symptoms are getting worse, or your symptoms are so severe that you need to seek medical attention.

You can download a free asthma action plan at www.nhlbi .nih.gov/health/public/lung/asthma /asthma_actplan.pdf. To order by phone, call the National Heart, Lung, and Blood Institute (NHLBI) Health Information Center at 301- 592-8573.

Step 2: Avoid Asthma Triggers.
Many people with asthma find that exposure to allergens and other substances can worsen their asthma. Common indoor allergens include mold, animal dander (flakes of skin or dried saliva from animals with fur or feathers), and residue from dust mites (microscopic bugs that live in fabric, bedding, and carpets) and cockroaches. Outdoors, mold and pollen also are common allergens.

Other asthma triggers include irritants, such as tobacco smoke, strong odors from certain chemicals, and sprays like hairspray and perfume. Vacuuming or consuming foods that contain sulfites, such as wine, dried fruit, or shrimp, can trigger an asthma attack in some people. The NAEPP guidelines recommend identifying the asthma triggers that make your asthma worse and taking steps to avoid them.

Step 3: Keep Track of Your Asthma Symptoms.
There are multiple ways to determine how your lungs are functioning, but one of the most important is how you're feeling from day to day. For example, how frequent and intense are your asthma symptoms? How often do symptoms limit your daily activities? Do you use an inhaler for quick relief from asthma symptoms? If so, how many puffs do you need? Make note of this information and tell your doctor at your next appointment.

If you use a peak flow meter, keep track of the readings for your doctor to review. If your peak flow is regularly at or near your best level, modifications to your treatment may not be necessary. Conversely, if your peak flow readings are consistently lower than your best and you've been experiencing symptoms, your doctor is likely to consider changing your current regimen. The more detailed information you can provide, the better your doctor can identify any changes to your condition and tailor treatment to best meet your needs. Keeping a written record is a good idea so you won't need to rely on your memory to recount how you've fared since your last visit. Keeping a diary or writing notes on a daily calendar can give the doctor an accurate picture of your day-to-day health.

Step 4: See Your Doctor on a Regular Basis.
The guidelines emphasize that while asthma can be controlled, your condition can change over time. That's why it's important for a doctor to regularly monitor your level of asthma control so that treatment can be adjusted as needed. In fact, one of the most important things that you can do is see your doctor regularly (every one to six months, depending on the severity of your asthma symptoms), not just when you're sick. By seeing the doctor when you're well, he or she will get a better picture of your lung health over time and can also better assess how severe your breathing problems are when your asthma is not under control.