There's nothing worse than waking up during the night struggling for breath due to the wheeze and cough of asthma. I know because, until I reached my teenage years, it happened to me every week.

In those days, there were no relievers or preventers, so my grandmother would gently massage my back with cornflour as I waited until the doctor came at 7am.

I'm not alone in my suffering, with more than two million Australians now diagnosed with asthma. That's one in four children, one in seven teenagers and one in 10 adults.

In childhood, about 75 per cent of asthma attacks are intermittent. This means the wheeze, cough and shortness of breath happens just every now and then. These attacks are often triggered by a viral infection of the lungs. Doctors call this a 'viral-induced wheeze'.

When the symptoms occur more frequently and are more severe, it's called 'persistent asthma'.

'Asthma can be devastating,' says Associate Professor Dominic Fitzgerald, respiratory and sleep specialist at The Children's Hospital at Westmead in Sydney. 'The most important thing is that it's diagnosed properly. Far too often it isn't, which puts people in danger of being given the wrong treatment.

'It's vital to realise that it's a wheeze and not just a cough that underlines the accurate diagnosis of asthma. It helps doctors formulate a treatment plan of action.'

This is where I'd like to stop for a moment. Some young people have difficulty with aerosol or powder medications prescribed to relieve asthma. They also experience problems using inhaled steroids, which have a preventative function.

For people experiencing such difficulties, a chewable tablet called Singulair (also known by its generic name Montelukast) works well to reduce the inflammation and congestion in the bronchial tubes.

The once-a-day medication is also very effective for young people who suffer from severe allergic rhinitis, with symptoms including repeated sneezing, itching as well as nasal obstruction due to those annoying dust mites.

Curse or cure?

But there is a downside to the medication. The US Food and Drug Administration is currently reviewing claims Singulair can make people severely depressed and can even lead to suicidal thoughts.

Merck & Co. Inc., the distributor of Singulair, studied 11,000 people in 40 clinical trials, which were all conducted before the medicine was released to the public. Severe emotional distress was not reported in any of them. However, there have been several reports of depression and agitation since the medication went on the market.

'Naturally, when we hear reports like this we are concerned,' Associate Professor Fitzgerald says.

But at this stage there is no strong evidence to suggest Singulair causes these emotional problems.

So Associate Professor Fitzgerald advises that, although Singulair may not be for everybody, people should be assessed on an individual basis.

He adds: 'Then we lay all the treatment cards on the table
and, together with them or their parents, make a decision as to which medication is best for them.'

Pros and Cons

Talk to your GP about what's best for you. But as a guide...

DO take Singulair:

• To prevent asthma with frequent mild symptoms.
• When a virus causes a chest infection and it sets off asthma attacks.
• When exercise triggers asthma symptoms such as shortness of breath.
• If you suffer periodic sneezing or congestion.

DON'T take Singulair:

• If you're experiencing an acute asthma attack. Relievers and preventers are much more effective in these cases.
• If your regular attacks cause moderate-to-severe sneezing, coughing and shortness of breath.
• If you have a history of psychological or emotional issues, or suffer depression (moodiness, sleep and eating problems or agitation). 
• If you've had a bad reaction to it in the past.

Action plan:

One of the most effective ways to conquer asthma is with an Asthma Management Plan.

It's designed specifically for the individual asthma sufferer and clearly details:

• What needs to be done should a serious asthma
  attack suddenly occur.
• How to take your medication in the correct way.
• The triggers that are likely to make the asthma worse. 
• How best to monitor your episodes of asthma.

A management plan is ideal for anyone with serious asthma, and particularly handy for schools or carers to help them know what action should be taken in the event of an attack. So if you don't have a plan, make sure you consult your GP.

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