I had asthma when I was younger, it went away for a few years then came back. In the last few years attacks were common and there has been more than once where I took 16 puffs of the inhaler and nothing happened. The debate of 'Do I take another puff and risk a heart attack or risk passing out' were common. There used to be at least one attack each night. When it got bad nothing really helped.

I've been able to mitigate it and now its at the point were I may need it once a week if that.

Here's what I did (warning; some of this stuff sounds crazy)

• Reduced my triggers
• Got an allergy test. I was allergic to cat dander, grass, and dust mites.
• For dust mites I replaced my carpeting, and put hypo allergenic covers on my mattress and pillows. The couches are also leather. Anything that is fabric which dust mites or other insects can live in should be washable (and washed often). Any fabric not used often should be bagged in plastic.
• The other way to control mites is to keep the humidity under 50%, and use a HEPA Filter to clear the particles in the air. Since my area is fairly dry, I just use a filter. If I were in SF or Seattle, a dehumidifier may help greatly.
• Truth be told I recommend the above regardless of dust mite allergies. A carpeted, damp, fabricated house is an unsanitary house.
  
• Found the right allergy medication
• I used Claritin for years but it really didn't work. Tried Allegra and Zyrtec. For me Zyrtec works. Its good to try all three and see what works best.
  
• Trained myself to breath correctly (i.e. Buteyko)
• My breathing was erratic and took in much more oxygen than I had to, causing myself to hyperventilate. That is under control, greatly reducing my symptoms.
• I learned to use my diaphragm instead of my chest to breathe. It did not feel right initially but breathing via the diaphragm helps. I used to breathe using the chest and once I stopped my asthma was reduced greatly.
• Almost exclusively breathe with the nose. I won't open my mouth to breathe unless my HR goes over 140. In addition to helping hyperventilation, it filters allergens.
• When sleeping, I would almost always get attacks. What helped was making sure to breathe out of my nose while I slept. If I woke up and noticed any symptoms of mouth breathing, I would tape my mouth shut, forcing myself to breathe out of my nose. Its something that usually has to be done for a few days then its not needed.
• Essentially, I just breathe less now. In fact when I do feel an attack coming on a few controlled pauses in my breathe help. Right now I can 'pause' my breathing for 35 seconds. Before I couldn't do it for 10.

If anyone wants info on the breathing technique I can forward the book / video I used, but I'm not going to promote the product here.