You can use the “rule of twos” to tell if your asthma control is working: If you have symptoms or have to use your inhaler more than twice a week, if you wake up from sleep with symptoms more than twice a month, or if you refill your quick-relief medication more than twice a year, you may have uncontrolled asthma. Over time, uncontrolled asthma can lead to irreversible changes in your lungs and breathing as well as other serious health problems.