Why Is My Asthma Worse in the Winter?

Many people with asthma find they are affected by the seasons and changes in temperature. Cold weather in particular is a common asthma trigger because the cold, dry air can irritate the airways causing coughing, wheezing and shortness of breath. When you have asthma, your airways are always a little swollen, but triggers can cause the swelling to increase and extra mucus to be produced, making it hard to breathe. Though winter brings its challenges, by being prepared you can learn to manage your symptoms and avoid triggers so you can enjoy this time of year.

Cold Air and Your Lungs

Everyone’s airways are protected by a layer of fluid that, when you breathe in dry air, evaporates faster than it can be replaced. This dryness can cause the airways to become irritated and swollen, a major problem for people with asthma. Our airways are also lined with protective mucus, which helps capture unhealthy particles. Unfortunately, cold weather causes your body to produce more mucus, that is also thicker and stickier than normal, further impeding breathing. This process occurs in everyone, even people without lung disease. People with asthma, who already experience inflamed airways and overproduction of mucus have a particularly hard time.

Exercising Outside with Asthma

Regular exercise is part of a healthy lifestyle, especially for people with chronic lung diseases like asthma. Unfortunately, their lung diseases may make it harder to participate in certain exercise and activities. This is especially true for people with exercise-induced asthma or EIB. For these people, their asthma symptoms are triggered by the rapid inhalation of cool, dry air through the mouth that happens when you exercise. This problem can be worsened by the cold, which is why, though many people enjoy exercising outdoors, for those with lung disease the drop in temperature can become concerning. People with EIB and other lung diseases find that their already inflamed airways are worsened by the cold, which can leave them short of breath or cause a tight or burning feeling in their chest. This is why American Lung Association’s Chief Medical Officer, Dr. Albert Rizzo, notes the importance of ongoing communication with your healthcare provider. “It’s important to try to maintain your activity level and exercise schedule for many health reasons despite the weather," says Dr. Rizzo. "But those with asthma and other respiratory conditions have to pay attention to potential triggers, such as cold air, and take some precautions which may include medication adjustments."

Winter and Indoor Allergies

When the weather is cold, you are more likely to spend long periods of time indoors with the windows closed and the heat on. This can mean a higher risk of exposure to indoor allergens, irritants and respiratory viruses. Common asthma triggers like dust, pet dander, and pests may be more likely to accumulate. Vacuuming and dusting your home frequently, washing your sheets and blankets with hot water frequently and using an air cleaner are all good ways to reduce indoor triggers.

In addition, winter is respiratory virus season, when colds, flu, RSV, COVID-19 and many other viruses tend to circulate. For people with asthma, these infections can lead to more inflammation and symptoms. Being up to date with your vaccines, trying to avoid large gatherings or sick individuals, practicing good hygiene habits such as washing your hands and masking when necessary, and drinking plenty of fluids are good ways to prevent catching an infection and causing an asthma flare-up.

Tips to Help Prevent Asthma Symptoms This Winter

If cold air is a trigger for you, the best way to keep in control is to stay indoors on the coldest days. Some experts suggest any day when temperatures drop below 10 degrees F is a dangerous time to venture outside. In these cases, consider moving outdoor activities, like exercise, to an indoor climate-controlled environment.

The more severe your asthma is the more likely cold will affect you and cause a flare-up, so follow these guidelines:

• Take your daily controller medicines as directed and always have a quick-relief inhaler available to use at the first sign of symptoms, especially when exposed to asthma triggers, such as cold air, outdoor exercise, indoor allergens or respiratory viruses. 
• If you must go outside, loosely wrap a scarf around your nose and mouth to warm the air before it enters your lungs. Breathe in through your nose and out through your mouth.
• Before you venture outdoors for cold air activities, consult with your healthcare provider about using your quick-relief inhaler about 20-30 minutes prior to the activity. This is a good tip before doing any activity that may trigger your asthma.
• Stay healthy during the respiratory virus season by updating your vaccinations, using good handwashing hygiene, avoiding crowds and masking when necessary.