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winter asthma

How to handle asthma during the winter months

Many people with asthma find their symptoms get worse in the winter months. So how can asthma be managed as the days get colder, and what can you do to avoid triggers?

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Winter asthma

It's natural to feel a bit low as winter approaches. As the days get colder, darker and gloomier, many of us would secretly prefer to hunker down and hide away until spring.

However, if you suffer with asthma you may be feeling this more than most. Many people find their asthma symptoms get worse during the colder months, meaning you might be dealing with irritated airways on top of all the usual seasonal bugs and wintertime blues.

Although not all asthma sufferers have the same triggers, a seasonal pattern to your asthma is very common. Studies have found that hospital admissions for asthma increase during the winter months1, while some research from Asthma + Lung UK found that December and January are the deadliest months for people with asthma2.

Even if your symptoms aren't severe, you may find the seasonal change affects your quality of life. In one study from chilly Sweden, 2 in 3 asthma patients said the cold was a factor in causing breathing difficulties, while more than 1 in 3 avoided going out during the winter3.

Why does asthma get worse in the winter?

"Asthma is an inflammatory condition made worse by triggers that make your airways oversensitive," explains Dr Jeff Foster, medical director at H3 Health. "Walking from a hot room to the cold air outside can make asthma worse - it triggers your smaller airways to tighten as they try not to let that nasty cold air deep into the lungs. However, the asthmatic lung can tighten too much, which can trigger an attack."

Cold air can also prompt the airways to produce histamine - the same hormone released during allergic reactions - which can trigger a bout of wheezing. In addition, the body is likely to ramp up its production of mucus, in an attempt to create a warm environment and filter the air entering the lungs.

Abbas Kanani, pharmacist at Chemist Click, says: "An increase in mucus can make asthma feel worse. Colds, flu, and chest infections are also more common during the colder months. Symptoms include a stuffy nose, cough, inflamed airways, and a general increase in mucus production, all of which can make symptoms of asthma worse."

Will staying indoors help?

Staying in all the time may not help either. Just being in a centrally heated house can be bad for asthma, as the heating dries out the natural moisture in the air, making it harder to breathe.

On the other hand, damp and mouldy environments produce spores, which can also trigger asthma symptoms.

"People also tend to light fires, candles and other devices in winter - these are direct lung irritants and can be much worse for someone who has asthma," says Foster.

How to reduce asthma triggers

Before you despair - or book your one-way ticket to the Bahamas - be aware there are lots of practical ways of avoiding triggers and managing symptoms.

  1. Protect your airways from the cold, for instance by wrapping a lightweight scarf around your mouth.

  2. Exercise indoors on very cold days. Remember, staying fit is important for your overall lung function, so don't let the perishing weather be a reason not to break a sweat.

  3. When it is cold outside, Kanani advises trying to breathe through your nose. Cold air warms up as it makes its way from the nose through the throat, and then into the airways.

  4. If you have mould at home, try to deal with the cause - for example if there are leaks or an issue with condensation. Opening doors and windows and using extractor fans can make a big difference, as can closing doors where condensation is likely.

  5. Dehumidifiers can also help. But use them at the right time when there is a high chance of condensation: "Using a dehumidifier too often can dry the air, making asthma symptoms worse. If you spend time in your garden, clear leaves on a regular basis, as they are a hotspot for mould spores."

Regarding coughs and colds, you may not be able to avoid every bug that's going round this winter. But you can take precautions, such as washing your hands regularly and wearing a mask in crowded settings. Some people with asthma are also eligible for the winter flu vaccine and COVID-19 booster - if your asthma is poorly controlled or you are over 65 - check here.

"If you have asthma patients you are at higher risk of severe asthma attacks and pneumonia if you get flu or COVID - but you can reduce the risk through a simple vaccine. Some asthmatic patients will be eligible for a pneumonia vaccine as well," says Foster.

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Create an asthma action plan

Whatever the time of year, if you've noticed your asthma getting worse, now might be the time for an asthma review. Make a note of what's going on around you when symptoms occur and book a GP appointment to discuss your personal triggers.

"They can help you to manage your asthma action plan, to keep your asthma under control as best as possible. Asthma action plans lower the chances of experiencing an asthma attack," says Kanani.

In milder cases, pharmacists can play a role too, for instance by helping you go through your inhaler technique, identify triggers, and offer advice on minimising flare-ups.

"Pharmacist prescribers are becoming more common, and you may even find that a pharmacist conducts your asthma review at your surgery," says Kanani.

Foster adds that asthma management has moved more towards prevention than relief. Your prevention inhaler, if you've been prescribed one, is your secret weapon during the winter months, making your airways less sensitive and lowering the risk of an asthma attack. You should also take your reliever inhaler with you wherever you go.

"If you need your reliever inhaler more than a few times a month you should see your doctor to get an asthma review," says Foster. "Also keep an emergency oral steroid and antibiotic pack at home if you are prone to chest infections. In the acute stage, if your inhalers are not working and you are still short of breath or wheezy, do not wait - seek medical help immediately."

The winter months may not be your favourite time of year if you have asthma. However, with the right asthma action plan in place, you have every chance of keeping symptoms at bay as the temperature plummets.

Further reading

  1. Zhang et al: Effects of meteorological factors on daily hospital admissions for asthma in adults: a time-series analysis.

  2. Asthma + Lung UK: You're twice as likely to die of a lung condition in Wales during winter compared to summer.

  3. Millqvist et al: Occurrence of breathing problems induced by cold climate in asthmatics.

Article history

The information on this page is peer reviewed by qualified clinicians.

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