How to handle asthma during the winter months

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.

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.

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.

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.