Cold air and asthma

Learn Your Triggers

When you inhale something that triggers your asthma, your airways — the tubes in your lungs that carry air — can become tight and clogged with mucus. You may cough, wheeze, and struggle to catch your breath.

Talk to your doctor about having tests to find out what your triggers are. Once you know them, you can make some changes at home that may help:

  • Limit time around pets. Having a dog or cat in your home may trigger your asthma. Try to keep it out of the bedroom. Curbing allergy triggers where you sleep can make a big difference, Wedner says.
  • Cover bedding. If mites are a trigger,use mite-proof covers on the mattress, box springs, and pillows, he says. These help keep dust mites away overnight.
  • “Keep the house cool and dry — dust mites as well as mold don’t grow very well when it’s cool and dry,” Wedner says. Ways to help keep your home dry during the winter include:

1. Run the fan in your bathroom when taking a bath or shower.

2. Use the exhaust fan in the kitchen when cooking or using the dishwasher.

3. Fix leaky pipes and windows.

The common cold and flu are both more likely to strike in the winter and can lead to asthma flare-ups. You can lower your family’s risk of these illnesses, though:

  • Wash your hands. This helps keep viruses from getting into your body when you touch your eyes, nose, or mouth.
  • Stay away from people who are ill. If a coworker or friend has the cold or flu, keep your distance.
  • Get a flu shot. Experts suggest that most people get a flu shot each year. This helps protect you from catching the flu.

Colds and flu can hit hard if you have asthma. In fact, the common cold is behind around 4 out of 5 bad asthma attacks. Make sure your lungs are in the best possible shape for winter by following these steps.

1. Get your lungs checked

See your doctor for an asthma review before the cold and flu season arrives. You can check the health of your lungs and work out if you need to make any changes to your asthma medicines so you stay well over winter.

2. Follow your asthma action plan

Together with your doctor, develop or update your personal written asthma action plan with instructions on how to manage your asthma over winter. A written asthma action plan helps you recognise worsening asthma and tells you what to do in response. Acting quickly can help prevent a mild flare-up from developing into a serious attack.

3. Use your medications wisely

Tell your doctor if you have been using your reliever puffer more than twice a week or are having asthma symptoms at night. These are important signs that your lungs may not be in the best condition for winter colds and flu. If you have been prescribed a preventer medication make sure you use it – even if you feel well.

4. Check your inhaler technique

All adults and children need careful training from a doctor, nurse, asthma educator or pharmacist to use inhaled medicines correctly. Proper use of inhalers helps medicines work properly, can reduce the risk of side-effects and is essential for good asthma management. The instructions are different for each type of inhaler device.

5. Take extra care if you are over 65

  • Colds and flu can hit extra hard in seniors with asthma.
  • Ask your doctor about vaccination for influenza and/or pneumonia
  • Don’t ignore symptoms or put off seeking help – prompt action can help keep you out of hospital
  • Make sure you’re taking your medicines the best way – ask your pharmacist or practice nurse to check you’re using your puffer or inhaler correctly
  • If you’re still using a nebuliser, speak to your doctor about making the switch to a puffer and spacer – this works just as well for treating asthma symptoms (including during an asthma attack) and is easier, faster and cheaper to use than a nebuliser

6. Take preventative action

  • Keep warm if cold air triggers your asthma
  • Control germs by washing your hands
  • Avoid contact with anyone who’s sick
  • Ask your doctor about having the flu vaccination

If you get sick…

Follow your written asthma action plan – if you don’t have one, contact your doctor to check what you should do.

  • Get lots of rest and take care of yourself
  • Stay home – try to avoid infecting others
  • Seek medical help straight away if your symptoms are severe or rapidly getting worse

Antibiotics are not recommended for treating viral infections like the common cold.

For many of the 25 million people with asthma, controlling it during the cold winter months can be difficult.

People with asthma may experience worse symptoms during winter or be more likely to have an asthma attack because they’re spending more time indoors, they’re more likely to get a cold or the flu, and the air outside is cold and dry.

“The cold, dry air outside can trigger asthma, but staying indoors more with the windows closed around dust mites, mold, pet dander and other allergens can also cause asthma to flare up,” said Anthony Wylie, D.O., a primary care physician at Geisinger Mt. Pleasant. “In addition, when someone with asthma gets a cold or the flu, it can trigger an asthma attack.”

Asthma is a chronic lung condition where irritants can cause the airways in your lungs to become inflamed and swollen, making it harder to breathe. Your lungs might also produce mucus as a result, which can further narrow your airways.

If you have asthma, you might experience periods of wheezing, coughing, shortness of breath and tightness in the chest. These symptoms sometimes go away on their own; however, people with asthma often use a long-term medication to control ongoing symptoms, as well as a short-term rescue inhaler for symptoms that appear quickly.

“The key to dealing with asthma during the winter months is understanding your triggers and planning for them,” said Dr. Wylie. Here are some things you can do to keep your asthma symptoms at bay during the cold winter months.

1. Breathe through your nose

It seems like simple advice, but breathing through your nose can actually prevent you from beginning to wheeze, feel short of breath or experience tightening in your chest. When you breathe through your nose, as opposed to your mouth, the air warms before it reaches your lungs.

2. Wear a scarf around your mouth when outside

Similarly, wearing a scarf or other cover over your mouth or nose when you’re out in the cold can help to warm the air that you breathe. This can also help you have a better workout if you want to exercise outside.

3. Clean frequently

Keeping your living space free of dust, dander and mold can help you keep asthma at bay during the cold months when your windows are closed.

“Replacing filters in your furnace is a good way to keep your air free of dirt and dust that irritates your lungs and causes flare-ups,” said Dr. Wylie.

4. Get a flu shot

People with asthma are not more likely to get the flu; however they are more likely to face flu-related complications if they get it. The flu vaccine is the best way to prevent the flu.

5. Work out indoors

When the temperature drops, consider taking your exercise regimen indoors to prevent asthma symptoms. The air in your home or gym is likely to be more humid and better for breathing than the cold air outside.

6. Create an action plan

To keep your asthma under control during the winter months, it’s important to work with your doctor on a medication plan should symptoms arise.

“Talk to your doctor before cold temperatures arrive so you know how to treat your asthma if it flares up,” said Dr. Wylie. “If you notice your symptoms are getting worse or you’re experiencing them more frequently, you should see your doctor again.”

Can the Weather Affect My Child’s Asthma?

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Yes. Weather conditions can bring on asthma symptoms. Some kids’ asthma symptoms get worse at certain times of the year. For others, a severe storm or sudden weather change can trigger a flare-up.

Cold, dry air is a common asthma trigger and can cause bad flare-ups. That’s especially true for people who play winter sports and have exercise-induced asthma.

Hot, humid air also can be a problem. In some places, heat and sunlight combine with pollutants to create ground-level ozone. This kind of ozone can be a strong asthma trigger.

Wet weather and windy weather can cause problems too. Wet weather encourages mold growth, and wind can blow mold and pollen through the air.

If you think weather plays a role in your child’s asthma, keep a diary of asthma symptoms and possible triggers and discuss them with your doctor. If pollen, mold, or other allergens make asthma symptoms worse, ask about allergy testing.

How Can We Avoid Weather Triggers?

Once you know what kind of weather triggers asthma symptoms, try these tips to protect your child:

  • Watch the forecast for pollen and mold counts plus other conditions (extreme cold or heat) that might affect your child’s asthma.
  • Limit your child’s outdoor activities on peak trigger days.
  • Make sure your child wears a scarf over the mouth and nose when outside in very cold weather.
  • Keep windows closed at night to keep pollen and molds out. If it’s hot, use air conditioning, which cleans, cools, and dries the air.
  • Keep your child indoors early in the morning (before 10 a.m.) when pollen is at its highest.
  • Your child shouldn’t mow the lawn or rake leaves, and should be kept away from freshly cut grass and leaf piles.
  • Dry clothes in the dryer (hanging clothes or sheets to dry can allow mold or pollen to collect on them).
  • Make sure your child always has quick-relief medicine (also called rescue or fast-acting medicine) on hand.

Your child’s written asthma action plan should list weather triggers and ways to manage them, including any seasonal changes in medicine.

Reviewed by: Elana Pearl Ben-Joseph, MD Date reviewed: August 2017

Why Does Cold Air Affect Asthma?

Winter months and cold air are hard on asthma.

Here are several reasons why:

Cold air is dry.

The airways transporting oxygen to your lungs are lined with fluid. If the air you breath is dry this fluid evaporates quicker than it can be replaced. Without that thin layer of fluid, dry airways become irritated and swollen.

Cold air also stimulates your body to produce histamine. If you have allergies, you are familiar with histamine – it’s is the same chemical your body makes during an allergy attack.

Cold increases mucus.

In addition to keeping your airways moist, this thin layer of fluid also helps to remove unhealthy particles.

Cold weather prompts your body to produce a thicker, stickier mucus. This extra mucus makes you more likely to catch a cold or other infection.

Indoor Air Recirculates Germs and Allergens

Colds, flu, and other respiratory infections, which are known to set off asthma symptoms are prevalent during the winter months. Indoors you’ll also find more dust, mold, and pet dander indoors, setting off asthma symptoms in some people.

What Precautions Should I Take?
Make sure your asthma is under control before winter arrives. Be sure to fully understand your Asthma Treatment Plan.

Long-term controller medicines are drugs you take every day to manage your asthma symptoms. They include inhaled corticosteroids, long-acting beta-agonists, and leukotriene modifiers.

Quick-relief medicines are medicines that you only take when you need them, such as before exercising in the cold. Short-acting bronchodilators and anticholinergics are examples of these drugs.

More Asthma Control Tips from our friends at Healthline:

Drink extra fluids in the winter. This can keep the mucus in your lungs thinner and easier for your body to remove.
Try to avoid anyone who appears to be sick.
Get your flu vaccine early in the fall.
Vacuum and dust your home often to remove indoor allergens.
Wash your sheets and blankets every week in hot water to get rid of dust mites.
To prevent asthma attacks when you exercise outdoors in cold weather:

Use your inhaler 15 to 30 minutes before you exercise to open up your airways so you can breathe easier.
Carry an inhaler with you in case you have an asthma attack.
Warm up for at least 10 to 15 minutes before you work out.
Wear a mask or scarf over your face to warm the air you breathe in.

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Photo: Getty In winter, the pollen allergic breathe sighs of relief. Not so those who have asthma triggered by cold air, exercise or indoor allergens. But winter need not be a cruel season for the lungs.

How cold air affects asthma

A winter wind whips your face. What do you do? Probably squint and tear up because cold air dries out and irritates the delicate tissue of the eyes.

Asthmatics can have a similar reaction in their lungs, one that literally takes their breath away. Cold, dry air irritates hypersensitive lungs that have become inflamed, causing bronchospasm.

The muscles around the irritated bronchial tubes constrict and become even more narrow, making it difficult to breathe. An increase of mucus in the lungs also limits breathing, resulting in wheezing, coughing and tightness in the chest.

Dr. Mark Greenwald, a Toronto allergist, notes that even non-asthmatics can feel their breath catch in a frosty gust on extremely cold, dry days. “That’s what the asthmatic feels, but it’s triggered much easier and by air that’s not as cold.” He reminds, however, that with proper treatment, the asthmatic should be able to do everything the non-asthmatic can. “Be very aggressive with your asthma control,” he says.

What should you do about cold air and asthma?
  • You don’t want to stay inside all winter: if you are experiencing symptoms from the cold, speak to your doctor soon about altering your medication plan.
  • Wear a scarf loosely over your nose and mouth and breathe through your nose to warm and humidify the air you breathe. (This is easier on asthmatic lungs, reducing the likelihood of irritation.)
  • Keep your inhalers close to your body, since warm medication is more easily distributed into the respiratory system.

Exercise and asthma

Greenwald points out that about 20 per cent of the winter Olympic team has asthma, and if they can handle strenuous workouts, you can exercise, too! It’s a question again of managing your asthma medication plan.

Be aware that if you have exercise-induced bronchoconstriction (EIB), it can flare during the winter (even if controlled the rest of the year). This is due to the fact that when people exercise, they often breathe through their mouths rather than noses.

When the air is cold and not warmed in the nose, that can irritate sensitive lungs. In a 2001 study, British researchers found that 70 per cent of asthma patients had symptoms triggered by a combination of cold air and exercise.

What should you do about exercise and asthma?
  • Choose indoor activities like swimming or basketball if you find your symptoms are increasing outdoors.
  • Speak to your doctor as soon as possible. He/she may suggest an increased dosage in your controller/preventive medications during the winter, or add a reliever medication to your routine. Then get out and ski or skate.
  • Be sure to warm up and cool down slowly with vigorous activity.

Allergic Living’s Guide to Asthma

Indoor allergens and asthma

Studies in recent years have found that the air quality inside the average home is up to five times worse than that outside. And North Americans spend about 90 per cent of their time indoors during the winter.

Besides increasing exposure to asthma triggers such as chemicals and fumes from cleaning products, a building sealed tightly against the cold also provides an ideal environment for mold and dust mites. Add pet dander or cigarette smoke and asthma problems are compounded.

What should you do about indoor allergens and asthma?
  • The best defence is a clean house. Use a HEPA-filtered vacuum on furniture, drapes and floors, and dust with a damp cloth.
  • Never let anyone smoke in your home.
  • Never let anything smoke in your house either: sorry, no fire in that fireplace.

Photo: Thinkstock

Cold and Flu – Added Aggravation for Asthma

“Asthmatics are more reactive to colds,” Greenwald says. In a study of students in Denver, researchers found that an upper respiratory infection doubled the likelihood that a child would have a full-blown asthma attack, and quadrupled the chance of a general increase in symptoms. Colds and chest infections are considered the most common trigger for a majority of asthmatics.

What should you do about colds and flu and asthma?

  • Prevent colds and viruses by washing your hands frequently and keeping your distance from infected friends and co-workers.
  • If you do get sick and your asthma symptoms worsen, ask your doctor about adjusting your medication.
  • The good news: though still in early stages of research, British scientists found that a drug developed to treat multiple sclerosis also inhibits the replication of cold virus cells in the lungs of asthmatics. This group usually has a higher rate of replication than non-asthmatics.

Be In Control of Your Asthma

If your asthma is under control, you should not be experiencing symptoms – even on the coldest days or when exercising vigorously. Yet, a majority of asthmatics are not managing their disease well. Greenwald admonishes: “Too many still rely on emergency treatment, and that’s not the way to go.”

So if you know the cold causes you grief, speak to your doctor, amend your asthma action plan, and breathe easy.

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Weather Changes and Asthma

Winter Survival Guide

Our top tips for managing your asthma through the winter!

1. Take Medication as Prescribed

This is vital all year round! It will help you control your asthma better and hopefully prevent an asthma attack. To check your technique, watch our inhaler techinique videos.

2. ALWAYS Carry Your Blue Inhaler

Having this inhaler with you ensures that in an asthma emergency you have a tool which will help ease and relieve your symptoms. However, if you are taking it more than twice a week it could be a sign that your asthma isn’t controlled and you should visit your GP or healthcare professional.

3. Have an Up-to-Date Asthma Action Plan

The Asthma Action Plan helps you manage your asthma and can help you identify if your symptoms mean you need a check up. You can download an Action Plan and complete it with the help of your GP or our free Asthma Adviceline (1800 44 54 64).

4. Use Your Nose

Breathing through your nose is ideal during the winter as it warms the air up before bringing it to the lungs. This can help reduce the impact of cold air as a trigger for asthma symptoms.

5. Make Your Home Asthma Friendly

When winter arrives, we spend an extraordinary amount of time indoors. With the cold, many fires and candles are lit. A lot of homes bring animals indoors due to the weather outside. All of these factors can trigger your asthma. To find out more on what you can do to make your home more asthma friendly, visit

6. Flu Jab: Better Late Than Never

Protect yourself against the flu this season. Visit your local pharmacy or GP to get the vaccine, if you haven’t already.

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