Winter comes with challenges you don’t experience the rest of the year, from slippery roads to blizzard-like conditions – it can be tempting to hunker down inside until it’s over. But trips out of the house can’t be paused for five to six months of cold air here in the Upper Midwest. And for the winter adventurers among us, winter offers unique outdoor opportunities like ice skating, pond hockey, sledding, snowshoeing and skiing.
But for people with asthma, spending time outside in the winter is especially challenging. Cold, dry air and changes in barometric pressure can trigger asthma symptoms, increasing the risk of an asthma attack.
What is it about cold weather that worsens your asthma? And do you have to stay inside all winter? We cover how cold air triggers asthma, symptoms to look for and how to prevent asthma attacks in the wintertime.
What is cold-induced asthma?
Asthma is a chronic lung disease that makes it hard to breathe – it might feel like you’re gasping for air. This happens because of inflammation and swelling of the bronchial tubes, which carry air to the lungs. Cold temperatures and dry air (common during Minnesota and Wisconsin winters) can increase this inflammation, which is why it’s called cold-induced asthma or winter asthma.
There are several reasons the cold weather can trigger asthma and cause a flare-up, including:
Cold, dry air causes inflammation
Cold air contains less moisture and can inflame and irritate airways, especially for those with asthma. This may cause the airways to spasm, triggering an asthma attack, which can involve coughing, wheezing or shortness of breath.
Cold air tightens the airways of your lungs (bronchospasms)
When you breathe in cold or dry air, your nose and mouth will typically warm and humidify the air before it reaches your lungs, so it’s easier to breathe. But winters in the Upper Midwest tend to be very cold and dry, making it more difficult for your body to warm the air before it reaches your lungs.
When someone with asthma breathes in cold, dry air, it can cause the muscles that line the airways in their lungs to tighten (also known as a bronchospasm). These spasms can trigger an asthma attack.
More mucus can irritate airways
When it’s cold outside, your body naturally produces more mucus. It’s also cold and flu season, which can cause mucus buildup if you get sick.
While mucus is a symptom commonly linked to asthma and allergies, it doesn’t mean you have cold-induced asthma if you’re feeling a little phlegmy. But if you have asthma and are coughing up a lot of phlegm, it could mean your airways are inflamed. Your primary care doctor or clinician can recommend over-the-counter remedies that may be able to give you relief from the mucus without having to rely as much on your rescue inhaler.
You’re spending more time around indoor irritants
You’re likely spending more time indoors when it’s cold. And if indoor irritants like dust, mold or pet dander trigger your asthma, you may experience an increase in asthma symptoms during the winter months. However, that doesn’t mean you have cold-induced asthma. Paying attention to where and when a flare-up happens will help your doctor customize your treatment plan to meet your needs. Sometimes it may be helpful to have allergy testing to help figure out what triggers your asthma. Your primary care doctor can help you understand whether allergy testing or a referral to an allergy specialist might be helpful.
You’re more likely to get sick during colder months
Cold weather brings cold and flu season. When it’s cold, you’re more likely to catch a virus that can contribute to excess mucus and inflammation, triggering asthma symptoms.
Who is affected by cold-weather asthma?
Anyone with asthma is at risk for experiencing an increase in symptoms when exposed to cold, dry air. People who play winter sports or sports in cold weather environments year-round – such as hockey or ice skating – are also at greater risk.
It’s possible for people without asthma to feel a difference in breathing when in the cold, but that doesn’t mean you have asthma. Learn how to spot the symptoms so you’ll know if it’s cold-induced asthma or something else.
Cold-induced asthma symptoms
Because cold air irritates the lining of your airways, it can cause someone with asthma to experience the usual symptoms of asthma and asthma attacks, including:
- Coughing
- Wheezing
- Shortness of breath
- Tightness in the chest
- Difficulty getting enough air
- Trouble exercising
If you’re experiencing any of these symptoms, you may be having an asthma flare-up. If you have an asthma action plan that you discussed with your doctor, use your rescue medications as directed, which may include an inhaler or steroid medications. If you don’t have an asthma action plan or your symptoms get worse even after taking asthma medication, seek medical care immediately.
How do you know it’s cold-induced asthma?
To determine if you have cold-induced asthma, it’s best to start with a physical exam by your primary care doctor. Your doctor will listen to your breathing, feel the muscles around your lungs and throat, and perform breathing tests. Depending on the severity of your asthma, you may also have a lung doctor (pulmonologist) or allergy doctor who can help establish a treatment plan.
Before your appointment, it’s a good idea to keep track of when you’re experiencing symptoms and what you think may be triggering them. This will help your doctor determine if it’s cold-induced asthma or something else.
Cold-air asthma treatment and prevention so you can enjoy wintertime
The best thing you can do is to take preventive measures before heading out in the cold, so you can avoid asthma attacks this winter. Give these tips a try the next time you head outside:
- Breathe through your nose when possible
- Get your flu vaccine in the fall
- Wear something that covers your mouth to reduce contact with cold air
- Warm up before exercising outdoors
- Drink extra fluids to stay hydrated and thin mucus
To get immediate relief from cold-induced asthma symptoms, you can use a short-acting inhaler to loosen and open the airways, then head someplace warm. You may also want to use a humidifier to keep the air in your living space from becoming too dry.
