Why does my asthma get worse in winter?

January 27, 2023

Cold Weather & Asthma

Is asthma triggered by cold air? YES!

When someone with asthma breathes in cold, dry air, it can make the muscles inside start to spasm while also trying to keep airways open. This further irritates the lining of the airways and causes coughing, wheezing and shortness of breath.

Cold air can trigger asthma symptoms and flare-ups, especially when there’s dryness in cold air. For many people with asthma, it’s the dryness in cold air that can lead to breathing problems. Cold air accompanied by windy conditions can also trigger symptoms. In general, the more severe your asthma is, the more likely cold air is to affect you.

What are cold weather-induced asthma symptoms?

Cold weather asthma symptoms are no different than asthma caused by other triggers. Asthma symptoms include:

  • Coughing, whether dry or with phlegm
  • Wheezing, especially when breathing out
  • Shortness of breath
  • Tightness in your chest

Why is cold weather hard on people with asthma? 

  • Wild weather: Winter often brings cold and dry air, snow, rain, wind and fluctuations in air pressure, even for those in mild climates. Rainy and windy weather can stir up mold spores and barometric pressure changes can trigger sinusitis. These can also cause asthma flare-ups.
  • Illnesses: Colds, flu and viruses are common in winter and can lead to more inflammation of your airways. Such illnesses thicken the mucus in bronchial tubes and make it harder to breathe. This can worsen symptoms or cause asthma flare-ups.
  • Time spent indoors: When the weather is cold, you may stay inside longer with the windows closed and the heat on. And you may be exposed to more indoor allergens, irritants and respiratory viruses. For example, you could be at risk for an asthma flare if your symptoms are triggered by dust, mold or pet dander, or cigarette smoke if there’s a smoker in the house.

Can cold air cause an asthma attack?

If your asthma is severe and cold air is a trigger, then you are at risk for an asthma attack in cold weather. Consult your Asthma Action Plan to manage asthma in cold weather. You should always seek medical attention if symptoms worsen.

To keep cold air from causing an asthma flare:

  1. Keep your mouth and nose shielded with a scarf to warm the air before you breathe it in.
  2. Use a short-acting albuterol inhaler at the first sign of symptoms to keep asthma from worsening.
  3. Stay inside as often as you can. Breathing warmer air will help open up your airways. Just make sure you’re inside a place with no indoor allergens and irritants.
  4. If you experience symptoms frequently in cold weather, talk with your doctor about a long-term treatment plan.

Is exercise-induced asthma in cold weather real?

It is definitely harder to exercise outdoors when the weather is cold. This is true for everyone, not just those with asthma. Breathing through your nose in cold weather may be easier on your body, but physical activity often forces you to breathe through the mouth to get more air.

Breathing through your mouth brings the cold, dry air straight to your airways. That air allows the mucus lining the bronchial tubes to dry out. This can worsen symptoms or cause an asthma flare-up.

If you prefer to exercise outside, or you enjoy skiing or ice skating, try doing a warm-up before leaving the house. Doctors always recommend warming up and stretching before exercise, but those with asthma may find it especially helpful. Walk in place, use a treadmill or dance to a few songs before heading out, and your lungs may function better in the cold.

If you have exercise-induced bronchospasm (EIB), also called exercise-induced asthma, your doctor may recommend you use a short-acting albuterol inhaler 15-20 minutes before exercise. This pre-treats your airways so they are better prepared for physical activity and cold weather.

How to handle asthma in the winter

What can you do to ease symptoms if winter weather affects your asthma?

  • Limit outdoor exercise. Work out at home or in the gym.
  • Wear a scarf and use it to warm the air you’re breathing.
  • Use humidifiers in your home. Keep them free of mold.
  • Wash hands frequently. Washing with soap for 20 seconds or using hand sanitizer while out can keep winter illnesses at bay.
  • Be conscious of your hands. Keep them away from your face and eyes to avoid spreading germs.
  • Get the flu vaccine in early fall. Stay up to date on COVID-19 vaccines.
  • Have an Asthma Action Plan in place. Know what to do in case of a flare-up.
  • Limit time with pets if you’re allergic to pet dander. Keep your bedroom pet-free.
  • If dust mites and mold trigger your symptoms, keep your home cool and dry to  inhibit their growth.
  • Clean and replace filters in your heating and cooling air ducts. Make sure filters are cleaned at the start of every season. Check periodically to keep indoor air quality optimal.

What else should I know about cold air and asthma?

Every person’s asthma is different. If cold weather triggers your asthma symptoms, you should treat it as you would any other flare-up.

Monitor the weather and try to stay inside on the very coldest days. Wear a scarf or face mask if you must go out. Guard your health so a virus doesn’t cause an asthma flare-up. Humidify the air indoors to the level that makes your breathing most comfortable.

Follow your doctor’s direction for medication use. If you are prescribed an inhaler or other medication to manage your asthma, don’t skip using it when you’re feeling fine. Always follow the plan you have in place to avoid unnecessary flare-ups.

  • Make sure all your prescriptions are current. Refill if needed.
  • Your Asthma Action Plan should include how to handle asthma when you have no symptoms, if symptoms begin, and if they become severe. Be prepared for all eventualities.
  • Keep a notebook to write down notes whenever symptoms worsen. This could shed light on new or old triggers. Keep track of your medication usage; your doctor will appreciate a big-picture view.
Our Highland Clinic Allergy Team is ready to help you create your Asthma Action Plan!