How To Manage Winter Asthma and Airway Irritability

For some, cold weather triggers airway irritability and asthma attacks. However, a little planning can help you breathe easier during the coldest months.

What is winter/cold air induced asthma?

Asthma is a condition that causes the airways to swell and constrict making it difficult for air to pass through. For many people, cold, frosty air irritates these airways. When asthma sufferers are exposed to triggers, like cold air, it makes symptoms worse. They might cough, wheeze or have tightness in the chest as well as chest pain or trouble breathing.

Why does cold air irritate my asthma? 

The airways in your lungs are protected by a layer of fluid. When exposed to cold air, this protective layer evaporates, causing your airways to become inflamed and irritated. Cold air also causes your airways to produce a substance called histamine, which is the same chemical your body makes during an allergy attack. Histamine triggers wheezing and other asthma symptoms.

What other things make asthma worse during the winter?

  • Dry air: During the winter months, air tends to be extra dry, even indoors, where the air is warmed by a furnace. Like cold air, very dry air can irritate your airways.
  • Flu season: During cold and flu (and this year RSV & COVID-19) virus season, we are especially susceptible to respiratory infections. That’s because our airways have a protective layer of mucus, and when it gets cold outside this layer of mucus can thicken which increases the likelihood of respiratory infections. 

Infections may also lead to airway swelling and irritation, which triggers asthma symptoms. Many adults and children suffer from virus-induced asthma, which means their asthma is exacerbated by respiratory infections.

  • Indoor allergens and air pollution: During cold weather, we tend to spend more time indoors. For some, that means more encounters with indoor asthma triggers like pet dander, dust mites, strong scents and tobacco smoke. Indoor air quality can often be worse than outdoor air quality.

Follow these tips to reduce cold-weather asthma attacks.

  1. Limit cold air exposure. If you or your child coughs every time cold air hits the lungs, try to keep outside time to a minimum and limit outdoor exercise and strenuous physical activity. If you usually exercise outdoors, find an alternative place with good air circulation. 
  • Breathe through your nose when you’re outside. Your nasal passages warm the air before it moves into your lungs. Use a scarf (or even a mask) over the mouth and nose to warm and humidify the air you breathe. Consider using your rescue inhaler 15 to 30 minutes before you exercise. This opens up your airways so you can breathe easier.
  • Take your asthma medication as prescribed all year but especially in the winter. Carry your rescue inhaler with you and keep it accessible at all times. Make sure that your rescue inhaler is relatively full and not expired before going out into the cold weather. 

Remember, that inhaled steroids and leukotriene modifiers are asthma “controller” medications that, when prescribed by your doctor, should be taken daily to reduce inflammation, even when you or your child feels good. It’s especially important to use them regularly in the winter if you’re sensitive to the cold. 

  • Check your “Peak Flows” and compare them to your baseline measurements. If on any winter day, it is 20% or more lower than your baseline, notify your doctor if you don’t already have an “Action Plan” in place. The “Peak Flow” meter is an easy and inexpensive home respiratory monitoring device that objectively measures your maximum exhalation air flow and is a very valuable tool for monitoring asthma, well before symptoms get worse.
  • Stay well hydrated by drinking extra water, soup and other liquids throughout the day.
  • Use a humidifier in the whole house or at least the bedroom at bedtime to put a little moisture back into the dry, winter air. The optimal range for relative humidity is 35 to 50%. If your home’s furnace doesn’t have a built-in option for measuring humidity, you can get a hygrometer (humidity gauge) at the hardware store. Remember to clean humidifiers regularly to avoid mold, which can be an asthma trigger. Saline nasal sprays can also help moisten dried-out nasal passages.
  • Try to avoid viral infections by steering clear of others with colds or the flu. Get in the habit of frequent handwashing to keep germs at bay. Be up to date with your flu and COVID-19 vaccines.
  • Remove indoor allergens by regularly vacuuming and dusting your home. Wash your sheets and blankets every week in hot water to get rid of dust mites. Inspect your chimney or fireplace if you have one to reduce indoor air pollution from wood burning. If you’ll be spending more time indoors during the winter, consider using a whole house air cleaner to improve your indoor air quality. 

What can I do if I’m having an asthma attack?

  • If your symptoms are so severe that you can’t speak, take your rescue inhaler and seek immediate medical attention. You may need to stay under medical observation until your breathing stabilizes.
  • If you start to wheeze or feel short of breath, refer to the asthma “action plan” you prepared with your provider. If you don’t have an action plan, speak with your provider about one at your next appointment. 

Other general guidelines for asthma attacks:

  • Take two puffs from a rescue inhaler. The medicine should open up your airways and help you breathe easier.
  • If your symptoms aren’t severe but they don’t improve with the first few puffs from your inhaler, wait 20 minutes and then take another dose and call your doctor. You may need to adjust your asthma regimen.

Lastly, don’t be shy to ask for help. If you feel uncomfortable about your asthma as winter settles in, don’t hesitate to reach out with questions. If you’re prone to winter month attacks, make an “Action Plan” with your provider. Let your provider help you manage symptoms so you can enjoy the season.

With 33 years of experience, Dr. Richard Finkel is certified by the American Board of Internal Medicine to provide pulmonary care, critical care and sleep medicine. He has cared for patients in private practice and hospital settings. For 28 years, Dr. Finkel provided consultations and management of pulmonary and critical care at a large metropolitan hospital, and has extensive experience in respiratory rehabilitation and comprehensive sleep medicine.

Dr. Finkel sees patients at our Main Street location.