StoneSprings Hospital Center December 14, 2016

Don’t be fooled by the crystal-clear winter air—asthma doesn’t go away just because the pollen’s gone. For many with asthma, the cold weather, plus seasonal indoor allergens means more asthma attacks during the holiday season.

“Winter brings the perfect storm of cold and flu season, coupled with indoor allergen irritant exposure,” says Adhuna Mathuria, MD, an allergy and immunology specialist affiliated with StoneSprings Hospital Center in Dulles, Virginia. On top of the bitter cold, there are asthma triggers all around:

  • Smoke and soot from the fireplace
  • Molds that can be found on fresh Christmas trees
  • Pet hair and dander
  • Dry indoor air from the central heater, plus year-round allergens like dust mites and mold

Cold and flu season is starting too, adds Dr. Mathuria. And when kids go back to school, they bring home a lot of viruses, which are some of the most common asthma triggers.

Here’s how to cope with typical winter allergens, plus how to breathe easier when the cold air hits.

Why is it harder to breathe in the cold?

If your asthma symptoms worsen while building snowmen and winning snowball fights, it’s probably because you’re breathing through your mouth from all of the energy and excitement.

Normally, nasal breathing humidifies, or moistens your air, explains Dr. Mathuria. But when we’re active, we tend to breathe through our mouths instead. With mouth breathing, the winter air—which is drier to begin with—is pulled directly into your airways without being moisturized.

That cold air then dries and irritates your airways and can be a trigger for bronchospasm, or the tightening of the muscles around your air passages, which happens during asthma attacks.

Facing the cold

“When you go outside, you can try to humidify the air naturally with a scarf that covers your nose and mouth,” recommends Dr. Mathuria. The scarf will trap the condensation from your breath to keep the air warm and moist.

You could pre-treat yourself before winter activities by taking your rescue inhaler as well. Just let your lung specialist know if you’re relying on your rescue inhaler more for everyday activities since he or she may need to increase your maintenance inhaler dose.

You may have to add a warm-up session or slowly ease into your normal exercise routine after the weather changes—but you might not have to stop exercising outside altogether. “The goal is to help you stay as active as possible,” says Dr. Mathuria. “Your lung specialist or allergist may be able to treat around your symptoms. He or she may increase or change your medications so you can keep exercising outside comfortably.”

Tackling winter triggers

In addition to the cold weather, the winter season brings a host of seasonal triggers. Here are expert tips on how to cope with common winter allergens.

For the Christmas tree: Consider an artificial tree to avoid this trigger all together.
Just can’t picture the holiday without fresh evergreen? “There are some Christmas trees that you may be less allergic to than others,” says Dr. Mathuria. Take your time when tree shopping and ask the attendant if any of the varieties are hypoallergenic.

Also, dry the tree out in your garage for about a week, recommends the American Academy of Allergy, Asthma and Immunology (AAAAI). Then shake it out to get rid of dead needles and mold spores before bringing it inside.

For the fireplace: Avoid wood-burning fireplaces since about 70 percent of the smoke may re-enter your home, even with the chimney flue open. If you rely on a wood-burning fireplace for heat, have it inspected by a local fire marshal or certified inspector yearly. He or she will ensure that it’s working properly and that there’s no buildup of dangerous chemicals. Make sure the room is well ventilated and opt for a glass fireplace door since screens still allow fine particles to float into your living room.

When the heat kicks on: When you turn on the heater after months of inactivity, you stir up the dust, germs and particles that have been collecting all summer. Consider getting your heating ducts cleaned before you need to use them. Ducts should be cleaned by professionals who have the proper equipment and won’t spread allergens throughout the house.

Air from the central heater can also lack humidity. If dry indoor air is irritating your airways, consider using a humidifier and set the dial to 35 to 50 percent humidity. Just be sure to clean it out regularly to keep mold and bacteria from growing in the water. If you’re allergic to dust mites, talk to your lung specialist before investing in a humidifier—dust mites thrive in moist environments.

When cuddling up with furry family members: With pets spending more time indoors, fur and dander can really build up on fabrics. Limiting your pet to one area of the house won’t help much because dander can still travel through the air.

Instead, consider investing in a HEPA filter or a HEPA vacuum, which can remove some, but not all, of the pet allergens. If possible, clear away area rugs and throw pillows, since filters work better in rooms with less fabric. If you have a dog, twice-weekly baths could reduce your symptoms as well, but let your vet know in case frequent baths are not appropriate for your dog’s breed.

“Even steam cleaning the carpets may help,” says Dr. Mathuria. “But steam cleaning can be a double-edged sword because some companies use a lot of water, which can actually promote mold growth. Choose a company that’s ‘allergy-aware’ and uses minimal moisture.”

Prevention is the best medicine

Since a cold or the flu is the last thing you need when your symptoms are flaring, get your flu shot and wash your hands regularly.

And speak up if asthma symptoms are keeping you from the activities and events you love this season. “Asthma shouldn't limit your ability to exercise or participate in athletic activities during the winter,” says Dr. Mathuria. “People worry about the limitations that come with asthma. But really, our goal in asthma medicine is to provide complete relief so people don't have to alter their lifestyles dramatically.”

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