This 20-year-old football enthusiast from Mumbai loves his morning game sessions. Romil (name changed on request) would never miss out on practicing, come rain or shine. One winter morning in 2021, in the middle of a game, something unforeseen happened — he developed exercise-induced asthma.
He began wheezing and feeling short of breath. Romil couldn’t decipher this sudden development, as his football games in the past would be smooth-flowing sans any hindrances. He immediately sought medical attention. Exercise-induced asthma also known as Exercise-Induced Bronchoconstriction (EIB) is a condition where asthma symptoms flare up during exercise.
How do exercise and winters affect asthma?
Asthma is a chronic condition where the airways become inflamed, swollen and narrow causing breathing difficulties. Several environmental factors including dust mites, pollens, viral infections and pet dander trigger asthma.
Cold dry air can also cause asthma flare-ups, making winters vulnerable for people with asthma. Additionally, physical exercise, while proven to be beneficial for asthma and improving lung health, can act as a trigger in those who don’t take the necessary precautions.
If the necessary precautions are not taken, exercising and the cold dry weather can be a double whammy for those with asthma.
Why does cold weather trigger asthma?
“The cold air during winters contains less moisture than warm air. Continuously breathing in the cold dry air can cause the airways to dry up, due to faster evaporation of moisture,” says Dr Mihir Gangakhedkar, consultant pulmonologist, Fortis Hospital, Mulund, Mumbai.
Further, he says, “People with asthma have sensitive airways and the dry air can irritate the lining of the airways, activating the inflammatory cell production, narrowing the airways and causing asthma flare-ups.” Cold air also affects certain nerves that are responsible for causing constriction of the airways.
Dr Soumya Das, consultant pulmonologist at Manipal Hospital Salt Lake, Kolkata opines that sudden weather changes can also aggravate asthma. “Coughing, wheezing and shortness of breath are the typical asthma symptoms,” he adds.
How does exercising in winter flare up asthma?
According to Dr Sunil Kumar K, lead consultant, Interventional Pulmonology, Aster CMI Hospital, Bangalore, the rapid breathing rate during exercise, intensifies the moisture loss. People whose asthma is not well controlled through regular medications are at a risk of developing a flare-up during exercise.
“There is also a tendency to breathe through the mouth during exercise. Breathing through the nose humidifies the air to some extent before it reaches the lungs,” says Dr Sunil. Mouth breathing causes dry air to directly enter the lungs, triggering asthma.
According to Asthma and Allergy Foundation of America, as many as 90% of all people who have asthma also have EIB. You can also have EIB even if you do not have asthma.
Should you stop exercising during winter?
A common misconception among many people with asthma is that it is ideal to refrain from exercise during winter. Experts opine that asthma shouldn’t deter one from exercising, provided the symptoms are well controlled. According to a 2023 study published in the journal Frontiers in Rehabilitation Sciences, physical exercises have shown promising effects on people with asthma.
Dr Gangakhedkar stresses the importance of being physically fit. In case of ongoing asthma symptoms, he advises bringing the symptoms under control and then resuming exercise.
Precautions while exercising in winter
Romil was advised to take inhalers before the football match. He was also asked to do warm-up exercises before the match and cool-down exercises after the match.
“Both controller inhalers (used on a day-to-day basis to manage asthma symptoms), as well as reliever inhalers (short-acting inhaler, which acts as a rescue inhaler), are prescribed by the doctors,” says Dr Sunil. Romil was advised to take a reliever inhaler before beginning any physical activities.
Dr Das advises against outdoor exercises like jogging during the early mornings. “The smog is high during the early hours and the air quality is poor when the temperature is low.” He recommends exercising post 7 am.
Takeaways
- Cold dry air can trigger asthma due to the drying up of the airways.
- Exercising during winter can further aggravate airway moisture loss.
- Warming up before exercise and cooling down after exercise can prevent EIB
- Experts advise compliance to asthma medications including reliever and controller inhalers.
