Do your asthma symptoms change with the seasons?
While the winter months can mean pesky infections and extreme cold temperatures (both potentially troublesome for asthma), summer can bring its own set of ‘triggers’ for the 5.4 million people living with the condition in the UK.
Pollen is thought to be a ‘hidden trigger’ for 80% of people with asthma, according to LloydsPharmacy, who report that last year, 91% of their asthma control tests (the high-street pharmacy offers an Asthma Treatment and Advice service) took place from March-May, peak hay-fever season. Furthermore, 46% of the tests carried out during that period found people were not controlling their asthma well.
If you have asthma and are prone to hay fever, or find your symptoms flare-up in spring and summer, it might be worth checking out some of the apps that monitor and alert you to pollen forecasts. And if you’re struggling to keep symptoms under control, speak to your nurse or GP.
Depending where you travel to, a holiday could mean a new set of triggers, especially if you’re in a new environment and climate that’s different to what you’re used to. Other people may find that changes in routine, location, temperature, or even air travel, can make their asthma symptoms worse
“The best thing people can do to prevent symptoms and attacks when they’re on holiday is to keep on top of their medicine routine.
Asthma UK has more advice about travelling with asthma on their website it’s always a good idea to carry your inhalers (and all your spare inhalers) in your hand luggage, in case your inhaler runs out or if your checked-in baggage goes missing.
Summer is all about letting your hair down and enjoying life – and there’s no reason your asthma should stop you. But, from smoky barbecues to greater exposure to air pollution if you’re pounding the pavements on days out, it’s a good idea to be aware of any potential summertime asthma triggers.
Many who suffer with respiratory disorders also find it difficult to sleep at night, often suffering from sleep apnoea and requiring oxygen at night. Extremes of temperatures can affect your sleep and your health.
Sleep apnoea is caused when the upper throat muscles relax too much during sleep, cutting off or restricting the airway. These episodes, which also cause the oxygen level in the blood to drop, last from 10 seconds to a minute or longer. The brain registers the lack of oxygen and the individual wakes up just enough to open the throat and begin breathing again, starting the cycle over. Most of the time, individuals don’t remember these episodes in the morning, but they severely disrupt the restorative effects of sleep.
Being too hot or too cold can worsen the situation, resulting in disrupted sleep, low oxygen levels, worsening health conditions and drowsiness the following day. Many find using oxygen at night helps to maintain oxygen levels, minimises the frequency of waking up and prevents your respiratory problems from worsening, but if you’re too hot during the summer months you still need to be able to sleep soundly as sleep provides you with so many rejuvenating and healing properties.
The most important factor is the ambient temperature in your bedroom, this needs to be slightly cool in order to help keep your body’s core temperature lower. Otherwise it puts the body clock out of sync and you wont sleep properly. It’s better for it to be a bit nippy as you get into bed as your body will generate heat during the night from metabolism and trying to maintain your body’s core temperature at the correct level.
If you’re lucky enough to have an AC unit then use it, however for the rest of us there are some ways that can help to make sure you get a good night’s sleep.
The head is the hottest part of the body so you want to keep it as cool as possible. Conventional pillows surround your head, trapping in the heat. A smaller, firmer pillow, although less comfy will allow more air circulation.
You can make a cheap version of an AC unit using these three simple household items – an electric fan, a large mixing bowl and some ice cubes. Place the ice cubes in the bowl, in the path of the airflow coming from the fan. The warm air causes the ice to melt, dispersing a cool breeze around the room.
3) Sleep like a Pharaoh
The so-called Egyptian method requires either a bed sheet or a towel large enough to cover your body. Soak the sheet in water, then put it in the washing machine on spin cycle -or just wring it out to stop any dripping. When you go to sleep, cover yourself with the damp sheet. This will keep you cool via latent heat, the same process that sweating uses to cool your body down.
4) Keep the sun out
The sun’s rays are far more powerful in the summer and keeping the blinds down stops the rooms heating up during the day.
5) Change what you eat
Usually when it;s hot you don’t feel like eating big meals anyway but remember that the larger the meal, the more metabolic heat you generate as your body breaks down the food. Try switching to salads, fruits and vegetables that the body can metabolise with less effort. If you cook a lot at home, switching to more raw foods will also mean less cooking, which means less heat being generated inside the house.
You could try sleeping in a hammock, as being suspended in mid-air means that air flows all around your body, unlike a mattress which absorbs and reflects your body heat. Lower storeys are generally cooler than upper ones as heat rises. Finally, if all else fails, there’s always outdoors.
If you do use oxygen at night ensure there is air flow in the room and maybe use a dehumidifier, as the equipment may be generating heat while you are trying to sleep. Also check with your doctor if you are having trouble sleeping as they may adjust your oxygen flow rate settings if needed.
References: http://sleepjunkies.com and www.sleepapnea.com
Whether you’re abroad or at home this summer it is recommended that those of us with respiratory-related illnesses should use caution as there is a strong link between rising temperatures and increased hospital admissions.
Older people have more difficulty adjusting to rising outdoor temperatures than younger people because as we age our body finds it harder and is less efficient at thermoregulation. This is the body’s ability to maintain your internal temperature within a healthy temperature range. Older people are also more likely to suffer from conditions such as heart failure, obesity, heart disease and obesity which heat can worsen, and take medication such as diuretics, beta blockers and antidepressants which can interfere with the body’s ability to cool off and perspire.
In a recent study there was shown a correlation between rising temperatures and the number of emergency admissions for people suffering with COPD and respiratory tract infections in the over 65 population. Even when air quality, pollution, pollen and ozone levels were taken into account, the heat exposure factor was still the most significant and even the following day after heat exposure the risk of hospitalisation was still extremely high.
The study suggested that the poor respiratory effects to heat exposure was likely due to the inhalation of hot air.
Inhaling hot air can exacerbate disorders like COPD as it can cause a bronchospasm which contracts he airways making it harder to breathe and this can happen just a few minutes are exposure. Breathing hot air may also aggravate existing respiratory infections which may also be initiated by pollen or mould.
Poor thermoregulation also plays a part as if you cant cool your body off it will result in hyperthermia which has symptoms such as heat cramps, heat exhaustion and heatstroke. It can cause a rapid heartbeat and increased blood flow to the skin for it to cool off, leaving vital organs deficient in blood flow and therefore oxygen.
The body will work harder as it tries to keep cool and therefore require additional oxygen supplies leading to rapid deep breathing (hyperpnea) and can lead to decreased lung function.
However it does seem that if you grew up in an area that experiences high summer temperatures then your body is used to acclimatising to these temperatures. It can thermoregulate fairly efficiently as your body’s ability to do this improves with repeated exposure. People who are not used to long-term heat can have a harder time adjusting and when we experience a heat-wave or go on holiday our bodies have difficulty adjusting and being able to regulate our body temperature and can impact our respiration ability.
The advice is to keep informed of heat, humidity and air quality whether at home or abroad and make sure you are prepared in case your symptoms worsen suddenly. Ensure you have enough medication, water to take it, oxygen equipment and a back-up concentrator and cannula in case of equipment failure. If travelling abroad a global oxygen supplier can arrange for additional equipment to be available for you, as it’s better to be safe than sorry.
Whatever stage your respiratory disease may be at, preventing flare-ups is highly important to ensure you stay as healthy as possible and to keep your breathing as easy as possible. This means you need to be aware of the triggers and eliminating any exposure to cigarette smoke, fire smoke, dust, chemicals, excessive wind and pollution. Breathing can also be difficult at temperatures around or below freezing, above 90 degrees F, or on days with high humidity, ozone levels or pollen counts.
Many patients have a component of asthma and some prefer warm, dry climates whereas others may prefer more humid environments.
Extreme hot or cold conditions can put stress on the entire body. In order to maintain a constant body temperature, you exert additional energy to warm or cool it down. This additional energy requirement also increases the amount of oxygen that your body is using. Breathing hot or cold air can also have a drying or irritating effect on the airway causing bronchospasm (contraction of the smooth muscle that surrounds the airway). This decreases the size of the airway and makes it more difficult to get the air in and out of the lung, increasing shortness of breath.
In general most patients find that they prefer minimal humidity levels of about 40%. This is also true of indoor humidity levels which can be difficult to maintain throughout the year, if it is a hot summer or a cold winter with the heating on. You can purchase a humidifier that works with your heating system or independent units for single rooms. De-humidifiers can also be purchased to help lower the humidity in certain rooms.
High indoor humidity is often also the source of mould growth in the home which is another trigger, as well as an increase in common indoor air pollutants like dust mites, cockroaches, bacteria and viruses. Also as humidity increases, the density of the air increases. This more dense air creates more resistance to airflow in the airway, resulting in an increased work of breathing (i.e. more shortness of breath).
Look out for common signs of high humidity:
• flooding or rainwater leaks from the roof or basement/crawl space
• poorly connected pipes or leaky pipes under sinks or in showers
• carpet that remains damp
• poorly ventilated bathrooms and kitchens
• condensation build-up from humidifiers and dehumidifiers, air conditioners, and drip pans under refrigerators/freezers
Here are some helpful pointers for when it is hot, although many are applicable to other weather conditions as well:
1. Drink plenty of fluids, fairly obvious for Australians, but please take into account if you have a fluid restriction.
2. Wear appropriate clothing and sunscreen.
3. Plan your activities carefully. Try to organise your activities or exercise for the coolest times of the day – early in the morning, or in the evening. When driving, park in shady areas if possible, and choose places to go that are air conditioned. Place sun protectors in your car when it is parked.
4. Keep cool, indoors. Use your air-conditioner if you have one and remember you do not need it to be freezing cold. A second benefit of the air conditioner is that it removes a great deal of humidity from the air as it cools it. If an air conditioner is not available, use fans and open windows to circulate the air during hot days. Special programmes are available in many places.
5. Use the buddy system. This means making sure that someone contacts you at least twice a day to check that you are OK.
6. Avoid rigorous exercise or excess activity.
7. Take your medications as directed.
8. Pay attention to weather reports.
References: www.healthline.com and http://lungfoundation.com and https://rotech.com