Why does COPD get worse in winter?

Chronic obstructive pulmonary disease (COPD) is a long-term respiratory condition that can have a significant impact on your health and ability to complete everyday tasks as normal. If you or a loved one have COPD, you might be aware that the condition can get worse in winter - but why exactly does this happen?

In this article, we explore what makes COPD get worse in winter, how you can protect yourself against severe symptoms and how a change in treatment may help you to feel better.

How does COPD get worse in winter?

Although the exact symptoms of COPD will vary from person to person, most people who have it will experience:

• Shortness of breath

• Persistent wheezing

• A chesty cough that won’t go away

• Frequent chest infections.

This is the case year round, but adverse weather conditions in winter can make symptoms worse. In some circumstances, this could mean you have to go into hospital for a severe chest infection. 

Cold weather can irritate the airways and cause them to narrow, meaning that mucus can more easily obstruct your airways and make it harder for you to breathe. This could make breathlessness, wheezing and coughing symptoms worse. 

Crucially, though, winter is a time when minor illnesses are rampant in the community - things like colds and the flu. To many, these are just that, minor illnesses, but for those with COPD, the combination of two respiratory conditions can make the effects more dangerous, leading to a need for hospitalisation. 

How to prevent COPD from getting worse in winter

Although there’s no way to completely prevent the possibility of picking up a minor illness in winter, there are things you can do to reduce your risk of doing so, as well as protective measures you can take in order to lessen any symptoms you experience. 

Avoiding minor illnesses

If you have COPD, it’s important to take the risk of minor illnesses seriously. To reduce your chances of catching the flu or a cold, you can:

• Wash your hands regularly with soap and warm water

• Avoid sharing towels or household items such as cups or plates with others - especially if they are showing symptoms.

• Don’t touch your face, eyes, nose or mouth without washing your hands thoroughly first

• Maintain a healthy, balanced diet

• Wear a face mask when in crowded or enclosed public places - such as when you’re shopping or on public transportation.

• Refrain from spending time with loved ones who are showing symptoms - what is of little consequence to them could result in a much more serious illness for you. 

If you experience a worsening of your COPD symptoms, or symptoms of a cold or flu infection, seek medical attention as soon as you can. Prompt treatment may help to lessen the impact of your symptoms.

Self care for COPD in winter

There are also things you can do to help your COPD more generally in winter, which may ease the severity of your symptoms. You should:

• Take all of your prescribed medication as instructed - check with your healthcare provider that you understand how and when to take your medication to ensure the treatment works as expected.

• Consult your healthcare team before using over-the-counter remedies - in some cases, these can interfere with your medication.

• Avoid airborne irritants wherever possible - including tobacco smoke, vapes and even wood smoke from events like Bonfire night gatherings; perfumes, strong fragrances and exhaust fumes; and dusty environments.

• Stay indoors if possible when the outside temperature is below 5°C

• Try to keep your house warm - it’s recommended to stay at 21°C for the living room, and 18°C for your bedroom.

• Get your vaccinations - people with COPD should get the annual flu vaccine, as well as the one-off pneumococcal jab which helps to protect against pneumonia and other serious illnesses.

• Keep an extra stock of your medications in case the weather prevents you from accessing them.

Staying warm as much as possible in winter is key to reducing your risk of COPD complications.

What to do if your COPD inhaler doesn’t seem to be working

If you’ve been prescribed an inhaler to help manage your COPD symptoms, but you don’t feel that it’s working, you should speak to your healthcare team about the problem. In some cases, it might be that you need a different medication; however, for some people with COPD, inhalers may not be the best delivery method to provide treatment with. 

One symptom associated with COPD is called ‘suboptimal peak inspiratory flow’. This means that, due to breathing difficulties caused by the condition, you struggle to breathe in with enough force for the treatment from your inhaler to reach your lungs. 

In practice, this can result in your treatment not seeming to work, so your symptoms don’t get better and may even get worse. Because you’re using your inhaler incorrectly, your healthcare team might think you need a different medication, but the real problem is that not enough of the medication is reaching your lungs. 

In situations like this, a nebuliser may be a more effective delivery system. 

Unlike inhalers, which deliver a short puff of medication you need to inhale at the right moment, nebulisers take a few minutes to deliver the medication in a fine mist. You use a mouthpiece or mask to inhale it, and since the delivery is gradual, all you need to do is breathe normally with the mouthpiece or mask in place to receive the medication.   

Note: Medication delivery is more effective through a mouthpiece, however using a well-fitting mask can be a convenient alternative.  

A nebuliser may be a better choice than an inhaler if you:

• Struggle to inhale sharply

• Find it hard to time your inhale at the right moment

• Have reduced hand strength or co-ordination, making it difficult to use your inhaler correctly.

If you think your inhaler isn’t working as it should, or you think a nebuliser may be more appropriate for your needs, speak to your healthcare team about your options. Getting the right treatment with the right delivery method can help to lessen COPD symptoms and help keep you safer in winter and all year round.