Does exercise-induced bronchospasm occur with physical activity in cold temperatures compared to mere exposure to cold?

From the Guidelines

Exercising in cold weather is more likely to trigger asthma symptoms than simply walking around in the cold due to the combination of exercise-induced bronchoconstriction (EIB) and cold air. This is because when you exercise, you breathe more rapidly and deeply, often through your mouth rather than your nose, causing cold, dry air to reach your airways without being properly warmed and humidified, leading to a loss of heat and moisture in the airways and triggering inflammation and narrowing of the bronchial tubes 1. The underlying mechanism involves the airways cooling and drying during exercise in cold air, triggering the release of inflammatory mediators that cause bronchospasm, with the thermal and osmotic effects of dehydration being key factors in the development of EIB 1. To manage this, using a prescribed rescue inhaler (like albuterol) 15-20 minutes before cold-weather exercise, wearing a face mask or scarf over the mouth and nose to warm and humidify the air, and a proper warm-up of 10-15 minutes before intense exercise can help reduce symptoms 1. If symptoms persist despite these measures, consulting a doctor about adding a long-acting bronchodilator or inhaled corticosteroid to the regimen may be necessary, as the intensity of cellular inflammation in the airways is an important factor in the susceptibility to EIB 1. Key factors to consider include:

• The rate of water loss from the airways, which can be monitored by controlling ventilation and inspired water content 1
• The use of devices that warm and humidify the air during exercise in cold weather, which can help minimize EIB symptoms 1
• The importance of proper warm-up and cool-down exercises to reduce the risk of EIB 1

From the Research

Exercise-Induced Bronchospasm in Cold Temperatures

• Exercise-induced bronchospasm is a common respiratory disorder that occurs in response to physical activity, particularly in cold temperatures 2.
• The primary stimulus for this disorder is likely a combination of airway cooling and drying, leading to hypertonicity of airway lining fluid 2.
• Studies have shown that intense exercise at cold air temperatures can lead to transient acute bronchoconstriction and symptoms of cough, particularly at temperatures colder than -15°C 3.

Comparison to Mere Exposure to Cold

• While mere exposure to cold can trigger respiratory symptoms in individuals with asthma, exercise-induced bronchospasm is a distinct phenomenon that occurs in response to physical activity 4.
• Research suggests that individuals with poorly controlled asthma are more prone to experience cold weather-related respiratory symptoms, including shortness of breath, cough, and wheezing 4.
• However, the relationship between physical activity and lung function in individuals with asthma is complex, and stronger physical activity has been shown to be concurrently associated with both higher lung function and increased shortness of breath 5.

Key Findings

• Exercise-induced bronchospasm can occur with physical activity in cold temperatures, but the relationship between physical activity and lung function in individuals with asthma is complex 2, 3, 5.
• Individuals with poorly controlled asthma are more prone to experience cold weather-related respiratory symptoms 4.
• Physical activity can trigger later bronchoconstriction in many patients with asthma, but the immediate effect of physical activity is bronchodilation 5.