COPD and Rising Temperatures: Mitigating Patient Risk
For some patients with chronic obstructive pulmonary disease (COPD), summer can be one of the most stressful times of the year. Not only is allergy season in full swing, but rising temperatures and humidity can prompt COPD flare-ups.
Major changes in humidity levels can lead to worsening symptoms for those with COPD. While winter weather tends to trigger coughing and phlegm, during the summer, patients with COPD generally experience increased fatigue and shortness of breath. This is because humid air is dense and contains a higher concentration of water vapor, which, in turn, makes it more challenging to breathe.
According to a 2023 survey of 36 patients, there was a significant connection between temperature and humidity and patients with COPD; high humidity contributed to worsening COPD symptoms.
The connection between rising temperatures and increased shortness of breath for patients with COPD stems from the fact that hot temperatures require the body to work harder to stay cool. For example, when inhaling hot air, airways can become inflamed. This increased workload on the lungs and heart makes it difficult for patients to breathe efficiently.
Heat can also contribute to dehydration, which often thickens mucus, making it more challenging for airways in the lungs to remain clear. In addition, many patients have COPD alongside asthma, both of which can be exacerbated by an increase in allergens in the air.
'As the weather gets warmer, pollen increases, too, so this makes breathing worse for COPD patients,' said Norman Edelman, MD, pulmonologist at Stony Brook University Hospital in Stony Brook, New York.
Cold and flu can trigger COPD symptoms, and there is sizable evidence indicating that environmental pollution — such as smog — can irritate the lungs.
'During the summer months, there's often an increase in air pollution,' said Daniel R. Ouellette, MD, chief of pulmonary and critical care medicine at Henry Ford Health in Detroit. 'With more particulates in the air, COPD patients will experience worsening symptoms.'
There can also be greater risk for heart failure among patients with COPD as higher temperatures soar.
'If your COPD is severe to begin with, and it gets worse due to some sort of offending agent, this puts a burden on the heart, and some patients can experience heart failure when their COPD is exacerbated,' Edelman said.
However, the specific reason for the link between COPD flare-ups and heart failure remains unclear.
'We have seen some evidence that during heat waves, there's increased mortality among COPD patients who also have cardiovascular disease,' Ouellette said. 'This may relate to stress on the heart, and we know that respiratory issues can lead to increased mortality, but the reason why this occurs isn't completely clear.'
What to Do When the Mercury Rises
To avoid exacerbating warm weather symptoms, patients with COPD should spend as little time outside as possible during the hottest times of the day. Patients should also routinely check the heat index — including humidity and ozone levels — before venturing outdoors. When outside, extreme exertion should be avoided.
When indoors, consider advising patients to keep their homes air-conditioned and mold- and dust mite–free, since these allergens can further irritate the lungs and worsen COPD symptoms.
'Air conditioning does two things: It ensures that you're not getting overheated, and it keeps outdoor pollutants from taxing your lungs,' Edelman said.
While no studies have definitively linked improved symptoms with the use of humidifiers or air purifiers, there's no downside to using these devices if either improves airway breathing, according to Ouellette. Patients should be sure to clean and maintain these products regularly.
It's also essential to drink plenty of water during the hotter months. The hotter it is outside, the more taxing temperatures are on the body, which responds by sweating and losing fluids.
Finally, patients should be sure to keep track of any respiratory symptoms and utilize inhaled medications as directed by their pulmonologist.
'[Patients should] always stay in touch with [their] healthcare providers,' Ouellette said. 'This is especially critical if we need to make changes to [their] medication to better handle seasonal changes.'
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