Medical and Lifestyle Complications of Asthma

There are many possible short-term and long-term complications of asthma, especially if it’s left untreated. The breathing problems it causes can affect your quality of life by affecting your sleep and limiting your activities. Asthma can also trigger dangerous attacks and increase your risk of conditions ranging from obesity to respiratory failure.

Learn about medical and lifestyle complications of asthma, their causes, what to do about them, and how to reduce the risk of experiencing them.

Types of Asthma

There are several types of asthma, and you could have more than one kind. Some of the most common types are:

• Adult-onset asthma, which is diagnosed in adults over age 20
• Pediatric asthma, which is diagnosed during childhood
• Allergic asthma, which is triggered by common allergens like pollen, mold, and dust
• Nonallergic asthma, a less common form of asthma that is not triggered by allergens
• Exercise-induced bronchoconstriction (EIB), which is triggered by strenuous physical activity
• Occupational asthma, which is triggered by exposure to irritants at the workplace
• Cough-variant asthma, which produces a dry cough but not wheezing or shortness of breath
• Nocturnal asthma, which causes symptoms only at night

While there is no cure for asthma, it can be controlled with prescription medications. Some medications offer fast-acting symptom relief. Others work to prevent swelling and excess mucus production in the airways. 

Most asthma medications are delivered through an inhaler (handheld device that delivers asthma medication) or nebulizer (powered device that delivers medication), although some may be injected. Devices called peak flow meters can help to monitor someone’s breathing to make sure their asthma is under control.

Lifestyle Complications of Asthma

Uncontrolled asthma can have negative effects on your physical and mental health, as well as your daily functioning and sense of well-being. Some of the lifestyle complications of asthma include sleep difficulties and physical inactivity.

Sleep Difficulties and Fatigue

Many people with asthma experience insomnia (difficulty falling asleep or staying asleep) and disrupted sleep due to asthma symptoms such as coughing and wheezing. Poorly controlled asthma can lead to sleep deprivation, daytime fatigue, and interference with daily living.

People whose asthma symptoms aren’t under control report struggling in work, school, and other aspects of daily life.

Physical Inactivity and Related Complications

Some people with asthma don’t exercise regularly due to their symptoms. Some might feel too tired from asthma-related sleep problems to work out or prepare healthy food. Others avoid exercise because physical exertion triggers their asthma. 

In the long term, physical inactivity can lead to other health complications, such as obesity, heart disease, high blood pressure, and diabetes.

Medical Complications of Asthma

When left untreated, chronic asthma symptoms can lead to various medical complications, including:

Asthma Medication Side Effects

Corticosteroids are often prescribed to treat chronic asthma symptoms. These anti-inflammatory drugs are used to reduce swelling in the bronchial airways. However, they have some potential side effects, including:

• Insomnia (difficulty falling asleep or staying asleep)
• Weight gain
• Thrush (an oral yeast infection)
• Elevated eye pressure (glaucoma)
• Elevated blood pressure
• Cataracts (clouding of the clear lens of the eye)
• Infections
• Bruising
• Osteoporosis (thinning and weakening of bones)

GERD

Up to 80% of people with asthma also have symptoms of gastroesophageal reflux disease (GERD), which causes heartburn due to the return of stomach acid into the esophagus. Symptoms of GERD can trigger and worsen asthma symptoms (and vice versa). Treating GERD can help with asthma symptoms.

Chronic Inflammation and Airway Remodeling

Chronic inflammation from severe asthma can eventually lead to airway remodeling, which refers to the permanent narrowing of the airways in the lungs.

Airway remodeling can permanently affect lung function, leading to ongoing breathing problems. It’s associated with chronic obstructive pulmonary disease (COPD), a group of progressive diseases that restrict airflow.

The Flu

Even people with mild asthma are more at risk of developing serious complications from the flu. The flu virus can also worsen asthma symptoms, potentially leading to infections and a greater risk of hospitalization. The seasonal flu vaccine is especially important for people with asthma.

Pneumonia

People with chronic, uncontrolled asthma have a higher risk of developing lung infections like pneumonia, especially after contracting the flu. In turn, pneumonia can make asthma symptoms worse.

Hospitalization

People with asthma may have to be hospitalized for severe asthma symptoms or other asthma-related complications, such as the flu or pneumonia. Asthma is one of the most common conditions among people who are hospitalized for the flu. In children, it is the most common.

Asthma Attack and Respiratory Failure

Respiratory failure—a potentially fatal condition in which the lungs don’t receive enough oxygen—can sometimes result from an asthma attack, especially among people with severe asthma (5%–10% of people with asthma). 

In many cases, this happens over a period of hours or days during which asthma-related respiratory distress goes untreated. Getting medical help right away can usually prevent severe complications.

Anxiety and Depression

There is some evidence that severe asthma is linked to certain mental health conditions, such as anxiety and depression. People with asthma and a coexisting mental health condition are also less likely to seek treatment for their asthma symptoms. 

The symptoms of anxiety and depression, such as stress, panic attacks, and uncontrolled crying, can also trigger asthma episodes due to related changes in breathing patterns. Practicing mindfulness techniques, taking prescription medications, and seeing a psychotherapist can help.

Weight Gain

People with asthma might experience weight gain as a result of other asthma complications, such as insomnia, decreased physical activity, and fatigue. Some asthma medications cause unwanted weight gain due to fluid retention and increased appetite. 

Weight gain can lead to various other health problems, such as:

• Obesity
• Heart disease
• High blood pressure
• Type 2 diabetes
• Certain cancers
• Stroke
• High cholesterol

Obstructive Sleep Apnea

People with asthma have a greater risk of developing obstructive sleep apnea (OSA), a condition that causes someone to briefly stop breathing while they sleep. Uncontrolled OSA can lead to snoring, sleep disruptions, poor quality of life, daytime fatigue, and serious health problems like stroke and heart disease.

If someone has both asthma and sleep apnea, it’s important to be treated for both conditions.

Racial Disparities and Asthma

There are disproportionately high rates of asthma complications—including hospitalizations, chronic conditions, and deaths—among Black, Hispanic, and American Indian/Alaska Native people in the United States.

For example, when compared to White Americans:

• Black Americans are 1.5 times likelier to have asthma, 5 times likelier to visit a hospital emergency room due to asthma symptoms, and 3 times likelier to die from asthma.
• Puerto Rican Americans have the highest prevalence of asthma in comparison to any ethnic or racial group and are 2 times likelier to experience asthma attacks.
• Indigenous Americans are almost twice as likely to experience asthma symptoms on a daily basis.

The reasons for these racial health disparities are complex, but they may include factors such as:

• Workplace discrimination and hazards
• Structural racism, segregation, and poverty
• Higher exposure to environmental pollution
• Unequal access to health care and education
• Health-related comorbidities (co-occurring illnesses)
• Genetics

Asthma-related racial health disparities have improved to an extent in recent years due to expanded access to health care and other reforms. However, more work is needed to address the ongoing disparity.

Asthma Complications: Adults vs. Children

Many of the signs, symptoms, and risk factors associated with asthma are the same in adults and children. However, there are a few differences between pediatric and adult-onset asthma:

• Asthma is more common in boys than in girls until the onset of puberty. Adult-onset asthma is more common in women than men.
• In some cases, childhood asthma may completely disappear before adulthood. Adults are more likely to take prescription medications, more likely to relapse, and less likely to go into “remission” from asthma.
• Childhood asthma is often caused by a combination of genetic and environmental factors. Adult-onset asthma is usually more closely related to environmental causes, lifestyle factors, and comorbidities (other conditions the person has).
• Children are more likely to experience difficulties in school and extracurricular activities due to asthma-related sleep problems. 
• Adults with asthma have higher rates of respiratory symptoms and depression. They may miss work or struggle with professional obligations due to fatigue and other asthma complications.
  

Summary

Asthma is a chronic medical condition that tightens and inflames the airways in the lungs. In addition to symptoms like coughing, wheezing, chest tightness, and asthma attacks, uncontrolled asthma can lead to lifestyle and medical complications. 

Some of the complications of asthma include insomnia, fatigue, physical inactivity and weight gain, the flu, mental health conditions, pneumonia, obstructive sleep apnea, and side effects from medication. In some cases, untreated asthma can lead to hospitalization, respiratory failure, and death.

A Word From Verywell

No matter how severe your asthma symptoms are, it’s important to talk to your healthcare provider about treatment. Medication, monitoring and preventive care can help to prevent serious health complications from asthma.