What to know about stress-induced asthma

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Yes — according to the Asthma and Allergy Foundation of America (AAFA), any strong emotion can trigger asthma symptoms. This is not a trigger for everyone, but it is common.

Stress can trigger asthma symptoms in people with a diagnosis. It may also contribute to the development of asthma. A 2020 study states that long-term stress is correlated with the new onset of asthma, particularly if it takes place during childhood or adolescence or someone has multiple sources of stress.

Stress is a mental and physical response to adversity. It happens when someone feels a sense of pressure, threat, or that they cannot cope.

Research suggests stress may contribute to asthma symptoms in several ways:

Faster breathing

The body interprets stress as a sign of danger, which then activates the sympathetic nervous system. This is the part of the nervous system that responds to emergencies.

When this occurs, the body prepares to fight or flee, as though someone is in physical danger. This causes faster breathing, muscle tension, and other changes.

This helps people survive dangerous situations, but it can also make someone feel as though it is difficult to breathe. It can also trigger asthma symptoms.

However, the reverse is also true. Relaxation and breathing exercises can help manage stress and activate the parasympathetic nervous system, calming the body down. This may improve asthma symptoms, according to the American College of Asthma, Allergy & Immunology.

Inflammation

Another way stress may contribute to asthma is through inflammation. The 2020 study states that stress is among several asthma triggers that elevate inflammation. The others include:

• exposure to tobacco smoke
• living close to traffic noise
• indoor and outdoor allergens

Older research from 2006 also notes that stress increases cytokine and eosinophil levels. Cytokines are chemicals involved in airway inflammation, while eosinophils are white blood cells also associated with inflammation. Both could increase the symptoms and severity of asthma.

Impact on medication

The 2020 study adds that stress can reduce a person’s response to certain asthma medications. These include inhaled beta-2-agonists, such as albuterol (Ventolin), and inhaled corticosteroids, such as fluticasone (Flovent HFA).

The symptoms of stress-induced asthma are the same as asthma that occurs due to other triggers. They include:

• coughing
• wheezing, or a whistling sound in the chest
• shortness of breath
• chest pain/tightness
• waking at night due to asthma symptoms

However, people with stress-induced asthma may also notice other symptoms related to the stress response, such as:

• faster breathing
• faster heartbeat
• muscle tension
• headaches
• sweating

Becoming mindful of these signs may help someone address stress before it starts to affect their asthma.

Here are some tools people can use to manage their stress-induced asthma:

Asthma action plan

Asthma action plans are customized plans for managing asthma that a doctor can help someone create. They have three sections that contain instructions on what to do when someone is:

• feeling good
• having a flare-up
• experiencing serious symptoms

The plans show:

• how to recognize asthma attacks
• what medications to take and when
• when to call a doctor and when to go directly to an emergency room

It is important to have doctor-prescribed medications on hand at all times. Using an automated prescription refill service can help ensure a person always has what they need.

Techniques to reverse the stress response

The AAFA recommends the below techniques for stress-induced asthma:

Observation

Select a nearby object from nature, such as a tree or flower, and focus on it for 1–2 minutes. Try to look at it as if seeing it for the first time, noticing the shapes, colors, and texture. Relax into the observation for a while until feeling better.

Mindful breathing

Begin by slowly breathing in through the nose and out through the mouth. If it helps, try inhaling for 7 seconds, holding the breath for 7 seconds, and exhaling for 7 seconds. Bring attention to breathing and try to let go of everything else.

Repeat this pattern three times or until feeling an improvement.

Self-care

General self-care practices can help reduce stress and improve overall well-being. The American Lung Association recommends:

• getting enough sleep
• eating three balanced meals per day, where possible
• exercising most days of the week
• reducing or avoiding caffeine
• spending time with friends and family

A person with asthma should speak with a doctor if they experience an asthma flare-up that:

• does not go away with their usual asthma medication
• improves with medication but keeps coming back
• disrupts daily activities or sleep

The AAFA also recommends speaking with a doctor if positive emotions or laughter cause asthma symptoms.

A person should dial 911 or the number of their nearest emergency department if they develop any of the following:

• severe shortness of breath
• blue or white lips or fingernails
• difficulty moving or talking due to breathlessness
• difficulty staying awake

An asthma action plan can provide tailored information on when to seek medical attention.

Stress-induced asthma refers to asthma that develops or flares up due to stress. Experts believe that stress causes physical changes in the body that may trigger the symptoms, including faster breathing and a rise in inflammation.

However, it is possible to control stress-induced asthma. A doctor can create an asthma action plan and prescribe fast-acting inhalers a person can carry with them at all times.

Support is also available for learning how to manage and reverse the stress response. This may involve breathing exercises, mindfulness, or any other activity that helps someone relax. Some may find it beneficial to seek additional support from a therapist if stress feels overwhelming.

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