But for some people with asthma, the condition’s symptoms can be difficult to control. In addition to having an increased risk for more severe symptoms, people with hard-to-control asthma also have an elevated risk for asthma-related health complications. (1) RELATED: Everything You Need to Know About the Symptoms of Asthma Even in people who are able to manage their symptoms with medication, asthma can potentially cause both short- and long-term complications. (2) Problems Engaging in Normal Daily Activities According to David Rosenstreich, MD, chief of the division of allergy and immunology at the Albert Einstein College of Medicine in New York City, symptoms of asthma like coughing, wheezing, and shortness of breath may prevent you from attending work or school, impacting your productivity. Asthma symptoms may also interfere with sleep or prevent you from exercising or engaging in other leisure or social activities. Disengagement from all of these activities can affect your overall health and increase your risk for conditions like heart disease and diabetes. People who have poorly controlled asthma, either because of failure to adhere to treatment or because asthma is difficult to control with treatment, are more likely to experience work and overall activity impairments than people who have asthma under control. (3) Severe Asthma Attacks Up to 10 percent of people who have asthma may have what’s termed severe asthma. (4) For these people, asthma symptoms occur daily and are often difficult to control, says Patricia Takach, MD, an associate professor of clinical medicine in the Section of Allergy and Immunology at the University of Pennsylvania’s Perelman School of Medicine in Philadelphia. People with severe asthma as well as people with less severe asthma may experience severe asthma attacks. These attacks generally bring on the same symptoms as milder attacks, but as their name would suggest, symptoms are more severe and don’t respond as quickly (or potentially at all) to treatment. Such attacks can cause extreme breathing problems or wheezing, problems speaking, blue lips or fingernails, and other symptoms that don’t improve after taking your rescue medication. (5) Some severe asthma attacks may require a trip to the emergency room or require hospitalization. (6) Seek immediate medical attention if your symptoms are not responding to your usual treatment. Medication Side Effects For people who use inhaled asthma treatments, side effects are rare and, in most cases, minor. Such side effects can include a hoarse voice or sore throat. (7) “Side effects are less common with inhaled medication [than with drugs taken orally] because the active ingredient stays in the airway or is rapidly metabolized once it gets into the bloodstream,” Rosenstreich explains. Oral corticosteroids, however, can cause side effects such as disturbed sleep, hyperactivity, and increased appetite, Rosenstreich adds. Long-term use of oral corticosteroids may also increase your risk of infections, high blood sugar, and osteoporosis. Talk to your doctor if you’re experiencing any side effects. Also, don’t stop taking your asthma medication unless you’ve cleared it with your doctor. Pneumonia and Other Respiratory Infections Asthma doesn’t directly increase your risk for pneumonia or other types of lung infections. But some asthma medication may contribute to your risk for these conditions. People who use the highest-strength inhaled corticosteroids to treat asthma are more than twice as likely to be diagnosed with pneumonia or another lower respiratory tract infection than the healthy control subjects. This may be due to the use of inhalers that aren’t properly cleaned, or because the corticosteroids, while reducing inflammation, interfere with some normal immune system function. (8) “These infections are a concern with the use of any anti-inflammatory,” Rosenstreich says. He adds that people who use inhalers can also experience fungal infections in the mouth. It’s important to properly clean and maintain your inhalers, and also to follow any other instructions your doctor gives you when it comes to your medication. This “airway remodeling” is irreversible and can affect how well you breathe. Some people may ultimately need to use an assistive device, like an oxygen machine, to breathe. (9) It’s believed that everyone who has asthma experiences airway modeling to some degree, however, severe airway remodeling is rare. “When inflammation in the lungs isn’t properly controlled by therapy with corticosteroids or bronchodilators, scar tissue can form and the airways are no longer able to open up, even after using an inhaler,” Rosenstreich says. “It can begin shortly after the onset of asthma, which is why we encourage people to stick to their prescribed therapy.” Anxiety and Depression As with some other chronic diseases, asthma may increase your risk for anxiety and depression. Some research has found that people with asthma are nearly twice as likely to develop depression as those without asthma. (10) Some research suggests the psychological stress and negative emotions (like fear, panic, and irritability) associated with asthma are what put individuals with asthma at higher risk for these mood disorders. (11) Sleep disturbances and inflammatory factors associated with asthma may also contribute. (11) “A condition like asthma can have a significant psychological toll,” Rosenstreich says. If you’re feeling depressed or anxious, talk to your doctor to ensure you get the treatment you need. “Asthma can be a challenge, but it’s treatable,” he adds. Weight Gain Asthma can make it difficult to exercise, either because exercise triggers symptoms or symptoms leave you feeling fatigued and without the energy to be physically active. Some asthma medication can increase appetite. For all these reasons, many people with asthma — roughly 2 out of 3 — have said their condition has caused them to gain weight, according to surveys by the nonprofit Asthma UK. (12) But at the same time, there’s good evidence that losing weight can help alleviate asthma symptoms. (13) A lot of nutrition research suggests a diet rich in whole foods — especially fruits and vegetables — and low in processed and refined grains can help people lose weight. RELATED: 9 Hard Truths About Weight Loss That Can Help You Slim Down Higher Risk of Developing GERD Gastroesophageal reflux disease (GERD) is a condition in which stomach acid travels up into the esophagus — the tube connecting the stomach and mouth — and causes burning (heartburn), a mucous-clearing cough, or other symptoms. (14) Up to 75 percent of people with asthma experience GERD. (15) And there’s some evidence that GERD may worsen asthma symptoms and further reduce the effectiveness of treatment. Also, asthma can make GERD symptoms worse. (15) “There’s some evidence that the bronchodilators used to treat asthma may promote acid creation in the stomach and regurgitation in the esophagus,” Rosenstreich explains. If you notice heartburn or other GERD symptoms, be sure to talk to your doctor. Obstructive Sleep Apnea (OSA) OSA is a condition in which the throat’s airways temporarily close during sleep. It can cause snoring and breathing difficulties during sleep, nighttime arousals, daytime fatigue, and potentially serious complications — including heart disease. Asthma is associated with an increased risk for OSA because asthma’s common features, such as nasal obstruction and nasal and airway structures that can limit breathing promote sleep apnea symptoms. (16) Also, OSA can make asthma’s symptoms worse because of the narrowing of the airways, gastroesophageal reflux, and inflammation associated with OSA. (16) If you have asthma, it’s important to tell your doctor if you’re snoring, waking up frequently during the night, or showing other symptoms of OSA. “Most people with asthma know the importance of staying on prescribed treatment,” Rosenstreich says. “Because if they don’t, they know they’ll see an increase in their symptoms. But your doctor will remind you that symptoms are only the start. These complications are, in most cases, rare and totally avoidable — simply by staying with your treatment.” If you have trouble controlling your symptoms despite following your treatment plan, you may have a more severe form of asthma. Let your doctor know about your struggles so he or she can help find a more appropriate treatment. With additional reporting by Markham Heid.
