Complications of Asthma: Medical and Lifestyle

Asthma is a chronic medical condition that affects the airways in the lungs, causing them to suddenly tighten and get inflamed. 

The immediate symptoms of asthma include wheezing, coughing, chest tightness, shortness of breath, and the overproduction of mucus. Asthma triggers, such as cold air, can set off asthma symptoms. Asthma attacks involve worsening symptoms. 

There are many possible short-term and long-term complications of asthma, especially if it's left untreated. 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.

When Is Asthma an Emergency?

Asthma may become a medical emergency, especially if a rescue inhaler fails to stop the asthma attack. Without emergency medical assistance, an asthma attack could lead to a potentially fatal respiratory system failure.

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.

When to Seek Emergency Help

Seek urgent medical help for the following asthma-related symptoms:

Extreme breathing difficulties
Difficulty walking or talking
Severe chest pain
Persistent sweating
Confusion
Color changes in lips, eyes, fingertips, or nail beds
Chest retractions 
In babies, failure to respond to parents

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.

Frequently Asked Questions

Some of the most common complications of asthma are asthma attacks, sleep problems, daytime sleepiness, fatigue, and lack of exercise. Many people with asthma also have GERD. Other complications may include frequent respiratory infections, complications from the flu, and pneumonia.
If left untreated, asthma can lead to serious health complications. These can include obstructive sleep apnea, chronic inflammation, airway remodeling, anxiety, depression, and pneumonia, among many other potential problems.
If someone has sleep problems and fatigue due to asthma, they may experience unwanted weight gain. Weight gain can lead to conditions like diabetes, heart disease, high cholesterol, high blood pressure, and stroke.
Poorly controlled severe asthma and untreated asthma attacks can lead to respiratory failure, which is potentially fatal.
Untreated asthma can also lead to chronic inflammation of the lungs and airway remodeling (structural changes in the airways). This can put someone at a higher risk of hospitalization for flu complications, pneumonia, and other infections.
Drowsiness and fatigue from asthma-related insomnia can disrupt your quality of life and interfere with daily functioning.
Other long-term effects of untreated asthma include weight gain, obstructive sleep apnea, chronic inflammation and airway remodeling, anxiety, depression, and vulnerability to infections such as pneumonia. In rare cases, severe asthma can lead to respiratory failure, which can be fatal.

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