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It’s common for people with asthma to have other health conditions, too. Sometimes, these other conditions can make asthma symptoms worse or trigger attacks. For some people, having other conditions can make it harder to treat asthma. Understanding the connection between asthma and these related conditions can help you and your healthcare provider develop an effective asthma action plan.
If you have more than one health condition at the same time, they’re called comorbidities. When a condition develops as a result of asthma or makes asthma treatment more difficult, it’s called a complication. In this article, we’ll cover six types of comorbidities and complications related to asthma.
Many people with asthma also have allergies or eczema (a skin condition that causes itchy, dry patches). These conditions are connected by atopy. Atopy is a genetic tendency for the immune system to overreact to common allergens, like pollen, dust mites, or pet dander.
Many children go through what doctors call the atopic march: first eczema (atopic dermatitis), then hay fever (allergic rhinitis), and later asthma. As many as one-third of children with atopy go on to develop asthma.
Food allergies may also play a role. People with severe eczema that starts early in life are more likely to have food allergies. These food allergies can make asthma worse because reactions in the gut can also spark inflammation in the lungs and airways. In other words, problems that start in the skin or stomach can sometimes “spread” and cause asthma symptoms.
Asthma can cause permanent damage to the airways. So, it can also raise the risk for developing certain respiratory and pulmonary (lung-related) conditions. Other breathing problems may worsen symptoms of asthma, such as wheezing, chest tightness, coughing, and trouble breathing — and vice versa.
Asthma and chronic obstructive pulmonary disease (COPD) are different lung diseases, but sometimes they can overlap. COPD is an umbrella term that includes emphysema and chronic bronchitis. Emphysema is a condition where the air sacs in the lungs are damaged, making it harder to breathe. Chronic bronchitis is long-term swelling of the airways that causes coughing and mucus.
Some people are diagnosed with asthma-COPD overlap syndrome (ACOS), which means they have features of both diseases. People with ACOS often have more severe asthma symptoms. They may also have more frequent flare-ups and reduced lung function, which impacts how well the lungs move air.
Having both COPD and asthma can complicate the diagnosis and lead to one condition or the other being missed. COPD is most commonly diagnosed in people ages 50 to 74 who currently or formerly smoked.
Nearly 10 percent of people with asthma also have aspirin-exacerbated respiratory disease (AERD), also known as Samter’s triad. This condition includes three parts: asthma, nasal polyps (growths in the nose), and sensitivity to aspirin or other nonsteroidal anti-inflammatory drugs (NSAIDs). This includes medicines like ibuprofen and naproxen. People with nasal polyps are more likely to have severe asthma.
Treatment for AERD is often difficult because standard asthma medicines may not fully control symptoms. Doctors may use inhaled steroids or recommend aspirin desensitization, which means slowly increasing aspirin doses under medical supervision. Newer biologic medicines may also help people with severe asthma or nasal polyps linked to AERD.
For people with AERD, taking NSAIDs triggers asthma symptoms, such as:
Obstructive sleep apnea (OSA) is a sleep disorder where the airway repeatedly collapses during sleep. It leads to loud snoring and pauses in breathing. It’s more common in adults who are overweight, and it can affect people of all ages.
OSA affects about half of people with asthma — more than twice the rate seen in people without asthma. For people with severe asthma, up to 90 percent may have OSA. Having both conditions is linked to more severe symptoms, worse sleep quality, and poorer overall asthma control.
People with asthma have a higher risk of serious problems from the flu, even if their asthma is mild or well controlled. The flu can make asthma symptoms worse by causing more swelling in the lungs. It can also lead to pneumonia, a lung infection that can be dangerous for people with asthma.
The U.S. Centers for Disease Control and Prevention (CDC) recommend that everyone older than 6 months get a flu shot every year. This is especially important in persons with asthma. They also recommend staying up to date on pneumococcal vaccines to prevent pneumonia.
Research shows that people with asthma are not more likely to get COVID-19 and usually don’t have worse outcomes compared to others. The CDC notes that people with moderate to severe asthma may be at slightly higher risk, but few studies support this statement. Some evidence suggests nonallergic asthma might carry a small risk.
However, some COVID-19 variants can still trigger asthma flare-ups. The best protection is keeping asthma well controlled and staying current on flu and COVID-19 vaccines.
Respiratory syncytial virus (RSV) is a common virus that causes cold-like symptoms, especially in young children. For babies and toddlers, RSV can be serious and lead to wheezing or trouble breathing.
Children who get RSV early in life have a higher risk of developing asthma later on. In people who already have asthma, RSV and other viral infections can trigger flare-ups and make symptoms worse.
The Centers for Disease Control recommends RSV vaccination for adults 50 to 75 years old with asthma or other chronic respiratory diseases.
Gastroesophageal reflux disease (GERD) causes stomach acid to flow back into the throat. This can cause heartburn, chest pain, or a sour taste in the mouth.
GERD is more common in people with asthma, and the two conditions can make each other worse. Acid reflux can irritate the airways, making them more sensitive to common asthma triggers and sometimes leading to nighttime asthma symptoms. Newer research shows that treating GERD with medicines or lifestyle changes may improve asthma control. This may be especially true in people with frequent reflux symptoms.
Having overweight or obesity raises the risk of developing asthma and makes symptoms harder to control. Extra weight can reduce lung function, increase inflammation, and trigger more frequent flare-ups. Children with obesity are especially likely to have severe asthma. Losing even a small amount of weight may improve breathing and reduce symptoms. Healthy eating, regular exercise, and social support can make weight loss and management easier.
Living with asthma can affect not only the body but also mental health. People with asthma are about three times more likely to develop anxiety and depression than those without asthma.
Stress and anxiety can also trigger asthma flare-ups or lead to overuse of rescue inhalers while skipping daily controller medicines. Talking with a healthcare provider, getting counseling, and building strong support systems can improve both mental health and asthma management.
Vocal cord dysfunction (VCD) occurs when the vocal cords close at times when they should stay open. This limits air flow and makes it harder to breathe. The symptoms can look like asthma — wheezing, coughing, shortness of breath — but medicines like inhalers don’t help.
Some studies suggest that nearly half of people with asthma may also have VCD. However, it’s easy to misdiagnose this condition, since the symptoms overlap with asthma. Doctors may use special breathing tests to tell the difference. Treatment often includes speech therapy and special breathing exercises.
Having other health problems in addition to asthma can complicate asthma management and lead to worse outcomes. Managing comorbid conditions can improve your health-related quality of life and help you avoid overtreating asthma. Speak openly with your healthcare provider about all your health concerns, and consider seeking care from an expert specialist for each condition.
On MyAsthmaTeam, people share their experiences with asthma, get advice, and find support from others who understand.
Do you have other health conditions related to asthma? Let others know in the comments below.
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I have esonophilic asthma. Dupixent has worked wonders, i only get achy if I do not do enough exercise Or go super hard on leg day.. Since the Dupixent, i don't need steroids hardly ever and no more… read more
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