September is full of transitions. The season shifts from summer into fall, the lazy days of summer vacation are replaced by the structure of the school week, and dinner menus change from smoky outdoor grilling to cozy simmering soups. September brings another shift, too, for those suffering from asthma—a dramatic increase in exposure to triggers that culminate in Asthma Peak Week.
For the more than 27 million children and adults in the United States who live with asthma, the third week of September, (or more precisely, the 38th week of the year, which in 2023 runs from September 18 to 24) represents a potential health hazard. Named “Asthma Peak Week” by experts and organizations in the northern hemisphere, the week seems to be a perfect storm of circumstances that converge into a significant health threat.
Asthma Peak Week is when asthma-related hospital and emergency room visits spike, with a quarter of all children’s hospitalizations due to asthma occurring in September. This increased exposure to a slew of potential asthma triggers occurs at a time when many people have a lingering summer vacation mindset, which often includes their having eased up on the use of their asthma medications.
Seasonal allergies, and allergies in general, are major potential asthma triggers. Dr. Purvi Parikh, an allergist and immunologist with the Allergy & Asthma Network, told the Epoch Times, “Allergies, including seasonal allergies, are the most common cause of asthma. Both asthma and allergies are immune reactions caused by the same parts of your immune system. The same way a pollen irritates your nose or eyes by triggering histamine and a cascade of inflammation—it can do the same thing in your lungs and this causes airway tightening and narrowing which can make it hard to breathe.”
Ragweed, which has its peak bloom in mid-September, is a major source of fall allergies, and for those with allergic asthma, can be a major trigger. Asthma triggers (the conditions or substances that can induce coughing, wheezing, chest tightening, or shortness of breath symptomatic of asthma attacks) can vary widely and affect each person differently. Other common asthma triggers include viruses, mold, cigarette smoke, dust mites, pet dander, indoor or outdoor air pollution, chemicals (for example, certain household cleaners), stress, and strenuous exercise.
With the drop in temperatures comes the beginning of cold and flu season, and exposure to new viruses. A study published in the January 2005 issue of the Journal of Allergy and Clinical Immunology found that respiratory viruses were the primary trigger for asthma attacks in children that resulted in hospitalizations in September. With schools back in session, children are much more likely to be exposed to respiratory viruses, as well as to bring them home to their families.
Identify Your ‘Asthma Triggers’Armed with the knowledge that this time of year presents special challenges for those with asthma, it’s important to take extra precautions to prevent asthma attacks or manage them well when they come. The first step involves identifying your particular asthma triggers—be aware of what seems to trigger asthma symptoms, and record it. Keeping an ongoing record of what may have triggered your symptoms can help you be proactive in avoiding those same things, and also provides valuable information to share with your doctor as you work together to come up with the best management plan.
Dr. Parikh also recommends allergy testing to help pinpoint your particular triggers, saying “Usually with a careful history and physical as well as allergy testing with a board-certified allergist and immunologist we can identify them.”
Beyond avoiding conditions and substances known to trigger an asthma attack, there are other ways you can prepare to face Asthma Peak Week with confidence.
Create an ‘Asthma Action Plan’Having an Asthma Action Plan (AAP) is an important first step, especially for children, as it can easily be shared with schools or childcare providers. The American Lung Association defines an AAP as “a written, individualized worksheet that shows you the steps to take to keep your asthma from getting worse. It also provides guidance on when to call your healthcare provider or when to go to the emergency room.”
Strengthening your immune system is also vital for fending off respiratory viruses, as well as recovering well when you do catch a bug. Getting enough sleep, eating a diet rich in whole, minimally processed foods, staying hydrated, managing stress, and practicing regular hand-washing will all go a long way towards staying healthy during peak asthma times and beyond.
Exercise is another important tool in asthma management. Exercise strengthens the lungs and increases blood flow to the lungs and heart, as well as reduces inflammation and boosts the immune system. For those with exercise-induced asthma (EIA)—a condition in which asthma symptoms flare up in response to strenuous exercise—the benefits of exercise are still vital, but extra care may have to be taken when exercising.
Those with EIA tend to be particularly sensitive to rapid changes in air temperature, and especially to cold, dry air. When it’s cold outside, or other outdoor asthma triggers (like pollen) are present at high levels, wearing a scarf over your mouth during exercise to both filter and warm the air reaching your lungs, may help. Staying hydrated and breathing through your nose, which also helps warm and filter the air you breathe, is also a good idea.
And of course, make sure asthma medications are refilled and ready to use before the temperatures drop.
A literature review published in August 2021 in Cureus Journal of Medical Science, found that adults with severe asthma frequently had low vitamin D levels when their asthma symptoms flared and that supplementing with vitamin D resulted in significant improvement. The review concluded that “In the adult population, supplementing vitamin D may lead to a statistically significant reduction of asthma exacerbation rates in asthmatic patients with low levels of vitamin D.” This is something to consider if you live in an area that receives limited amounts of sunlight in the fall and winter. However, supplementing with vitamin D was not found to be similarly beneficial for children, or adults whose vitamin D levels were within normal ranges.
Taking a proactive approach to preventing flare-ups and boosting overall health can help you through Asthma Peak Week and beyond with confidence. As Dr. Parikh recommends “Make sure your medications are up to date and not expired, start preventative and control medicines early—even before you feel symptoms—it’s much harder to control once you are having an asthma attack. Since viruses are a key part of asthma peak week, wash hands often, [and] don’t touch face or mouth or eyes.”