Weather and Your Lungs: How Temperature and Humidity Affect IPF Symptoms

Environmental factors including temperature, humidity, air quality, and seasonal changes can significantly impact idiopathic pulmonary fibrosis (IPF). These triggers can exacerbate symptoms and lead to flare-ups. There are steps you can take to reduce the impact of these triggers and the effect on your health.

“Regardless of the weather, make sure your antifibrotic medications, oxygen prescription, and any inhalers are up-to-date and taken as prescribed,” says Mary B. Rice, MD, the Mark and Catherine Winkler Associate Professor of Environmental Respiratory Health and the director of the Center for Climate Health and the Global Environment at the Harvard T.H. Chan School of Public Health in Boston. “Work with your pulmonologist on an action plan — what to watch for, when to increase oxygen, and when to call or go to the emergency department.”

For people with respiratory diseases, including IPF, weather can cause worse symptoms, also known as flare-ups. This can happen if it’s too hot outside, or too cold, or if it’s too humid or not humid enough. Air pollution can also wreak havoc on your lungs. Any of these triggers can worsen breathlessness, cough, or fatigue.

Cold Air

“People often unconsciously breathe faster and more shallowly [when the air is cold], which can heighten the feeling of breathlessness,” says Dr. Rice. “Population data show that mortality from pulmonary fibrosis is highest in winter, even after excluding obvious infections, suggesting that cold, infections, and possibly indoor exposures all play a role.”

Heat and Humidity

In addition, she adds, high humidity also provides an ideal environment for mold and other allergens.

Air Pollution

“Air pollution can trigger respiratory symptoms and cause exacerbations of many chronic lung diseases, including IPF,” says Jamie Garfield, MD, a medical spokesperson for the American Lung Association and a professor of thoracic medicine and surgery at the Temple Lung Center at Temple University Hospital in Philadelphia. “Air pollution or particle pollution and poor air quality or ozone can irritate your lungs. Chronic exposure to both particle pollution and ozone can cause coughing, chest tightness, and shortness of breath.”

She noted that in some patients with IPF, exposure to air pollution can increase oxygen requirements and reduce lung function. “It may also exacerbate otherwise stable disease,” says Dr. Garfield.

• Cover Your Face “When going outside in cold weather, consider wearing a scarf or mask over your nose and mouth to warm the air before breathing it in,” says Garfield. This can minimize the harmful effects of breathing in cold air.
• Wear Layers Layering clothing may be better at trapping warm air as opposed to bundling up in one thick layer.
• Keep Oxygen Equipment Warm If you use supplemental oxygen, keep the cannula or tubing inside of your coat if it is very cold outside. This will help prevent it from getting stiff or splitting.
• Limit Time Spent Outdoors “When it’s very cold outside, limit the time you spend out there,” says Garfield. You may want to postpone appointments or other plans if the weather is too severe.
• Change Breathing Patterns Try to inhale through your nose and exhale through your mouth. Breathing in through your nose will warm the air and keep it more moist than breathing in through your mouth.
• Check Pollution Levels Air pollution can be problematic during the winter, especially in areas with high use of wood-burning stoves and fireplaces. Stay indoors when air pollution is high or limit your time outside.
• Pace Yourself “Avoid sudden bursts of exertion in the cold, such as sprinting for a bus,” says Rice. “Start slowly and pace yourself.”
• Get Vaccinated The risk of exposure to a respiratory virus is higher during the winter. “Vaccinations are strongly recommended to prevent respiratory infections that can worsen IPF, including influenza, COVID-19, RSV, and pneumococcal vaccines,” says Garfield.

• Humidify the Air Heating systems can cause indoor air to be very dry during the winter. A humidifier can add moisture to the air. But it’s just as important to avoid over-humidifying, as that can encourage mold, so moderation and regular cleaning of the humidifier is important.
• Stay Hydrated “Saline nasal sprays and staying well-hydrated can reduce dryness and cough,” says Rice.
• Exercise Indoors If temperatures really drop to frigid levels, try to exercise indoors, such as walking around in an indoor mall or on a treadmill. Exercise causes more intense breathing, and in cold weather, this can increase symptoms.
• Monitor Indoor Lung Irritants You may be spending more time indoors during the winter, which means higher exposure to indoor pollutants. These can be anything from dust, fumes from cooking and cleaning products, mold, or smoke if you have a wood burning fireplace. Keep the house as clean as possible, be vigilant in getting rid of any early signs of mold, and use mild cleaning products. You may want to wear a mask when cooking, especially if you are using high heat and there’s a chance of producing significant fumes or smoke.

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• Warm Up the Oxygen If you use home oxygen, ask about heated humidification for your oxygen device, which can make breathing more comfortable in dry environments.

• Stay Indoors “During hot days, consider staying in air-conditioned spaces when possible, and avoid outdoor activities during the hottest parts of the day,” says Garfield. On very hot and humid days, try to find an air-conditioned public space such as a shopping center or library, if you don’t have air conditioning at home.
• Keep Your Home Cool Even if you have air conditioning, you can keep your home cooler by closing blinds and shades during the day to block out sunlight.
• Use a Dehumidifier Air-conditioning lowers humidity levels, but if it still bothers you, consider installing a dehumidifier. It can reduce the humidity to a more comfortable level and allow you to breathe easier.
• Plan Your Activities Avoid strenuous activities during periods of high heat, as well as reducing the amount and length of time of exercise. Plan walks or errands for early morning or evening, when it is cooler outside.
• Monitor Air Quality Check the weather, air pollution, and humidity and pollen forecasts in your local area. This can help you plan your day and prepare for hot weather.
• Stay Hydrated Drink plenty of fluids, especially water and noncaffeinated drinks throughout the day. Limit alcohol and caffeinated beverages, both of which can lead to dehydration.
• Choose the Right Clothing Wear loose, lightweight clothing and take frequent rest breaks if you’re exerting yourself.
• Know the Signs of Heat Stress “Watch for warning signs of heat stress — worsening breathlessness, chest tightness, dizziness, rapid heartbeat — and seek medical care if symptoms persist,” says Rice. “If you are older and live alone with IPF, be sure someone checks in with you every day on hot days.”

You can also check daily pollen counts, which are available on weather websites and apps. A high pollen count means that most people with any sensitivity to pollen and molds will likely experience symptoms. Pollen is typically highest in spring and fall, although this may vary depending on the region and types of plants.

• Stay Indoors Limit your outdoor activity as much as possible on high pollution days.
• Check Your HVAC Settings Set HVAC systems to “recirculate” rather than bringing in outside air if the air outdoors is poor quality.
• Use Air Purifiers “Consider using a HEPA air purifier in the rooms where you spend the most time,” says Rice. “While IPF-specific HEPA trials are limited, HEPA filters clearly reduce indoor particulate levels and improve symptoms in other chronic lung diseases.”
• Wear a Mask When Going Outdoors Consider wearing a well-fitted N95-type mask, which can significantly reduce inhaled particulate pollution.
• Treat Allergies Rice recommends discussing antihistamines or inhaled medications with your doctor if seasonal allergies are a problem. “Controlling allergy symptoms can reduce cough and upper-airway irritation,” she says.

• Weather extremes can cause IPF symptom flare-ups, with cold, dry air and heat and humidity being common triggers.
• Air pollutants and pollen may aggravate symptoms of cough and breathlessness.
• Practical measures can be taken to manage your home environment and keep symptoms under control, regardless of the weather.
• It is important that all your medications are up-to-date and that you have an action plan in case of an emergency or a sudden change in symptoms.