An ECG heartrate pattern against a blue background.
If left untreated, asthma can lead to heart disease and even respiratory failure.

What Are the Complications of Asthma?

As someone who has had asthma for most of my life, it is difficult to look into the future and know that I may face complications. After all, I am a healthy woman in my mid-30s. What could happen if I accidentally miss my inhaler at bedtime? As it turns out, uncontrolled asthma can cause many complications. But what are the exact complications of asthma to know about? Let’s get into it.

Can Asthma Cause Complications?

Uncontrolled asthma can cause various complications. Some are short-term, such as a visit to the emergency room, and other complications can become chronic, such as airway remodeling.

1. Problems Engaging in Everyday Life

Common asthma symptoms, such as wheezing, coughing and shortness of breath can impact your ability to engage in everyday life, especially if you are not adherent to your treatment plan or if your asthma is difficult to control.

When asthma affects your ability to go to work, school and get exercise, it can also impact your overall health. It can increase your risk for other diseases, such as heart disease.

2. Medication Side Effects

Many of the medications used to treat asthma can cause side effects. Though most of the side effects are minor, some can disrupt life.

The most common side effect of asthma medication is a hoarse throat or a sore throat. However, oral medications, such as corticosteroids, can cause an increased appetite, difficulty sleeping and hyperactivity.

David Rosenstreich, MD, chief of the division of allergy and immunology at the Albert Einstein College of Medicine in New York City, states, “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.”

3. Anxiety and Depression

Because asthma is a chronic disease, your risk of developing anxiety and depression is increased. New research indicates that those with asthma are twice as likely to develop depression as their counterparts without asthma.

What is the correlation between asthma and mental illness? As someone with asthma, much time is spent worrying about our health. In addition, if asthma impacts sleep and causes inflammation, the risk of asthma is increased.

4. GERD

Gastroesophageal reflux disease (GERD) causes stomach acid to travel up the esophagus. GERD can cause heartburn and a cough.

Though it is a confusing correlation, Rosenstreich says, “There’s some evidence that the bronchodilators used to treat asthma may promote acid creation in the stomach and regurgitation in the esophagus.”

If you are experiencing heartburn, you should speak to your doctor. There may be an alternate medication that she can prescribe.

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5. Airway Remodeling

Airway remodeling, or a restructuring of the airways, occurs due to chronic inflammation. Chronic inflammation will eventually cause the bronchial walls to narrow, causing permanent changes to the structure of the lungs.

Researchers are still a bit puzzled about airway remodeling. However, there does seem to be a positive effect on the structure of the lungs when inhaled corticosteroids are used.

6. Obstructive Sleep Apnea

Obstructive sleep apnea (OSA) causes the airways to close temporarily during sleep. Though OSA can occur in anyone, those with asthma are at an increased risk of OSA. This is because those with asthma are more likely to have nasal obstructions and restructuring of airway passages, which also increase the risk of OSA.

Conversely, OSA can worsen other comorbid conditions, such as GERD and inflammation of the airways.

7. Respiratory Failure

Respiratory failure occurs when the lungs are no longer able to take in a proper amount of air. It is important to note that respiratory failure is an emergency.

You should seek emergency medical treatment when:

  • You have severe shortness of breath that makes it difficult to speak.
  • You are using your chest muscles (accessory muscles) with each breath.
  • No improvement in symptoms with the use of a rescue inhaler within 15 minutes.
  • You have a peak flow reading below 50% of the best peak flow.

Reducing Your Risk of Complications

The best way to reduce complications of asthma is to prevent them from occurring in the first place!

Rosenstreich states, “Most people with asthma know the importance of staying on prescribed treatment. 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 feel that your current treatment regimen is not working, you should discuss it with your doctor. In addition, you should let them know if the regimen is too complicated or too costly. The only way to find a regimen that works for you is to discuss your concerns with your doctor.