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Difficulty Breathing in Face Mask with Asthma and Lung Disease

Few people enjoy wearing a cloth face mask, as is recommended by the U.S. Centers Disease Control and Prevention for going out in public places during the coronavirus pandemic. But if you have a chronic respiratory condition such as asthma or COPD, covering your mouth and nose can be especially challenging. The physical barrier of the mask makes it harder to take in air; it also traps some carbon dioxide as you exhale, which means you end up breathing in air that is warmer and moister. Add a compromised respiratory system to the equation and a mask can feel downright suffocating.

Unfortunately, that sensation of having trouble breathing in a mask might get even worse as summer approaches. Many people with chronic lung conditions find it harder to breathe in hot, humid air (though some others fare worse when the weather is cold and dry).

As tempting as it might be to skip the face mask, health experts say that going mask-free if you’re in crowded public places during the coronavirus pandemic is a major no-no.

“I definitely recommend using a face mask for everyone in these times, especially for people with asthma and COPD,” says Neil Schachter, MD, professor of medicine, pulmonary, critical care, and sleep medicine at Mount Sinai Hospital in New York City. “We need to protect those at risk, in particular those with fragile airways.”

How can you stay safe when wearing a mask feels unbearable? Follow this expert advice.

Stay home if you can

Unless you have a coronavirus infection or someone else in your family does, there is no reason to wear a mask in your home. Because people with respiratory conditions like asthma and COPD are more apt to develop complications if they contract coronavirus, it is best to get groceries delivered or have someone else pick them up for you. “Avoid public places as much as possible,” says Tania Elliott, MD, a spokesperson for the American College of Allergy, Asthma, and Immunology and an allergist/immunologist at NYU Langone Health in New York City.

Check the weather

If you must go out, check the weather first. Many people find it harder to breathe when it’s hot and humid, so try to pick a day when it’s a bit cooler outside or go first thing in the morning or later in the evening.

Air pollution is another important factor for people with respiratory issues, says Adrian Rawlinson, MD, vice president of medical affairs for Upswing Health, a telehealth company. Go to airnow.gov and enter your zip code to find out how the air quality is in your area today before venturing out.

Practice at home

“Most people find that it takes a few days to adjust to wearing a mask, and for those with pulmonary issues like asthma or COPD the accommodation period can be longer because of the increased sense of breathlessness,” says Dr. Schachter. “I suggest trying to wear the mask at home [for short periods] to get used to the sensation.”

Pick a comfortable face covering

Do not use N-95 respirators. First of all, they should be reserved for health care providers. They’re the most effective at blocking virus particles compared with other kinds of masks, but they’re also more difficult to breathe through. The CDC currently recommends that most people opt for cloth face coverings rather than N-95 respirators or even surgical masks for venturing out in public.

Look for a mask that is made of a moisture-wicking and breathable fabric, says Dr. Elliott. If you’re really struggling, you might be better off with a bandana or neck gaitor. “They are more breathable since they are open at the bottom but still provide a protective barrier,” she says.

Whatever you choose, make sure it covers your nose and mouth. “If a patient requires portable supplemental oxygen, the mask needs to snuggly accommodate the oxygen tubing,” says Dr. Schachter. “In these situations, it is wise to limit outside activities to the essential minimum.”

Make it quick

This is not the time to be lingering in the supermarket while you ponder what to make for dinner. If you have to go to a grocery store or pharmacy, put on your mask, grab what you need, and get out (and sanitize your hands right after, then wash with soap and water when you get home). “Wearing cloth masks can lead to a buildup of sweat, mucous, and secretions if worn for a prolonged period of time,” says Dr. Elliott.

When you come home, clean your reusable mask. “It’s very important to wash and dry masks on the highest heat setting after each usage so it doesn’t become a source of infection, especially for asthma or COPD patients,” she says.

Be cautious about outdoor exercise

If your condition is mild and you’re used to exercising outdoors it might be OK to continue. In sparse areas you might not need to wear a mask, but it is smart to carry one with you in case you end up closer to others than expected.

People with asthma might benefit from using a rescue inhaler before heading outdoors with a mask on. “While not perfect, it may not be a bad idea because it can open your airways and at least improve your baseline air flow in the short term,” says Dr. Elliott.

Consider other benefits

While wearing a mask might be uncomfortable for people with asthma or COPD, Dr. Schachter says there are some benefits beyond those related to coronavirus. “In warm weather it helps protect against the harmful effects of pollution like dust and mold as well as pollen. In the winter it acts as a reservoir for warm exhaled air, preventing cold dry air that could trigger bronchospasm,” he says.

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5 Tips to Help You Breathe Easier in Hot Weather. Cleveland Clinic. https://health.clevelandclinic.org/5-tips-to-help-you-breathe-easier-in-hot-weather.

Interview with Adrian Rawlinson, MD, vice president of medical affairs for Upswing Health, a telehealth company

Interview with Neil Schachter, MD, professor of medicine, pulmonary, critical care, and sleep medicine at Mount Sinai Hospital in New York City

Interview with Tania Elliott, MD, a spokesperson for the American College of Allergy, Asthma, and Immunology and an allergist/immunologist at NYU Langone Health in New York City

Recommendation Regarding the Use of Cloth Face Coverings, Especially in Areas of Significant Community-Based Transmission. U.S. Centers for Disease Control and Prevention. https://www.cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/cloth-face-cover.html.