If you’re one of the 24 million Americans living with asthma, you probably already know that the winter months can be the hardest. While everyone else is excited about skiing and snowboarding, you’re taking extra care to ensure that you don’t find yourself in the middle of an asthma attack. And for good reason: A 2014 study found that hospital admissions for asthma attacks peak in the winter months. Here’s why.

The cold truth: Why asthma symptoms are worse in the winter

What is it about winter weather that seems to trigger asthma symptoms? According to the Asthma and Allergy Foundation of America (AAFA), dry wind, cold air, and sudden changes in weather can all trigger an asthma attack. And if you live anywhere with seasonal weather patterns, the winter months can certainly mean more of all three.

That dry, cold air can contribute to greater mucus production, irritated airways, and other respiratory infections that might increase your asthma symptoms.

Iced out: Avoiding outdoor exercise and other triggers

To complicate matters, exercise can make symptoms worse. This is because the cold air can lead to bronchoconstriction, a narrowing of the airways that makes it difficult to breathe.

Add in the labored breathing that typically coexists with exercise, and the increased respiratory issues that accompany asthma, and outdoor athletic pursuits can be perilous for those with asthma in winter months.

It might seem like the simple answer is to remain indoors during the coldest months of the year, but that won’t necessarily help you reduce asthma attacks. The AAFA lists things like wood fires, mold, and dust mites as triggers. And you’re more likely to come into contact with these triggers while inside. You’re also more likely to encounter pet dander and strong odors (like perfume and cologne) when you’re holed up indoors. Both of these can contribute to increased asthma symptoms, too.

Additionally, asthma attacks can be spurred on by respiratory infections. They tend to occur more frequently in the colder temperatures of late fall and winter and are most commonly due to a viral infection in the upper respiratory tract.

Take action: Survive the season

If you’ve got asthma, you likely already know that the winter months can be harder to breathe through. But what can you do to improve your symptoms?

If you’ve had an attack while around a wood fire before, let friends and family know that keeping the fireplace empty might help you to breathe. And if you know that outdoor exercise in winter months leaves you wheezing, try to find indoor alternatives that won’t be as hard on your lungs.

Coming down with a respiratory infection can absolutely make your asthma symptoms worse. Avoid this by making an effort to stay healthy. While you’re at it, wash your hands and steer clear of anyone who might be sick.

When you’re outside, try covering your face with a light scarf or winter face mask, and breathe through your nose. Doing this tends to warm the air a bit before it reaches your lungs, according to Asthma UK.

You should also talk to your doctor about your increase in symptomology. There are several types of medications available and it’s possible you will benefit from trying something new.