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Stress and Asthma:
Acute Stress Takes Breath Away

By Adam Marcus

HealthSCOUT Reporter
Tuesday September 19 03:08 AM EDT

MONDAY, Sept. 18 (HealthSCOUT)
-- Episodes of acute stress,
like the death of a relative or a parent moving out, may trigger
bouts of asthma in children who already have the breathing
disorder, European researchers report.

Doctors have long known that chronic stress can worsen asthma
in children. But the latest work is the first to show that incidents
that severely test the nerves can spark attacks, sometimes almost
immediately. A report on the finding appears in this week's issue
of The Lancet.

Dr. Seija Sandberg of the HYKS Institute in Helsinki, Finland,
and her colleagues in Britain followed 90 children, ages 6 to 14,
with chronic asthma.

For 18 months, the children kept regular diaries of their asthma
symptoms and had daily breath tests to measure their airway
function. They also were frequently interviewed about major
life events.

Without the backdrop of chronic stress, an asthma attack ensued
between two weeks and a month after an episode of acute stress.
But when a severely stressful event, like the death of a grandparent
or a divorce, occurred in a child already dealing with chronic stress,
asthma bouts followed quickly, typically within two weeks.

Keep a dilator handy

"Severely negative life events increase the risk of children's asthma
attacks over the coming few weeks,"
the authors write. "This risk
is magnified and brought forward in time if the child's life situation
is also characterized by multiple chronic stressors."

Dr. Jerry Shier, an allergy and asthma specialist in Silver Spring,
Md., a suburb of Washington, D.C., says stress and strong emotions
can lead to breathing patterns that exacerbate asthma.

Hyperventilation, for example, which is common during intense
crying, but also heavy laughter, cools and dries the airways and
in the process encourages attacks.

Patients who are aware of the link can take steps to prevent an
asthma bout by using an airway dilator immediately after crying
or belly-laughing, Shier says.

"If [patients] weren't really sure why it was happening, it's almost
reassuring to know that they'll have to medicate themselves,"
Shier says.

Dr. Harold Nelson, an asthma expert at National Jewish Medical
and Research Center in Denver, says the study has implications
for treating children with asthma. "The question is, what can you
do about it? It's not like you can write a prescription to correct
these things," says Nelson.

On the other hand, Nelson says, doctors who treat young asthma
patients in turbulent environments could direct them to social
workers or psychotherapists if they appear to need such help.

What To Do

The key to effective asthma management is prompt treatment,
Shier says. So parents of asthmatic children need to make sure
that they have medication handy in the event of a breathing attack.

Asthma affects some 17 million Americans. To lean more about
the condition and ways to help prevent flare-ups, visit the American
Academy of Allergy, Asthma & Immunology .

You can also try the Journal of the American Medical Association.


posted 13 Jan 2001 11:32 (EST)

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