Beer And Breathing: Is There A Link?

Alcohol is a central nervous system depressant and can cause breathing problems from the moment it is consumed. When someone consumes alcohol, the central nervous system is slowed down, resulting in a slower breathing rate and shallower breaths. This is known as alcohol-induced respiratory depression.

For people with asthma, alcohol can be a trigger for breathing concerns, leading to an increased sensitivity in the airways, inflammation, and even bronchoconstriction. Alcohol can also cause sleep apnea, a sleep disorder where individuals suffer from intermittent breathing pauses during sleep.

In addition, long-term alcohol abuse has been linked to chronic obstructive pulmonary disorder (COPD), a painful and debilitating lung condition that can become life-threatening. Alcohol can also cause or contribute to a wide range of long-term health conditions associated with breathing difficulties, such as alcoholic cardiomyopathy (ACM), a heart disease caused by chronic alcohol consumption.

Therefore, it is important for individuals to be aware of the potential risks of drinking and to practice responsible drinking habits to minimize any breathing problems.

Alcohol-induced respiratory depression

People with asthma are particularly vulnerable to alcohol-induced respiratory depression. Alcohol can trigger an asthma attack, causing the upper airways to constrict and mucus to be produced, making it difficult to breathe. Wine and beer, in particular, have been found to contain sulfites and histamines that can trigger asthma symptoms.

In addition, alcohol impacts sleep by increasing drowsiness and relaxing the upper airway muscles, which can cause periods of sleep apnea. This is especially problematic for those already diagnosed with obstructive sleep apnea.

Chronic heavy alcohol consumption has also been linked to an increased risk of developing Acute Respiratory Distress Syndrome (ARDS) and Chronic Obstructive Pulmonary Disease (COPD). Alcohol abuse decreases levels of glutathione, an antioxidant that protects the lungs from damage caused by smoke. It also interferes with the body's ability to clear mucus and contaminants from the airways.

To prevent alcohol-induced respiratory depression, it is important to drink in moderation or abstain from alcohol altogether, especially if one has a history of respiratory problems or asthma. Seeking medical attention is crucial if breathing difficulties persist or become severe.

Alcohol and asthma

Asthma is a condition that causes a person's airways to become narrower, which affects their breathing. Triggers for an asthma attack vary from person to person, but they include stress, dust, pollen, diet, and, according to some studies, alcohol.

Alcohol as a Trigger

According to a 2000 study in The Journal of Allergy and Clinical Immunology, 33% of respondents reported that alcohol had triggered an asthma attack on at least two occasions. The study also found that wine was the most common trigger among alcoholic beverages, with symptoms typically starting within an hour of drinking.

Histamines and sulfites, two ingredients found in various types of alcohol, are thought to be the main culprits. Histamines are produced from bacteria and yeast during the fermentation process and are especially prevalent in red wine. They are known to cause problems for people with allergies, including those with asthma. Sulfites, commonly used as preservatives in wine and beer, can also trigger allergic reactions in people who are sensitive to them, including those with asthma.

Managing Asthma and Alcohol Consumption

If you have asthma and find that alcohol triggers your symptoms, you may want to consider the following:

• Choose your alcohol wisely or avoid it altogether: Opt for alcoholic drinks that don't affect your asthma, or try non-alcoholic alternatives. Low-sulfite wines are also an option, but remember that even these contain some sulfites.
• Be aware of triggers: Triggers can change over time, so always carry your reliever inhaler with you.
• Don't skip your preventer medicine: Using your preventer inhaler or MART inhaler daily as prescribed can help protect you from asthma triggers by reducing inflammation and swelling in your airways.
• Share your asthma action plan: Keep an up-to-date asthma action plan on your phone so that friends and family know when you need your reliever inhaler and how to help if your symptoms worsen.
• Have your annual asthma review: Discuss any alcoholic drinks that have affected you or any new triggers with your doctor during your annual asthma review.
• Limit alcohol intake: The NHS recommends drinking no more than 14 units of alcohol per week, spread over 3 or more days.

Sleep apnoea and alcohol

Alcohol is a relaxant that can worsen airway obstruction in sleep apnoea. It inhibits the nervous system and the brain's response to breathing issues during sleep.

Drinking alcohol can affect your sleep in a number of ways. Research shows that drinking alcohol disrupts the brain's normal electrical activity during sleep, altering your sleep cycle. This can lead to:

• Altered circadian rhythms
• Shorter sleep duration
• Insomnia
• Lower sleep quality

Alcohol can also slow your breathing and relax the muscles of your throat, making it more likely for your upper airway to collapse. That can contribute to snoring (the vibration of soft tissues) and complete obstruction that occurs in sleep apnoea.

If you have sleep apnoea, drinking alcohol can increase your risk of apnoeic events and induce snoring by relaxing the muscles of the airway. It can also slow down the central nervous system, which can make central sleep apnoea worse.

For people with obstructive sleep apnoea (OSA), the effects of sleep apnoea can become more serious when alcohol is added. In addition to relaxing the airway, alcohol can also increase the time between when you stop breathing and "wake up" to breathe again. Alcohol can also cause nasal congestion, making it harder to breathe through your nose.

Drinking alcohol close to bedtime increases the likelihood that a person will snore. Alcohol causes the muscles in the mouth and throat to relax, which makes these tissues susceptible to fluttering and making noise as a person breathes in and out.

If you have sleep apnoea, your doctor will encourage you to avoid alcohol. At the very least, they will suggest that you do not consume alcohol a few hours before bedtime.

Alcoholic cardiomyopathy

The risk factors for developing ACM include chronic alcohol abuse, genetic mutations that cause slower processing of alcohol, and lifestyle choices such as using recreational drugs and tobacco. There is no specific cutoff for alcohol consumption that would lead to the development of ACM, but research shows that drinking 80 grams of alcohol or more per day for at least five years significantly increases the risk.

The treatment for ACM involves helping individuals reduce their alcohol intake or stop drinking entirely, along with supportive care to manage withdrawal symptoms. Abstaining from alcohol is crucial for recovery, and even reducing alcohol intake to light or moderate levels can lead to improvements. Medications such as beta-blockers and diuretics are also used to treat heart rhythm problems and other symptoms of heart failure.

The long-term survival rate and prognosis of ACM are influenced by the amount and duration of alcohol consumption. Continued alcohol consumption is associated with poor outcomes, including progressive heart failure, arrhythmias, and cardioembolic events. Mortality rates within 10 years can be as high as 40-80%, depending on the type of alcohol consumed.

Alcohol-related lung disease

ARLD can refer to any lung problems influenced by chronic alcohol consumption, including pneumonia, tuberculosis (TB), and acute respiratory distress syndrome (ARDS). These conditions can have severe symptoms, such as extreme shortness of breath and discolouration of the lips and nail beds due to low oxygen levels.

Alcohol abuse has been recognised as an independent factor that increases the risk of acute lung injury by three to four times. This results in tens of thousands of excess deaths in the United States each year from alcohol-mediated lung injury. Alcohol abuse also increases the risk of acute lung injury following major trauma, such as a motor vehicle accident or other events requiring hospitalisation.

Chronic alcohol ingestion impairs multiple critical cellular functions in the lung, leading to increased susceptibility to serious complications from pre-existing lung diseases. Alcoholics have a higher risk of developing ARDS and experience higher mortality rates from this condition compared to non-alcoholics.

The mechanisms of alcoholic lung disease include:

• Metabolism of alcohol reduces glutathione antioxidant levels in the lungs.
• Oxidation damage to the cells impairs the ability of the lungs to remove fluid.
• Oxidative damage to cells reduces immune response.
• Oxidative damage to cells results in a reduced ability to recover from injury.

Alcohol can also trigger asthma attacks and worsen asthma symptoms, especially in wine lovers. Wine, and also beer, contain higher levels of histamines and sulfites, which may cause asthma symptoms. Alcohol can also trigger sleep apnea by increasing drowsiness and relaxing the upper airway muscles.

Frequently asked questions