Living with Aspergillosis Archives - Aspergillosis Patients & Carers Support

Removing mould from a front-loading washing machine by cleaning the rubber door seal to reduce moisture and help prevent mould growth in the home.

How to Remove Mould from Your Washing Machine and Stop It Coming Back

Mould inside a washing machine is common, particularly in front-loading machines. It often develops in the rubber door seal, detergent drawer, filter and other areas where moisture and detergent residue collect.

For most people, a small amount of washing-machine mould is mainly an unpleasant cleaning problem. However, people living with aspergillosis, severe asthma, allergies or other long-term lung conditions may reasonably want to reduce avoidable mould exposure in the home.

The most effective approach is not only to remove visible mould, but also to keep the machine dry and clean enough to prevent it returning.

Key points

Mould grows where moisture, detergent residue and dirt remain inside the machine.
The rubber door seal and detergent drawer are the most common problem areas.
Use gentle cleaning methods that avoid spraying mould spores or strong chemicals into the air.
Never mix bleach with vinegar, acidic cleaners, ammonia or other cleaning products.
Leaving the door and detergent drawer open between washes can greatly reduce recurrence.

Why does mould grow inside washing machines?

Modern washing machines often use less water and lower washing temperatures. This saves energy, but it can also allow detergent residue, fabric conditioner, skin oils, dirt and moisture to build up inside the machine.

Mould is more likely to develop when:

the door is closed immediately after a wash;
wet laundry is left inside the drum;
mostly cool or eco washes are used;
too much detergent or fabric conditioner is added;
the rubber seal is not wiped or allowed to dry;
the detergent drawer or filter is rarely cleaned;
the machine is kept in a poorly ventilated room.

Where to check for mould

Mould may not always be immediately visible. Check the following areas carefully:

Rubber door seal: pull back the folds and inspect underneath.
Detergent drawer: remove it if possible and check the compartment behind it.
Drum: look around the door opening and drainage holes.
Filter: check the manufacturer’s instructions before opening it.
Drainage area: persistent odours may indicate residue or stagnant water deeper inside the machine.

Before you start cleaning

Check the washing machine manufacturer’s instructions first. Different manufacturers recommend different cleaning products, temperatures and maintenance programmes.

To reduce exposure while cleaning:

open a window or improve ventilation;
wear household cleaning gloves;
avoid leaning directly over mouldy areas;
use damp disposable cloths rather than dry brushing;
avoid scraping or scrubbing so vigorously that material is dispersed into the air;
ask someone else to clean the machine if mould exposure usually worsens your breathing.

Some people with aspergillosis or severe respiratory disease may choose to wear a well-fitting FFP2 or FFP3 mask during mould cleaning. A mask does not replace ventilation or careful cleaning methods.

How to clean mould from the rubber door seal

Switch off the washing machine.
Gently pull back the folds of the rubber seal.
Remove any trapped lint, hair, tissues or other debris.
Wipe the area using a damp cloth and a cleaning product approved by the machine manufacturer.
Pay particular attention to the lower part of the seal, where water often collects.
Use a clean damp cloth to remove any remaining cleaning product.
Dry the seal thoroughly.

Black staining may remain even after mould has been removed. Persistent staining does not always mean that mould is still actively growing, but damaged or deeply contaminated seals may need replacing.

How to clean the detergent drawer

Remove the drawer according to the manufacturer’s instructions.
Wash it with warm water and washing-up liquid.
Use a small brush for narrow areas, taking care not to flick residue into the air.
Wipe the compartment where the drawer sits.
Rinse and dry the drawer before replacing it.

Using too much detergent or fabric conditioner can encourage residue to collect in this area. Follow the dosing instructions for your detergent and local water hardness.

Cleaning the filter

Many washing machines have a filter behind a small panel near the bottom of the machine. This may collect lint, hair, coins and other debris.

Before opening it:

read the manufacturer’s instructions;
switch off and unplug the machine;
place towels or a shallow tray underneath, as water may escape;
allow hot water to cool before opening the filter.

Clean the filter, remove debris and replace it securely. A blocked or dirty filter can contribute to poor drainage and unpleasant smells.

Run a maintenance wash

After cleaning the visible parts of the machine, run the manufacturer’s drum-clean or maintenance programme.

If the machine does not have a dedicated cleaning cycle, the manufacturer may recommend an empty hot wash. Use only a cleaning product that is suitable for your particular machine.

Do not assume that adding more cleaner will work better. Excessive detergent or cleaning product may leave additional residue behind.

Avoid mixing cleaning chemicals

Important safety warning

Never mix bleach with vinegar, limescale remover, toilet cleaner, ammonia or other household cleaning products.

Mixing bleach with acidic products can release chlorine gas, which can cause serious breathing difficulties and may require urgent medical attention.

Use one product at a time, follow the label instructions and rinse surfaces before using any different product.

How to stop washing-machine mould coming back

Keeping the machine dry between washes is often more effective than repeatedly carrying out deep cleaning.

Remove laundry promptly when the cycle finishes.
Leave the washing-machine door slightly open between washes.
Leave the detergent drawer open so it can dry.
Wipe moisture from the door seal, particularly from the lower folds.
Use the correct amount of detergent.
Reduce or avoid fabric conditioner if residue repeatedly builds up.
Run the manufacturer’s maintenance cycle regularly.
Clean the drawer, seal and filter routinely.
Make sure the room is adequately ventilated.

How often should the machine be cleaned?

There is no single schedule suitable for every household. A machine used daily may need more frequent attention than one used only occasionally.

As a practical guide:

wipe and check the door seal every week or two;
clean the detergent drawer approximately once a month;
run a maintenance wash according to the manufacturer’s advice;
check the filter every few months, or sooner if drainage becomes slow or the machine smells.

Clean the machine sooner if you notice visible mould, slime, residue or a persistent musty smell.

When should the door seal be replaced?

Replacing the rubber door seal may be more effective than repeated cleaning if:

the seal is cracked, torn or misshapen;
mould is deeply embedded in the rubber;
water repeatedly collects because the seal is damaged;
the machine leaks;
a persistent smell remains after thorough cleaning.

A competent appliance engineer may be able to replace the seal without replacing the whole washing machine.

When might the washing machine need professional attention?

Consider contacting the manufacturer or an appliance engineer if:

the machine does not drain properly;
stagnant water remains inside;
the smell returns immediately after cleaning;
mould appears to be growing behind inaccessible panels;
the machine leaks;
the seal or internal pipework needs replacing.

Is washing-machine mould dangerous for people with aspergillosis?

Finding mould in a washing machine does not necessarily mean that your home contains unusually high levels of airborne mould. Washing machines are naturally damp environments, and small amounts of mould are common.

However, people with aspergillosis or other significant respiratory conditions may wish to take reasonable precautions, particularly when disturbing visible mould.

Try to avoid:

dry brushing;
scraping large mouldy areas;
using sprays that create a fine mist;
mixing cleaning chemicals;
remaining in a poorly ventilated room while strong products are being used.

If cleaning mould reliably causes coughing, wheezing, chest tightness or breathlessness, ask someone else to do the cleaning where possible.

When to seek medical advice

Seek medical advice if you develop a persistent worsening of respiratory symptoms after mould exposure, particularly if you have aspergillosis, severe asthma, bronchiectasis or another chronic lung condition.

Call 999 or seek urgent medical help if exposure to cleaning chemicals causes severe breathlessness, chest pain, confusion, collapse or difficulty speaking in full sentences.

Frequently asked questions

Can I use bleach in my washing machine?

Only use bleach if the washing-machine manufacturer states that it is safe for your model. Bleach can damage some rubber seals, metal parts and internal components.

Never mix bleach with vinegar or any other cleaning product.

Can I use vinegar?

Some manufacturers advise against regular vinegar use because concentrated acids may damage rubber seals or internal components. Check the instructions for your machine before using it.

Does a hot wash kill mould?

A hot maintenance wash may help reduce microorganisms and remove detergent residue, but it may not remove mould that is deeply embedded in a damaged rubber seal. Physical cleaning and drying are still important.

Should I replace the machine if there is mould in the seal?

Usually not. The seal can often be cleaned or replaced. Replacing the entire machine is generally only necessary if there is extensive inaccessible contamination, repeated drainage problems or the cost of repair is not economical.

Should I keep the door open all the time?

Leaving the door slightly open helps moisture evaporate. However, consider the safety of children and pets, who may climb into an open machine. Keep the laundry area secure where necessary.

Does washing at low temperatures cause mould?

Low-temperature washes can contribute to residue building up inside the machine, particularly if too much detergent or fabric conditioner is used. Regular maintenance cycles can help control this.

Related information

Always follow the cleaning and maintenance instructions supplied by the manufacturer of your washing machine.

by GAtherton

Heatwaves

We usually think of winter as being the worst season for respiratory conditions, but heatwaves can be just as dangerous – and they are becoming more frequent. Many people with aspergillosis have to juggle several long-term health conditions (e.g. COPD, diabetes, anxiety), so it is important to be well-prepared

Severe heat puts extra strain on the body and destabilises the core routines that keep a person well:

Harder to get good-quality sleep
Lack of appetite
Exercise is more tiring
Holidays & visiting family away from home

Air pollution

Carry your inhaler
Check the air pollution forecast for your neighbourhood at DEFRA or BreatheLondon
Check the pollen forecast for your region at the Met Office
Check the national fungal spore count at Worcester University
Be cautious about travelling to regions experiencing wildfires
Plan your route: walk via tree-lined side streets and parks that are generally cooler and have much lower levels of particulates than busy main roads
Consider staying indoors with the windows closed on very high pollution days, or when neighbours are having BBQs or bonfires (read our guide to choosing an indoor air purifier)
Read more tips at Asthma & Lung UK,

Humidity is often higher in the UK than other countries, so the heat feels worse

Humidity should be around 30-50%
Damp air can trap pollution like pollen, ozone and traffic fumes. Check the air quality before you go out on the DEFRA website
Damp conditions can encourage growth of mould, especially in bathrooms and kitchens that will take longer to dry out
Read more: Healthline,

Your urine should be the colour of pale straw – if it is darker, you need to drink more water
Sip water throughout the day so that your body can absorb it gradually
Keep a jug of water in the fridge with a few slices of lemon, cucumber or a sprig of mint for variety
Freeze plenty of ice cubes before the heatwaves starts
Carry extra water on day trips and journeys – you may get stuck in a traffic jam or train delays
Salads and ice lollies help boost your water intake

Close the curtains on south-facing windows, or tape tin foil to the glass
Turn off any lights and electrical devices while not in use
Open windows in the morning and evenings, but close them if the heat outside becomes hotter than the air inside
Use a fan to blow air over ice cubes or a bottle of frozen water
Place a damp flannel on your neck and sit in front of a fan – the evaporation produces a strong cooling effect
Keep any water reservoirs and paper elements in air cooling devices clean otherwise they may grow mould over time

It is important to read the information leaflet for every medication you take, and ask your pharmacist for advice if you have any questions

Be VERY careful about sun exposure if you are taking voriconazole, as it can causes photosensitivity. Even short amounts of time in the sun can cause severe sunburn and blistering. Avoid direct sunlight as much as possible by staying in the shade and wearing long loose clothing. Don’t forget your feet!
Check each of your medications for the correct storage temperature. Be careful never to leave medication in a hot car.
If medication needs to be kept in the fridge (~4°C), put it on a shelf (the door changes temperature every time you open it). Ask your pharmacist for advice on using a cool pouch to carry medication on day trips
If medication must be kept at room temperature, do NOT put it in the fridge as it can damage the formulation (e.g. some antibiotics)
Be aware of any side-effects that may become worse in hot weather
- Diuretics –> dehydration
- Vomiting/diarrhoea –> dehydration
- Nausea –> loss of appetite –> tablet absorption
Injected medications may absorb faster than usual
Carry your rescue inhaler (even if you rarely use it)

Swimming is a great way to keep cool

Outdoor water can contain harmful microbes that may be dangerous for immunocompromised people. Check the water quality of UK beaches using the Swimfo tool produced by the Environment Agency. Be cautious about ‘wild swimming‘ in rivers or lakes, especially in urban or agricultural areas
Never jump into water if you don’t know how deep or cold it is. If you do experience cold water shock, try to float on your back and breathe steadily – you will recover within a couple of minutes
Be careful not to overdo it! It’s easy to use more energy than you expect, especially in cooler water. Take regular breaks and remember to reapply sunscreen. Bring a drink/snack in your bag and check your blood sugar regularly (if relevant). Warm up gradually and pace yourself. Consider bringing a buoyancy aid (e.g. flotation belt, kick board, pool noodle) to reduce the energy demand

ADRENAL INSUFFICIENCY affects some aspergillosis patients who take steroids for a long time

www.addisonsdisease.org.uk/hot-weather

Stay hydrated (bottled water often has very low sodium)
Carry salt tablets or salty snacks
If you feel tired and dizzy, you may need more of your medication
Build in plenty of rest time (even if it feels a bit boring)
Carry your emergency kit and card
If away from home, keep the phone number and postcode handy for where to get medical help
Be quick to seek help if you feel unwell in ANY way, even if it’s inconvenient

DIABETES is common among older people

www.diabetes.org.uk/about-diabetes/looking-after-diabetes/hot-weather

Injected insulin may be absorbed faster
Factor in changes in activity and food (maybe keep a diary)
Check your blood sugar more often (especially right before and after exercise)
Keep insulin cool and watch for cloudiness or brownish colour
Make sure friends and family know how to help you in case of a hypo

by Beth Bradshaw

Vaccination protects people living with aspergillosis and other chronic lung diseases against serious respiratory infections.

Vaccinations for People Living with Aspergillosis

First published: [add original date]
Last reviewed: July 2026

Vaccinations are an important part of staying well when you live with aspergillosis or another long-term lung condition. They cannot prevent aspergillosis itself, but they can reduce the risk of infections that may make breathing symptoms worse, trigger flare-ups, or lead to hospital admission.

International readers: This article explains why vaccination matters for people living with aspergillosis. Vaccine recommendations, availability and eligibility vary between countries. Where healthcare-system information is included, it refers to the UK unless otherwise stated. Always follow advice from your own healthcare team.

Key points

Vaccines do not prevent aspergillosis, but they can reduce the risk of serious infections that may worsen lung disease.
People with aspergillosis often also have asthma, bronchiectasis, COPD or immune system problems, which can make infections more serious.
Flu, COVID-19, pneumococcal, RSV and shingles vaccines may be relevant, depending on your age, health conditions and local guidance.
Some people need additional vaccines or vaccine-response testing as part of specialist immunology care.
If you take long-term steroids, biologics or other immune-suppressing medicines, ask which vaccines are suitable for you.

Why vaccination matters if you have aspergillosis

Many people living with aspergillosis already have lungs that are more vulnerable than usual. This may be because of asthma, bronchiectasis, COPD, previous infection, scarring, mucus plugging, cavities in the lung, or reduced lung function.

For this reason, an infection that is mild for one person can sometimes cause a much bigger setback for someone with aspergillosis. A respiratory infection may lead to increased breathlessness, more coughing, thicker sputum, a flare-up of asthma or COPD, or a chest infection that takes weeks to recover from.

Vaccination is one way to reduce this risk. It does not replace usual aspergillosis treatment, airway clearance, antifungal medication, inhalers or other care, but it can be an important part of protecting your lungs.

Which vaccines are most important?

The vaccines that matter most will depend on your age, diagnosis, immune system, medications, previous vaccine history and the country where you live. The vaccines below are commonly discussed for people with long-term lung disease or increased infection risk.

Influenza (flu) vaccine

For many people living with aspergillosis, the annual flu vaccine is one of the most important ways to reduce the risk of a serious winter chest infection.

Flu is not just a heavy cold. It can cause fever, severe tiredness, muscle aches and worsening breathing symptoms. In people with asthma, bronchiectasis, COPD or other lung disease, flu may trigger a flare-up or lead to pneumonia.

Because flu viruses change over time, the vaccine is updated regularly and is usually offered each year before the main flu season.

COVID-19 vaccine

COVID-19 can still cause serious illness in people who are older, immunosuppressed or living with chronic lung disease. Some people with aspergillosis may therefore be offered seasonal COVID-19 vaccination or booster doses.

Eligibility changes over time and differs between countries. If you are unsure whether you should receive a COVID-19 booster, ask your GP, pharmacist, respiratory specialist or local healthcare team.

Pneumococcal vaccine

Pneumococcal disease is caused by bacteria that can lead to pneumonia and, less commonly, serious infections such as bloodstream infection or meningitis.

This vaccine is particularly relevant for many people with chronic respiratory disease. People with aspergillosis may also have bronchiectasis, COPD, asthma, scarring or cavities in the lung, all of which can make bacterial chest infections more difficult to recover from.

If you are not sure whether you have had a pneumococcal vaccine, or whether your record is up to date, ask your GP surgery or specialist team.

RSV vaccine

Respiratory syncytial virus, usually called RSV, is a common respiratory virus. In many people it causes cold-like symptoms, but in older adults and people with lung disease it can cause more serious lower respiratory tract infection.

RSV vaccination is a newer area of adult vaccination. Some countries now recommend RSV vaccination for older adults or people at increased risk of severe respiratory illness.

If you are older or have chronic lung disease, it is worth asking whether RSV vaccination is recommended for you.

Shingles vaccine

Shingles is caused by reactivation of the chickenpox virus. It can cause a painful rash and may lead to long-lasting nerve pain.

The shingles vaccine reduces the risk of shingles and its complications. It may be particularly relevant for older adults and some people with weakened immune systems.

Additional vaccines for some people

Some people with aspergillosis also have other medical conditions that affect the immune system or increase their risk of certain infections. In these situations, your specialist may recommend additional vaccines as part of your care.

For example, some people with immune deficiencies, those without a functioning spleen, or people who have received a stem cell transplant may be advised to receive vaccines such as Haemophilus influenzae type b (Hib) or meningococcal vaccines. These vaccines are not routinely recommended for everyone with aspergillosis, but they may be appropriate for certain individuals.

If you have recurrent infections, your respiratory specialist or immunologist may also investigate how well your immune system responds to vaccines. In some cases, measuring antibody responses to vaccines such as the pneumococcal vaccine forms part of an assessment for possible antibody deficiency.

Travel vaccines may also be needed if you are visiting countries where certain infections are more common. If you are planning travel, ask for advice well in advance, especially if you are immunosuppressed.

Vaccines and steroids, biologics or immune-suppressing treatment

Some people with aspergillosis take medicines that affect the immune system, including:

oral steroids such as prednisolone or methylprednisolone
long-term or repeated courses of steroids
biologic medicines for severe asthma or ABPA
immune-suppressing medicines for other conditions
chemotherapy or transplant-related medicines

Most routine adult vaccines are not live vaccines and are generally safe for people with chronic lung disease. However, live vaccines may not be suitable for people who are significantly immunosuppressed.

Important: Do not stop steroids, antifungal treatment or biologic medicines just to have a vaccine unless your own doctor tells you to. If you are immunosuppressed, ask your GP, pharmacist or specialist team which vaccines are suitable and when they should be given.

UK NHS information

In the UK, vaccination eligibility is based on age, medical conditions, pregnancy, occupation and immune status. It can also change between seasonal campaigns.

People with chronic respiratory disease are commonly eligible for seasonal flu vaccination and may be eligible for other vaccines depending on their age, diagnosis and treatment. This may include COVID-19 boosters, pneumococcal vaccination, RSV vaccination or shingles vaccination.

Ask your GP surgery, pharmacist or specialist respiratory team whether your vaccination record is up to date. This is especially important if you have:

bronchiectasis, COPD, severe asthma or another long-term lung condition
chronic pulmonary aspergillosis (CPA)
allergic bronchopulmonary aspergillosis (ABPA)
recurrent chest infections
long-term steroid treatment
other immune-suppressing treatment
a known or suspected immune deficiency

Can vaccines make aspergillosis worse?

Vaccines do not cause aspergillosis. They do not contain Aspergillus and cannot give you a fungal infection.

Some people feel tired, achy or feverish for a short time after vaccination. This is usually a normal immune response and settles within a few days.

If you develop worsening breathlessness, chest pain, coughing blood, oxygen levels lower than usual, or symptoms that feel very different from your usual pattern, seek medical advice.

Should family members be vaccinated?

Vaccination is not only about protecting the individual. If you live with someone who is clinically vulnerable, keeping household vaccinations up to date can reduce the chance of bringing infections into the home.

This may be especially important for people who are immunosuppressed, older, or living with severe lung disease.

Questions to ask your healthcare team

At your next GP, pharmacist or specialist appointment, consider asking:

Am I eligible for the annual flu vaccine?
Am I eligible for a COVID-19 booster this season?
Have I had the correct pneumococcal vaccine?
Am I eligible for the RSV vaccine?
Am I eligible for the shingles vaccine?
Do any of my medicines affect which vaccines I can have?
Do I need any additional vaccines because of immune problems or recurrent infections?
Should my antibody response to any vaccine be checked?
Are any vaccines recommended before starting a new immune-suppressing treatment?

Frequently asked questions

Can I have vaccines while taking antifungal medication?

In most cases, antifungal medicines such as itraconazole, voriconazole, posaconazole or isavuconazole do not prevent vaccination. If you are unsure, ask your pharmacist, GP or specialist team.

Can I have more than one vaccine at the same appointment?

Some vaccines can be given at the same appointment, but this depends on the vaccine, your health and local guidance. Your GP surgery or pharmacist can advise.

Should I delay vaccination if I am unwell?

If you have a high temperature or are acutely unwell, you may be advised to wait until you have recovered. Mild cold symptoms do not always mean vaccination must be delayed, but check with the vaccinator if you are unsure.

What if I had a reaction to a vaccine before?

Tell the vaccinator before receiving any vaccine. Serious allergic reactions are rare, but your history should be checked carefully.

Can vaccines give me aspergillosis?

No. Vaccines do not contain Aspergillus and cannot give you aspergillosis.

When to seek medical advice urgently

Seek urgent medical help if you have:

severe or rapidly worsening breathlessness
chest pain
blue lips or confusion
coughing up blood
oxygen levels lower than usual, if you monitor them
signs of a severe allergic reaction after vaccination, such as swelling of the face or throat, wheezing, collapse or a widespread rash

Useful links

Related information

You may also find these guides helpful:

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Summary

Vaccination is one of the simplest ways to reduce the risk of serious respiratory infection. For people living with aspergillosis, bronchiectasis, COPD, severe asthma or immune suppression, it is worth checking regularly that your vaccination record is up to date.

The medical reasons for vaccination are relevant internationally, but vaccine eligibility and availability vary between countries. Ask your GP, pharmacist, respiratory specialist or local healthcare team which vaccines are recommended for you.

by GAtherton

Preparing for a Disability Assessment: A Practical Guide for People Living with Aspergillosis in UK

Originally published: August 2018
Last reviewed: July 2026

If you have been invited to attend a disability assessment, it is natural to feel anxious. Many people worry about saying the wrong thing, forgetting important information or not being believed.

The purpose of the assessment is not simply to confirm your diagnosis. Instead, it aims to understand how your health condition affects your daily life, including your ability to carry out everyday activities safely, reliably and repeatedly.

For people living with aspergillosis, symptoms such as breathlessness, fatigue, chronic cough, medication side effects and frequent infections can all have a significant impact on daily life, even if they are not always obvious to other people.

This guide explains how to prepare for your assessment and how to describe your symptoms clearly and honestly.

What is a disability assessment?

Several UK benefits and support schemes may involve an assessment of how your condition affects your daily life. These include:

Personal Independence Payment (PIP)
Adult Disability Payment (Scotland)
Employment and Support Allowance (ESA)
Universal Credit health assessments

The assessment is usually carried out by an independent healthcare professional working on behalf of the Department for Work and Pensions (DWP) or the relevant national authority.

The assessor is interested less in the name of your condition than in understanding how it affects your ability to manage everyday tasks.

Before your assessment

Good preparation can make the assessment less stressful and help ensure you provide an accurate picture of how your condition affects you.

You may find it helpful to gather:

recent clinic letters
hospital discharge summaries
lung function results, where available
CT scan reports if relevant
your current medication list
details of inhalers, nebulisers or oxygen therapy
letters from your GP or specialist nurse

Having these documents available can help you answer questions confidently and provide supporting evidence if requested.

Keep a symptom diary

Many people underestimate how much their condition affects them because they gradually adapt to living with it.

Keeping a diary for one or two weeks before your assessment can help you remember important details.

Record things such as:

how far you can walk before stopping
how often you become breathless
episodes of coughing or coughing up blood
levels of fatigue
sleep disturbance
days when you cannot leave the house
help you receive from family or friends

This provides real-life examples that are often easier to explain during the assessment.

Describe your worst days as well as your better days

Many long-term lung conditions fluctuate. Some days may be manageable, while others are much more difficult.

It is important to explain:

how often bad days occur
how long they last
what you cannot do during these periods

If your condition varies, explain what happens on both good and bad days rather than describing only how you feel on the day of the assessment.

Explain how your symptoms affect everyday life

Assessors are interested in the practical impact of your condition.

Rather than simply saying:

"I get breathless."

Explain what that means in daily life.

"I have to stop halfway up the stairs to catch my breath."

Instead of saying:

"I'm tired all the time."

You might explain:

"After having a shower I usually need to rest for an hour before I can prepare breakfast."

These practical examples help assessors understand the real impact of your condition.

Remember the symptoms people cannot see

Not all symptoms are visible.

People living with aspergillosis often experience:

severe fatigue
brain fog
poor concentration
chronic cough
disturbed sleep
medication side effects
anxiety about breathlessness or haemoptysis
recurrent infections

These symptoms can significantly affect daily living, even when you appear well during the assessment.

Be honest about the help you need

Many people naturally try to remain independent and may overlook the assistance they receive from others.

Think about whether family members or friends help you with:

shopping
housework
gardening
transport
preparing meals
managing medication
heavy lifting

Needing help occasionally is still important to mention.

Medication side effects matter too

Your symptoms are only part of the picture.

Treatments for aspergillosis and associated conditions may also affect daily life.

Examples include:

fatigue
nausea
light sensitivity
tremor
dizziness
sleep disturbance
frequent blood tests and hospital appointments

Explain how these affect your ability to work, travel or carry out everyday activities.

During the assessment

Try not to rush your answers.

If you do not understand a question, ask for it to be repeated or explained.

Answer honestly. Avoid both minimising and exaggerating your symptoms.

If you become upset or need to pause because of coughing or breathlessness, take your time. Assessors understand that some conditions make conversations difficult.

After the assessment

You may wish to request a copy of the assessment report once it has been completed.

If you disagree with the decision, you usually have the right to ask for a mandatory reconsideration and, if necessary, to appeal.

Many successful claims are awarded following reconsideration or appeal, so do not assume the first decision is always final.

Getting support

You do not have to manage the process alone.

Help may be available from:

Citizens Advice
local welfare rights advisers
disability charities
hospital benefits advisers where available
your GP or specialist team, who may be able to provide supporting medical evidence

Key points to remember

Prepare before your assessment.
Use real-life examples rather than general statements.
Describe both good days and bad days.
Include fatigue, medication side effects and invisible symptoms.
Be honest about the help you need.
If you disagree with the decision, remember that you may be able to request a review or appeal.

Further information

You may also find these articles helpful:

References

Department for Work and Pensions. Personal Independence Payment Assessment Guide.
PIP Assessment Guide for Assessment Providers – GOV.UK
Department for Work and Pensions. Work Capability Assessment Guidance.
Employment and Support Allowance: Work Capability Assessment – GOV.UK
Citizens Advice. Benefits and disability assessment guidance.
Benefits guidance – Citizens Advice
NHS. Living with long-term respiratory conditions.
Living with COPD – NHS

by GAtherton

Person wearing a well-fitted FFP3 respirator in a mould-affected environment, illustrating how face masks can help reduce exposure to airborne mould spores for people with aspergillosis and bronchiectasis.

Choosing the Right Face Mask for Aspergillosis | FFP2, FFP3 & Mould Protection

Originally published: Aug 2018
Last reviewed: July 2026

Key points

Wearing a well-fitting mask can reduce exposure to Aspergillus spores during higher-risk activities.
FFP2 and FFP3 respirators provide much better protection than cloth face coverings or standard surgical masks.
The fit of the mask is just as important as the type of mask.
Masks are most useful for short periods of increased exposure, such as gardening, handling compost or dusty DIY.
A face mask is only one part of reducing exposure. Ventilation, avoiding unnecessary dust and changing clothes after high-risk activities can also help.

Why might people with aspergillosis wear a face mask?

Aspergillus moulds are common in the environment. Their microscopic spores are present in outdoor and indoor air every day, and for most people they cause no problems.

However, for people living with aspergillosis, severe asthma, bronchiectasis, chronic lung disease or weakened immune systems, breathing in large numbers of fungal spores may increase symptoms or, in some situations, increase the risk of infection.

It is impossible to avoid Aspergillus completely, but reducing exposure during activities that generate large amounts of dust or disturb mouldy material may be helpful.

When is wearing a mask most useful?

You may wish to wear a well-fitting respirator during activities such as:

gardening, particularly digging or turning soil
opening bags of compost or potting mix
leaf clearing
handling mulch, bark or wood chippings
cleaning mouldy areas, where appropriate and safe
DIY projects that create dust
sweeping sheds, garages or lofts
visiting farms, stables or grain stores
construction or demolition work
working in dusty environments

For some people, avoiding these activities altogether is the safest option. If they cannot be avoided, appropriate respiratory protection may help reduce exposure.

Which type of mask should I choose?

Not all masks provide the same level of protection.

Mask type	Protection against fungal spores	Recommended?
Cloth face covering	Low	No
Standard surgical mask	Limited	Better than nothing, but not designed for airborne spores
FFP2 respirator	Good	Suitable for most situations
FFP3 respirator	Excellent	Best disposable option
Reusable respirator with P3 filters	Excellent	Useful for frequent or higher-exposure activities

An FFP2 respirator filters at least 94% of airborne particles when properly fitted.

An FFP3 respirator filters at least 99% of airborne particles and offers the highest level of protection available in disposable masks.

For people who regularly garden or work in dusty environments, a reusable respirator fitted with certified P3 filters may be more comfortable and economical over time.

Fit is just as important as the mask itself

Even the best respirator works poorly if air leaks around the edges.

To improve protection:

choose the correct size where available
adjust the nose clip carefully
tighten the straps so the mask seals comfortably
ensure the mask covers both your nose and mouth
check for gaps around the cheeks and chin
replace disposable masks if they become damp, damaged or difficult to breathe through

Facial hair can prevent a tight seal, reducing the effectiveness of close-fitting respirators.

Valved and non-valved masks

Some respirators have an exhalation valve. Patients often report that these masks feel more comfortable, are less warm and humid, and are less likely to steam up glasses.

A valved FFP2 or FFP3 respirator can help protect the wearer from breathing in dust and fungal spores, provided it fits well. However, the valve allows exhaled air to leave the mask more easily, so it does not filter your breath outwards in the same way as a non-valved mask.

This means valved masks may be useful for gardening, DIY or other mould-exposure activities, but may not be appropriate in healthcare settings or situations where you are trying to reduce the spread of respiratory infections to other people.

Some people also find FFP3 masks harder to breathe through than FFP2 masks because they provide higher filtration. If FFP3 feels too difficult to tolerate, a well-fitting FFP2 respirator may be a more practical option for short, lower-risk activities.

Disposable or reusable?

Disposable FFP2 or FFP3 masks

Advantages:

lightweight
convenient
no maintenance
widely available

Disadvantages:

ongoing replacement cost
more waste
may not fit every face shape equally well

Reusable respirators

Advantages:

often provide a better seal
replaceable filters
lower long-term cost if used regularly
less waste

Disadvantages:

higher initial cost
require cleaning and maintenance
bulkier than disposable masks

If you only occasionally garden or carry out DIY, disposable FFP2 or FFP3 masks are usually sufficient. If you need respiratory protection frequently, a reusable respirator may be worth considering.

Are masks uncomfortable?

Many people find respirators take a little time to get used to.

You may notice:

slightly warmer air inside the mask
increased humidity
pressure around the nose
difficulty wearing glasses without fogging

Taking regular breaks in a safe environment and ensuring a good fit often improves comfort.

Can I wear a mask if I have asthma or bronchiectasis?

Many people with asthma or bronchiectasis can safely wear FFP2 or FFP3 respirators for short periods.

However, masks may feel uncomfortable if you are already very breathless. If wearing a respirator causes significant breathlessness, dizziness or distress, stop the activity, remove the mask in a safe place, and discuss suitable options with your healthcare team.

Other ways to reduce exposure

A mask is only one part of reducing mould exposure.

You may also wish to:

ask someone else to turn compost or carry out particularly dusty gardening jobs
wet down dusty materials before moving them, where appropriate
keep windows closed if neighbours are disturbing large amounts of compost, soil or building dust
remove outdoor clothing after gardening
wash your hands after handling soil or compost
shower and wash your hair after heavy exposure if practical

No mask can eliminate exposure completely, but combining several simple measures can reduce the amount of dust and fungal spores you breathe in.

Where can I buy suitable masks?

Certified FFP2 and FFP3 respirators are widely available from:

major pharmacies
builders' merchants
DIY retailers
industrial safety equipment suppliers
reputable online PPE suppliers

When buying a respirator, look for products that meet recognised UK or European standards and carry appropriate certification markings. Avoid products that make unrealistic claims or do not clearly state their filtration standard.

Frequently asked questions

Is a cloth face covering enough?

No. Cloth face coverings are not designed to filter the tiny airborne particles that include fungal spores.

Is FFP3 better than FFP2?

Yes. FFP3 provides a higher level of filtration, although a well-fitting FFP2 respirator offers good protection for many situations.

Can I reuse disposable masks?

Disposable respirators are designed for limited use. Replace them if they become damp, damaged, dirty or difficult to breathe through. Always follow the manufacturer’s instructions.

Should I wear eye protection?

Most people do not need goggles for routine gardening. However, eye protection may be sensible if working in very dusty environments or using power tools.

When should I seek medical advice?

Contact your healthcare team if:

your respiratory symptoms worsen after heavy mould exposure
you develop increasing breathlessness, fever or persistent cough
you notice coughing up blood
your asthma becomes more difficult to control
you are unsure whether your work or hobbies are exposing you to excessive mould

Further information

by GAtherton

Healthy balanced meal illustrating evidence-based dietary advice for people living with aspergillosis.

Trying a New Diet? A Guide for People with Aspergillosis

Originally published: August 2018
Last reviewed: July 2026

If you have searched online for “the best diet for aspergillosis”, you may have found advice ranging from sensible healthy eating to highly restrictive diets claiming to treat fungal infections. It can be difficult to know what to believe.

This guide explains what diet can and cannot do, how to recognise marketing claims, and how to try dietary changes safely if you decide to do so.

A note from the National Aspergillosis Centre

People often ask whether changing their diet can help control aspergillosis. It is a sensible question, and many patients find that healthier eating improves their overall wellbeing. However, current research has not identified any specific diet that treats aspergillosis itself.

This guide is designed to help you separate evidence-based advice from common myths and make informed choices alongside your usual medical care.

Key points

There is no proven “anti-fungal diet” that treats aspergillosis.
A healthy, balanced diet can support general health, energy levels and recovery from illness.
Dietary changes should not replace antifungal medicines, inhalers, steroids or other prescribed treatments.
Be cautious of diets, supplements or programmes that promise cures.
Marketing phrases such as “immune boosting”, “natural antifungal” or “clinically proven” do not always mean strong evidence.
If you try a new diet, make one change at a time and monitor whether it genuinely helps.
Speak to your healthcare team before making major dietary changes, especially if you have diabetes, kidney disease, weight loss or are taking antifungal medication.

Why do people with aspergillosis look at diet?

Living with aspergillosis can be frustrating and exhausting. People may experience breathlessness, fatigue, weight changes, repeated flare-ups, steroid side effects or uncertainty about the future. It is understandable to look for things you can control yourself.

Diet is one of the most common areas people explore. Some dietary changes may be helpful for general health, but many claims online go much further than the evidence supports.

Over the years, patients have asked about anti-fungal diets, Candida diets, sugar-free diets, ketogenic diets, low-carbohydrate diets, gluten-free diets, dairy-free diets, alkaline diets, detox programmes and supplement regimens. Some of these approaches may be appropriate for specific medical reasons, but none has been shown to treat aspergillosis itself.

So how can you separate reliable advice from persuasive marketing?

Recognising marketing claims

Many websites, social media posts and advertisements use scientific-sounding language to make products appear more effective than the evidence supports. This does not necessarily mean the product is ineffective, but it does mean you should look carefully for independent evidence rather than relying on marketing claims.

Be particularly cautious if you see terms such as:

“clinically proven”
“doctor recommended”
“immune boosting”
“natural antifungal”
“detoxifies the body”
“supports immunity”
“research backed”
“breakthrough formula”
“ancient remedy”
“pharmaceutical grade”
“exclusive blend”
“used by leading experts”

These phrases are commonly used in advertising but do not necessarily indicate strong clinical evidence. In some cases, the supporting research may involve only laboratory studies, animal research, very small human studies, or research funded by the manufacturer. Such studies can provide useful early information but are rarely enough on their own to show that a product benefits people with aspergillosis.

Similarly, remember that “natural” does not automatically mean safe, and “evidence based” does not necessarily mean there is good-quality evidence that a product works for people with aspergillosis. Even products described as “clinically tested” may only have been evaluated in a small number of people or for conditions unrelated to aspergillosis.

If a supplement or diet genuinely provides a meaningful health benefit, you should usually be able to find independent recommendations from organisations such as the NHS, registered dietitians, recognised medical societies or high-quality systematic reviews — not just testimonials, celebrity endorsements or promotional websites.

It is perfectly reasonable to ask whether a particular diet, supplement or health product might help. Your healthcare team can help you interpret the available evidence and identify any potential interactions with your medication before you spend money or make major changes.

A simple rule of thumb is to follow the evidence, not the marketing.

So what does the evidence actually tell us?

What does the evidence say?

Nutrition is important for everyone living with a chronic illness. A good diet can support general health, but current research has not identified any diet that treats aspergillosis itself.

What diet can help with

A healthy eating pattern may help you:

maintain strength and muscle mass
recover from illness
manage weight
support bone health
control blood sugar
reduce cardiovascular risk
improve general wellbeing

This can be especially important for people living with long-term lung disease, chronic infection, steroid treatment or reduced physical activity.

What diet cannot do

Diet cannot:

kill Aspergillus growing in the lungs
cure chronic pulmonary aspergillosis
cure allergic bronchopulmonary aspergillosis
replace antifungal treatment
replace specialist respiratory care

If someone claims that a diet can cure aspergillosis, it is reasonable to ask whether this has been tested in properly conducted clinical studies. At present, there is no good evidence that any specific diet cures aspergillosis.

How to judge a new diet

Before trying a diet you have found online, ask:

Does it promise a cure?
Does it claim to “starve” fungus from the body?
Does it recommend stopping prescribed medicines?
Does it require expensive supplements, tests or coaching?
Does it remove whole food groups without a clear medical reason?
Is it based mainly on personal stories rather than research?
Is it supported by recognised healthcare organisations?

The more warning signs you see, the more cautious you should be.

If you decide to try a new diet

1. Be clear about your goal

Decide what you are trying to improve. For example:

energy levels
weight
blood sugar
digestion
reflux
general fitness

A clear goal makes it easier to judge whether the change is helping.

2. Change one thing at a time

If you change several things at once, it becomes difficult to know what made a difference. Try one change for a few weeks before adding another.

3. Keep a simple diary

You may want to record:

what you changed
symptoms
energy levels
weight
blood sugar, if relevant
exercise tolerance
side effects

4. Do not stop prescribed treatment

Dietary changes should complement your medical care, not replace it. Do not stop antifungal medication, steroids, inhalers or other prescribed treatments without medical advice.

5. Review honestly

If a change has not helped after a reasonable trial, it may not be worth continuing. A diet should improve your life, not make it more stressful, expensive or restrictive.

Healthy eating in practice

For most people, the best starting point is not an extreme diet but a balanced eating pattern that can be maintained long term.

This usually means:

plenty of vegetables and fruit
whole grains where tolerated
beans, pulses, nuts and seeds
adequate protein
fish, lean meat, eggs or suitable alternatives
healthy fats such as olive oil
enough fluid
limiting highly processed foods and sugary drinks

A Mediterranean-style diet is often recommended for general health because it supports heart health and provides a wide range of nutrients. However, the best diet for an individual also depends on their medical conditions, preferences, culture, budget and ability to prepare food.

Special situations

If you take corticosteroids

Many people with ABPA or severe asthma take corticosteroids such as prednisolone. These medicines can be very useful, but they may also increase the risk of:

weight gain
raised blood sugar
diabetes
bone thinning
muscle loss

If you take steroids regularly, it is worth paying attention to:

adequate protein
calcium intake
vitamin D, if advised
blood sugar control
gradual weight management
strength-building activity where possible

If you take antifungal medicines

Some antifungal medicines can interact with other medicines, supplements, herbal products and certain foods. Always tell your healthcare team about any supplements or alternative products you are taking or planning to take.

This includes:

herbal remedies
vitamin and mineral supplements
protein powders
weight-loss products
traditional medicines
detox products

“Natural” does not always mean safe. Some products can affect liver function or alter medicine levels.

If you have diabetes or steroid-induced high blood sugar

People with diabetes, or those who develop raised blood sugar while taking steroids, may need more specific dietary advice. Reducing excess sugar and refined carbohydrates may help blood sugar control, but very restrictive diets should be discussed with a healthcare professional.

If you monitor your blood sugar, it can be useful to record any dietary changes alongside your readings. This can help you and your healthcare team see what is actually making a difference.

Common questions

What about sugar?

A common claim is that sugar “feeds” Aspergillus in the lungs. This is an oversimplification.

Reducing excess sugar is sensible for general health, particularly if you have diabetes or take steroids. However, there is no evidence that eliminating sugar cures aspergillosis.

Should I avoid mouldy foods?

You should avoid obviously mouldy food, as anyone should. Mouldy food can contain harmful substances and may not be safe to eat.

This does not mean that everyone with aspergillosis needs to follow an extreme mould-free diet. If you are unsure about food safety, ask your healthcare team or a registered dietitian.

Do probiotics help?

There is growing interest in the gut microbiome. Probiotics may help some digestive problems, but there is currently little evidence that they directly improve aspergillosis.

For most people, a varied diet containing fibre-rich foods is a better long-term foundation for gut health than relying only on supplements.

Be cautious with miracle diets

Be especially careful with diets or programmes that promise to:

cure fungal infection
detox the body
starve Aspergillus
replace medication
rapidly reset the immune system

These claims are rarely supported by good evidence. Very restrictive diets can also lead to weight loss, poor nutrition, social isolation and unnecessary anxiety around food.

When should I ask for professional advice?

Ask your GP, specialist team or a registered dietitian for advice if you:

are losing weight without trying
are struggling to eat enough
feel breathless while eating
have diabetes or steroid-induced high blood sugar
have kidney disease
are considering a very restrictive diet
are using supplements alongside antifungal medicines
have concerns about malnutrition

When should I seek urgent medical help?

Seek urgent medical advice if you develop:

rapid unexplained weight loss
persistent vomiting
difficulty swallowing
signs of dehydration
confusion or severe weakness
large amounts of coughing up blood

Summary

Living with aspergillosis often means making decisions about treatments, lifestyle and nutrition. While there is no diet that has been proven to treat aspergillosis, healthy eating can play an important role in maintaining strength, supporting recovery and improving overall wellbeing.

If you decide to make dietary changes, do so gradually, keep an open mind, and discuss major changes with your healthcare team. Be especially cautious of diets, supplements or programmes that promise more than the evidence can support.

The best dietary advice is usually the simplest: follow the evidence, not the marketing.

In people with aspergillosis, asthma, bronchiectasis or chronic airway inflammation, mucus can become thicker and stickier. It can then build up in the airways and become harder to clear.

This may lead to:

persistent coughing
breathlessness
wheezing
chest discomfort
recurrent chest infections
mucus plugs that block part of the airway

For more background, read our companion article: Airways Mucus and Aspergillosis.

1. Keep well hydrated

Drinking enough fluid helps prevent mucus from becoming even thicker. Water will not dissolve mucus, but good hydration can make mucus less sticky and easier to clear.

Top tip: sip drinks regularly throughout the day rather than waiting until you feel thirsty.

Warm drinks may also feel soothing, and some people find they temporarily make mucus easier to cough up.

2. Practise airway clearance techniques

Respiratory physiotherapists teach breathing exercises designed to move mucus from the smaller airways into the larger airways, where it can be coughed out more easily.

Active Cycle of Breathing Technique (ACBT)

Active Cycle of Breathing Technique, often called ACBT, combines three stages:

gentle relaxed breathing
deep breathing exercises
huff coughing

Many people with bronchiectasis, ABPA and Aspergillus bronchitis find that practising ACBT regularly makes mucus easier to clear.

Huff coughing

A huff is usually gentler and more effective than repeated forceful coughing.

Take a medium-sized breath, then breathe out quickly through an open mouth, as though steaming up a mirror. This helps move mucus upwards while placing less strain on your airways.

Remember: gentle, regular airway clearance is usually more effective than repeated forceful coughing, which can leave you exhausted and irritate your airways.

Postural drainage

Changing your position can allow gravity to help drain mucus from different parts of the lungs. Your respiratory physiotherapist can advise which positions are suitable for you.

Postural drainage may not be appropriate for everyone, especially if you have reflux, heart disease, severe breathlessness or a history of significant haemoptysis.

3. Consider airway clearance devices

Some people benefit from handheld devices that create gentle vibration or resistance while breathing out.

Examples include:

Acapella®
Flutter®
Aerobika®

These devices are commonly used in bronchiectasis care and may help loosen mucus. Ask your respiratory physiotherapist whether one would be suitable for you.

If you have recently coughed up blood, check with your healthcare team before using airway clearance devices, especially devices that create pressure or vibration in the airways.

4. Keep moving

Physical activity is one of the simplest ways to help loosen mucus.

Depending on your health, this may include:

walking
gentle cycling
pulmonary rehabilitation
light strength exercises
stretching and breathing exercises

Even a short walk can stimulate coughing and help move mucus towards the larger airways.

5. Medicines and nebulisers

Your healthcare team may prescribe treatments to improve mucus clearance or treat the underlying cause of excess mucus.

These may include:

inhalers
antifungal medicines
antibiotics
nebulised saline
mucolytic medicines
other treatments recommended by your respiratory team

Nebulised treatments should only be used as prescribed. Some can temporarily worsen wheezing or chest tightness in certain people.

Never start, stop or change medication without discussing it with your healthcare team.

Haemoptysis: what if I cough up blood?

Some people with aspergillosis, particularly those with bronchiectasis or chronic pulmonary aspergillosis (CPA), may occasionally cough up blood. This is called haemoptysis.

Haemoptysis can range from a few small streaks of blood in the sputum to larger amounts that need urgent medical attention.

If you notice a small amount of blood, try to remain calm and avoid repeated forceful coughing, which may irritate the airways further. Gentle techniques such as relaxed breathing and huff coughing may be more appropriate until you have spoken to your healthcare team.

Contact your respiratory team or GP for advice, especially if the bleeding is new, becoming more frequent or accompanied by worsening symptoms.

Seek emergency medical help immediately if:

you cough up a large amount of blood
the bleeding continues
you become increasingly breathless
you feel faint, weak or very unwell
you think a mucus plug is stopping you from breathing normally

If your specialist team has given you a personalised haemoptysis action plan, follow that advice.

If you have experienced haemoptysis before, ask your respiratory physiotherapist or respiratory specialist for personalised guidance about airway clearance during and after an episode. They can advise when it is safe to restart techniques such as ACBT, huff coughing or airway clearance devices.

For more information, see:

When should I seek medical advice?

Contact your healthcare team if:

your mucus suddenly becomes much thicker than usual
your mucus changes colour and you feel more unwell
you become increasingly breathless
you develop fever or symptoms of a chest infection
your usual airway clearance techniques are becoming less effective
you start coughing up blood, even in small amounts

Frequently asked questions

Should I keep coughing until all the mucus has gone?

No. Repeated forceful coughing can be exhausting and may irritate your airways. Controlled airway clearance techniques are usually more effective.

Does drinking water dissolve mucus?

No. Water does not dissolve mucus, but good hydration can make mucus less sticky and easier to clear.

Are steam inhalations helpful?

Some people find warm steam soothing, although there is limited evidence that it improves mucus clearance. Avoid very hot steam because of the risk of burns.

Can exercise help clear mucus?

Yes. Many people find that movement helps loosen mucus and makes coughing more productive. Choose activity that is appropriate for your health and pace yourself.

Should I use an airway clearance device?

Some people benefit from devices such as Acapella®, Flutter® or Aerobika®, but they are not suitable for everyone. Ask your respiratory physiotherapist for advice.

References

Author: National Aspergillosis Centre

Last medically reviewed: 6 July 2026

This information is intended to support, not replace, advice from your own healthcare professionals.

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by GAtherton

Person practising mindfulness meditation outdoors to support relaxation and emotional wellbeing while living with aspergillosis.

Mindfulness, Meditation and Relaxation for People Living with Aspergillosis

Living with aspergillosis can be physically and emotionally demanding. Many people describe feeling anxious about breathlessness, frustrated by fatigue, worried while waiting for test results, or overwhelmed by the uncertainty of living with a long-term condition.

These feelings are entirely understandable. Mindfulness is not a treatment for aspergillosis, but many people find that it helps them manage stress, cope more effectively with symptoms, and improve their overall quality of life alongside their medical care.

Several people living with aspergillosis have told us that mindfulness, meditation or related approaches have helped them cope with the emotional challenges of living with a long-term respiratory condition. Some describe it as being similar to cognitive behavioural therapy (CBT), because it can help them notice anxious thoughts, recognise unhelpful cycles, and respond more calmly.

Mindfulness and CBT are not the same thing, but there is overlap. Both can help people become more aware of how thoughts, feelings, physical sensations and behaviours influence each other. This may be especially relevant when breathlessness, anxiety and stress start to reinforce one another.

Mind and body are connected. Our thoughts and feelings can affect how we breathe, and our breathing can affect how we feel. Mindfulness may help some people break the cycle of stress, anxiety and breathlessness.

What is mindfulness?

Mindfulness means paying attention to the present moment with openness and without judgement. It involves noticing your thoughts, emotions and body sensations as they are happening, rather than becoming caught up in worries about the future or memories of the past.

The NHS describes mindfulness as becoming more aware of what is happening both inside ourselves and in the world around us. This greater awareness can help us recognise stress earlier and respond to it in healthier ways.

Can mindfulness help?

Research suggests that mindfulness-based approaches may help some people living with long-term health conditions by:

reducing stress and anxiety
improving emotional wellbeing
helping people cope with uncertainty
improving sleep in some individuals
increasing confidence in managing long-term illness
supporting overall quality of life

Mindfulness is not a replacement for medical treatment, but it may be a useful addition to an overall self-management plan.

Mindfulness and breathing

Breathing is central to many mindfulness exercises.

People living with aspergillosis may become understandably focused on their breathing, particularly during episodes of breathlessness. Gentle breathing awareness can help some people slow their breathing, reduce feelings of panic and regain a greater sense of control.

The aim is not to force deeper breaths, but to develop a calm awareness of your natural breathing pattern.

If you become uncomfortable or increasingly breathless during any exercise, stop and return to your normal breathing. Always follow the advice of your respiratory team if you have concerns about breathlessness.

Meditation

Meditation is one way of practising mindfulness. Even five to ten minutes each day may help you develop greater awareness of your breathing, thoughts and emotions.

There are many different styles of meditation. Some focus on breathing, while others use guided relaxation, body awareness or gentle visualisation. There is no single correct approach, so it is worth trying different techniques to discover what works best for you.

Tai Chi and Yoga

Gentle activities such as Tai Chi and yoga combine movement, breathing and relaxation. Many people with chronic respiratory conditions find these activities helpful for improving confidence, flexibility, balance and emotional wellbeing.

Choose exercises that match your current level of fitness and avoid pushing yourself beyond your comfort level. If you are unsure whether an activity is suitable, discuss it with your healthcare team.

Getting started

You do not need any special equipment or previous experience.

You could begin by:

spending five minutes focusing on your breathing each day
taking a slow, mindful walk while noticing your surroundings
trying a guided mindfulness session
practising gentle stretching, yoga or Tai Chi
using relaxation exercises before bed or during stressful periods

Many people find that practising little and often is easier than trying long sessions.

Useful resources

You may also find it helpful to explore aspergillosis.org resources on breathing exercises, fatigue, emotional wellbeing, exercise and gentle movement.

When should I seek additional support?

Living with a long-term illness can affect emotional wellbeing. If anxiety, low mood or stress are becoming overwhelming, speak with your GP or specialist team. Support is available, and looking after your mental wellbeing is an important part of living well with aspergillosis.

Originally published: July 2018

Last substantially updated: July 2026

Next review due: July 2028

by GAtherton

Illustration showing the close communication between the brain, lungs and nervous system, explaining how breathing is influenced by physical, neurological and emotional factors in people living with aspergillosis.

Living with Aspergillosis: Understanding the Brain–Lung Connection

Why emotions, stress, sleep, confidence and the nervous system all influence how we experience chronic lung disease

Aspergillosis Living Knowledge Hub | Built with patients | Living document

This is a Living Knowledge Hub

Unlike a traditional article, this Knowledge Hub is designed to evolve.

As new scientific research becomes available, and as people living with aspergillosis ask new questions, we will continue to expand and improve this resource.

The current version already contains evidence-based information that has been reviewed before publication, but it is only the beginning.

This approach allows us to share useful information now, rather than waiting until every section is complete, while continuing to improve the resource over time.

Current version: 0.1
Last updated: July 2026
Status: Living Knowledge Hub
Reading time: approximately 18 minutes
Who is this for? People living with aspergillosis, families, carers and healthcare professionals
Review policy: This Knowledge Hub is reviewed whenever important new evidence becomes available and at least annually to ensure it remains accurate and up to date.

Planned additions

The immune system and psychoneuroimmunology
Sleep, fatigue and breathing
Stress hormones, inflammation and infection
Living with uncertainty
Pulmonary rehabilitation and rebuilding confidence
Additional illustrations and diagrams
Expanded references and further reading

Before you begin: you are not imagining it
Why we wrote this guide
Why does my breathing feel worse when my scan has not changed?
Why does the brain matter if my lungs are the problem?
Can emotions really change my breathing?
What’s new?
Help us improve this Knowledge Hub

Before you begin...

If you have arrived here because someone suggested that stress or anxiety might be affecting your breathing, this page is for you.

If you have arrived here because you are wondering why some days are so much harder than others, this page is for you.

If you have ever worried that family members, friends or even healthcare professionals thought your symptoms were “all in your head”, this page is for you too.

And if you are a family member or healthcare professional trying to understand what it is really like to live with aspergillosis, we hope this guide helps explain an aspect of chronic lung disease that is rarely discussed in detail.

The most important message comes first.

Your illness is real.

Your symptoms are real.

Modern respiratory medicine recognises that the brain, lungs, nervous system and immune system constantly work together. Understanding that relationship does not make your illness any less real. It helps explain why living with chronic lung disease can sometimes be so challenging.

Why we wrote this guide

Over many years at the National Aspergillosis Centre, we have listened to many people living with aspergillosis.

Again and again, we hear similar questions.

“Why do I feel much worse today when my scan hasn’t changed?”

“Why does poor sleep affect my breathing so much?”

“Can stress make my symptoms worse?”

“If my emotions affect my breathing, does that mean my illness isn’t real?”

These are important questions. Unfortunately, they can be difficult to answer fully during a busy clinic appointment.

This guide has been written to provide the explanation many people tell us they never had.

It brings together modern respiratory medicine, neuroscience, immunology, pulmonary rehabilitation and the lived experience of people with aspergillosis.

Our aim is not simply to explain the science. Our aim is to help you understand your own experience.

A false choice

Many people living with chronic illness feel they have been offered two very different explanations for their symptoms.

Either the symptoms are caused by the lungs, or the symptoms are caused by anxiety.

Modern medicine increasingly recognises that this is a false choice.

The lungs are real. The brain is real. The nervous system is real. The immune system is real. Hormones are real.

Every one of these systems communicates continuously with the others. When we understand that partnership, many experiences that once seemed confusing begin to make sense.

More than just the lungs

Most of us think breathing happens entirely inside the lungs. In reality, every breath depends on an extraordinary partnership between many different parts of the body.

Body system	Its role in breathing
The lungs	Exchange oxygen and carbon dioxide.
The brain	Interprets breathing signals and decides how much air the body needs.
The nervous system	Adjusts breathing, heart rate and muscle activity.
The breathing muscles	Power every breath you take.
The immune system	Responds to infection and inflammation in the lungs.
Your previous experiences	Help the brain judge whether breathing feels safe or threatening.

Scientists often describe this constant communication as the brain–lung axis.

Understanding how this partnership works has transformed the way respiratory specialists think about chronic breathlessness.

What you will learn

By the end of this guide you will understand:

why scans and lung function tests do not always match how you feel
why frightening experiences can change the way breathing feels
why sleep, fatigue and emotions influence symptoms
what scientists know about stress and the immune system
why pulmonary rehabilitation works
how confidence can be rebuilt after serious illness
what is known, and what is still uncertain, about these important questions.

If you remember only one thing from this opening section, remember this:

Your illness is real. Your symptoms are real. The science that explains the connection between the brain and lungs is real too.

Why Does My Breathing Feel Worse When My Scan Hasn’t Changed?

This is probably one of the most common questions asked by people living with chronic lung disease.

“My doctor says my CT scan looks stable, so why do I feel so much worse?”

It is an excellent question. It is also one that causes enormous frustration.

Many people begin wondering whether they are imagining their symptoms or whether something has been missed.

Fortunately, modern respiratory medicine has a much better explanation.

The first thing to understand

A CT scan is an extraordinarily useful investigation. It allows doctors to see inflammation, cavities, bronchiectasis, scarring and many other important changes inside the lungs.

But a scan has one important limitation.

It shows what your lungs look like.

It cannot show what breathing feels like.

Those are two different things.

Structure versus function

A useful way to think about this is to separate structure from function.

Structure	Function and lived experience
CT scans	Breathing comfort and effort
X-rays	Exercise tolerance
Blood tests	Energy and fatigue
Lung function tests	Quality of life and confidence

Your medical team needs both kinds of information. One does not replace the other.

Breathlessness is an experience

The American Thoracic Society defines breathlessness, also called dyspnoea, as:

“A subjective experience of breathing discomfort that consists of qualitatively distinct sensations that vary in intensity.”

That definition is important. It tells us that breathlessness is something that is experienced.

The lungs send information. The brain turns that information into the experience of breathing.

An orchestra, not a solo instrument

Imagine listening to an orchestra. You do not hear only the violins. You hear the combined sound of strings, woodwind, brass and percussion.

Breathing works in much the same way. What you experience is produced by many different systems working together.

System	Contribution
Lungs	Move oxygen and carbon dioxide.
Heart	Delivers oxygen.
Breathing muscles	Generate each breath.
Brain	Interprets signals.
Nervous system	Adjusts breathing.
Sleep	Influences fatigue and resilience.
Confidence	Changes how safe breathing feels.
Previous experiences	Influence future breathing responses.

No single instrument produces the whole performance.

What your scan cannot see

Your CT scan cannot show:

how well you slept
whether your breathing muscles are tired
whether you recently recovered from a viral infection
whether you feel anxious about another haemoptysis
whether today’s humidity is making your chest feel tight
whether your body is still recovering from yesterday’s activity
how much mental effort breathing requires today.

All of these may influence how breathing feels. None of them mean your illness is imaginary.

Research Spotlight

Why the modern definition of breathlessness matters

Older medical thinking often treated breathlessness as a simple consequence of lung damage.

Research over recent decades has shown that the experience of breathlessness depends upon interactions between the lungs, brain, nervous system and many other factors.

This is why modern respiratory medicine increasingly measures quality of life alongside scans and lung function tests.

Why this matters: it validates what patients have always known: how they feel cannot always be predicted by test results alone.

Why this matters if you have aspergillosis

If your scan has not changed but your breathing feels worse, this does not automatically mean:

the disease has suddenly progressed
the scan is wrong
your symptoms are “all in your head”.

It means breathing is influenced by many different parts of the body working together.

Understanding those interactions is one of the biggest advances in modern respiratory medicine.

Why Does the Brain Matter If My Lungs Are the Problem?

This question worries many people.

“If my doctor starts talking about my brain, are they saying my illness isn’t real?”

The answer is simple. No.

Talking about the brain is not changing the diagnosis. It is explaining how breathing works.

Your lungs cannot create the sensation of breathlessness on their own, just as your ears cannot create music on their own, or your eyes cannot create vision on their own.

Every one of these experiences depends on the brain interpreting information coming from the body. Breathing is no different.

Your brain is your body’s prediction machine

Most of us imagine the brain as a computer that simply receives information. Modern neuroscience paints a much more interesting picture.

The brain is constantly trying to predict what is about to happen.

Every second it asks questions such as:

Am I safe?
Am I getting enough oxygen?
Should I breathe faster?
How hard are my breathing muscles working?
Does this feel familiar?

It compares what it expects to happen with what is actually happening.

If everything matches, breathing usually fades into the background. If something unexpected happens, breathing suddenly becomes the centre of attention.

This is one reason healthy people rarely notice their breathing, while people living with chronic lung disease may think about it many times each day.

The smoke alarm inside your brain

A smoke alarm has one job: to detect danger. It would rather ring unnecessarily than miss a real fire.

Your brain works in much the same way.

If you have experienced:

a severe asthma attack
haemoptysis
being unable to catch your breath
an emergency admission to hospital
months of unexplained symptoms before diagnosis

your brain learns something very important.

“Breathing can sometimes become dangerous.”

Once that lesson has been learned, your brain naturally pays much closer attention to breathing than it did before.

This is not a fault. It is exactly what evolution intended. Your brain is trying to protect you.

Patient Perspective

“After coughing up blood I became frightened every time I coughed.

I knew the bleeding had stopped, but every cough made me wonder whether it was happening again.

Learning that my brain was trying to protect me, not trick me, changed the way I understood my recovery.”

The Brain–Lung Axis

Scientists describe the close communication between the brain and lungs as the brain–lung axis.

This communication works in both directions.

The lungs tell the brain...	The brain tells the lungs...
How much oxygen is available.	How fast to breathe.
How much carbon dioxide is present.	How deeply to breathe.
Whether the airways are irritated.	When to cough.
How hard the breathing muscles are working.	How to respond to exercise.

Every breath is the result of this continuous conversation.

Illustration showing the brain, lungs and nervous system communicating, explaining how breathing symptoms in aspergillosis can be influenced by physical, neurological and emotional factors. — The brain, lungs and nervous system work together continuously. Understanding this partnership helps explain why breathing symptoms can change from day to day.

Why this matters if you have aspergillosis

If you understand that breathing is created by a partnership between the lungs and brain, several confusing experiences suddenly make much more sense.

Why one day can feel much harder than another.
Why sleep affects breathing.
Why fatigue affects breathing.
Why confidence affects breathing.
Why pulmonary rehabilitation improves symptoms even when scans remain unchanged.
Why frightening respiratory events can continue to affect confidence long after the lungs have recovered.

None of these observations suggest your illness is psychological.

They demonstrate how remarkably sophisticated the breathing system really is.

Research Spotlight

Brain imaging studies have shown that breathlessness activates areas of the brain involved in attention, emotion and decision-making, as well as areas involved in sensory processing.

This reinforces an important message:

Breathlessness is not simply a signal from the lungs. It is a whole-body experience.

Can Emotions Really Change My Breathing?

Many people living with aspergillosis are reluctant to ask this question.

Some worry that even mentioning stress or emotions will mean their symptoms are no longer taken seriously. Others have experienced exactly that in the past.

Modern respiratory medicine takes a very different view.

It recognises two equally important facts.

Your lung disease is real.
Your emotional state can influence how that disease is experienced.

These statements are not contradictory. They describe how the human body normally works.

Every emotion has a physical effect

Think about the last time you were startled. Before you had time to think, your body had already responded.

Your heart rate increased.
Your breathing became faster.
Your muscles tightened.
Your mouth became dry.
Your attention narrowed onto the potential danger.

You did not choose any of those reactions. They happened automatically.

This is because emotions are not separate from the body. They are produced by the body and immediately affect the body’s physiology.

Breathing is especially sensitive

Unlike many other organs, the breathing system has to respond continuously to both physical demands and emotional demands.

Situation	What happens?
Walking upstairs	Your breathing increases because your muscles need more oxygen.
Receiving frightening news	Your breathing may also increase, even though your muscles are resting.
Laughing	Your breathing pattern changes completely.
Crying	Your breathing becomes irregular and deeper.
Feeling calm and relaxed	Your breathing usually slows and becomes more efficient.

These changes happen in everyone.

People with chronic lung disease often notice them more because their breathing system is already working harder.

Why frightening experiences matter

Imagine two people climbing exactly the same flight of stairs.

One has never experienced serious breathing problems. The other has previously been admitted to hospital with severe breathlessness.

Their lungs may be working equally hard. But their brains interpret those signals differently.

The first person thinks:

“I’m out of breath because I climbed the stairs.”

The second person may immediately wonder:

“Is something going wrong again?”

Neither response is irrational. They reflect different life experiences.

This is one reason why previous severe respiratory events can continue to influence confidence long after recovery.

Patient Perspective

“I realised I wasn’t frightened of exercise.

I was frightened of becoming breathless because, in the past, breathlessness had meant I was seriously ill.”

The vicious circle of fear

Fear itself does not damage the lungs. However, fear can unintentionally make breathing feel more difficult.

Breathlessness
       ↓
Concern
       ↓
Breathing becomes faster
       ↓
Chest muscles tighten
       ↓
Breathing feels harder
       ↓
More concern

This is not imaginary. Every stage involves genuine physical changes.

The encouraging news is that this cycle can also be interrupted.

Understanding
       ↓
Greater confidence
       ↓
Calmer breathing
       ↓
More efficient breathing
       ↓
Activity feels easier
       ↓
Confidence grows

This does not remove aspergillosis. It changes how effectively the whole breathing system works together.

Research Spotlight

Why pulmonary rehabilitation improves confidence

Research consistently shows that pulmonary rehabilitation improves quality of life, exercise capacity and confidence, even when lung function changes only modestly.

Patients often describe feeling more in control of their breathing.

This improvement reflects better physical conditioning, improved breathing efficiency, increased confidence and a better understanding of symptoms.

These benefits are recognised internationally and form an important part of managing many chronic respiratory diseases.

Why this matters if you have aspergillosis

You are not expected to ignore your emotions.

You are not expected to “stay positive” all the time.

You are not expected to pretend your illness is less serious than it is.

Instead, understanding how emotions influence breathing gives you another tool.

It helps explain why:

some days feel harder than others
confidence matters
breathing techniques can help
pulmonary rehabilitation works
being listened to is part of good medical care

Knowledge does not remove the disease.

But it can remove unnecessary fear and replace it with understanding.

Emotions do not make aspergillosis imaginary.

They are one of the many biological systems that influence how living with aspergillosis feels from day to day.

What's New?

This Knowledge Hub is updated regularly as new evidence becomes available and in response to questions from readers.

Version 0.1 – July 2026

Initial publication.
Introduced the Brain–Lung Connection.
Explained why breathlessness is more than lung function alone.
Explored how previous experiences and emotions can influence breathing.

Next planned update

The immune system and psychoneuroimmunology.
Stress hormones, inflammation and infection.
Sleep and breathing.

Help Shape Future Editions

Every month we review this Knowledge Hub.

Some improvements come from newly published scientific research.

Others come directly from the questions and experiences shared by people living with aspergillosis, their families and healthcare professionals.

Many of the most valuable pages on aspergillosis.org have started with a single patient question.

If there was something you expected to find but didn't...

If something wasn't explained clearly...

If your own experience has been different...

Or if there is a question you think every patient should have answered...

Please tell us.

Your feedback will help shape future editions of this Knowledge Hub and may inspire entirely new patient resources.

📝 Share your feedback (2–3 minutes)

Thank you for helping us build one of the world's most comprehensive patient education resources on aspergillosis.

This Knowledge Hub has evolved thanks to our readers

Future updates will be listed here so you can see how this resource has grown over time.

Version	What's changed
0.1	Initial publication introducing the Brain–Lung Connection, explaining why breathlessness is more than lung function, and describing how previous experiences and emotions can influence breathing.
0.2	Coming soon: immune system, psychoneuroimmunology, stress hormones, inflammation and sleep.
0.3	Coming soon.
1.0	First complete edition.

Key Points

Electric fans can help most people stay comfortable during UK heatwaves.
Fans cool the body by increasing the evaporation of sweat.
In extreme heat (above about 35°C), fans may become less effective for some people.
Hydration remains one of the most important ways to protect yourself during hot weather.
People with chronic lung conditions should pay particular attention to avoiding dehydration, which can make mucus thicker and harder to clear.

How do electric fans cool us?

Electric fans do not lower the temperature of the air. Instead, they move air across the skin, helping sweat evaporate more quickly. Because evaporation removes heat from the body, this can make you feel cooler and more comfortable.

For most people, particularly during typical UK summer temperatures, fans are a useful and inexpensive way to reduce discomfort during hot weather.

Why is there advice to limit fan use in extreme heat?

Some public health guidance advises caution when temperatures rise above about 35°C. At these temperatures, a fan may simply blow very hot air across the body. If a person is unable to sweat effectively because of age, illness, dehydration, or certain medications, the cooling benefit may be reduced.

This concern led organisations such as the NHS, UK Health Security Agency (UKHSA), and World Health Organization (WHO) to recommend that fans should not be relied upon as the only cooling strategy during extreme heat.

However, research over the last few years has shown that the situation is more complicated than a simple temperature cut-off. Factors such as humidity, hydration, age, and overall health all influence whether a fan is helpful.

What does the research say?

Recent studies suggest that electric fans may still provide benefits for many people, even when temperatures exceed 35°C, particularly if humidity levels are high and the body is able to sweat normally.

Researchers now recognise that there is no single temperature at which fans suddenly become harmful. Instead, their effectiveness depends on the balance between heat gained from the surrounding air and heat lost through sweat evaporation.

The overall message from researchers and public health organisations is that fans remain useful for many people but should be combined with other cooling measures such as drinking fluids, seeking shade, and cooling the skin with water.

What does this mean for people with aspergillosis?

For people living with aspergillosis, asthma, chronic pulmonary aspergillosis (CPA), allergic bronchopulmonary aspergillosis (ABPA), or bronchiectasis, a fan is generally safe and may improve comfort during hot weather.

The greater concern is often dehydration. Hot weather can lead to fluid loss through sweating, which may cause mucus and sputum to become thicker and more difficult to clear from the lungs. This can increase coughing, breathlessness, and discomfort.

If you use a fan during hot weather:

Drink water regularly throughout the day.
Keep curtains or blinds closed on sun-facing windows.
Open windows when outdoor temperatures are cooler, particularly overnight.
Use cool showers, damp cloths, or a spray bottle to cool the skin.
Avoid strenuous activity during the hottest part of the day.
Continue any airway clearance techniques recommended by your healthcare team.

Watch for signs of heat exhaustion

Seek medical advice if you experience:

Dizziness or fainting
Severe headache
Nausea or vomiting
Excessive tiredness or weakness
Confusion or difficulty concentrating
Worsening breathlessness

The bottom line

For most people in the UK, electric fans remain a helpful way to stay comfortable during hot weather. Current evidence suggests that fans are generally beneficial during typical UK heatwaves, especially when used alongside other cooling measures.

The most important message for people with chronic lung conditions is to stay hydrated. Fans can help you feel cooler, but drinking enough fluids, avoiding overheating, and recognising the signs of heat-related illness are equally important.

A note from the National Aspergillosis Centre

Contents

Before you begin...

Why we wrote this guide

A false choice

More than just the lungs

What you will learn

Why Does My Breathing Feel Worse When My Scan Hasn’t Changed?

The first thing to understand

Structure versus function

Breathlessness is an experience

An orchestra, not a solo instrument

What your scan cannot see

Research Spotlight

Why the modern definition of breathlessness matters

Why this matters if you have aspergillosis

Why Does the Brain Matter If My Lungs Are the Problem?

Your brain is your body’s prediction machine

The smoke alarm inside your brain

Patient Perspective

The Brain–Lung Axis

Why this matters if you have aspergillosis

Research Spotlight

Can Emotions Really Change My Breathing?

Every emotion has a physical effect

Breathing is especially sensitive

Why frightening experiences matter

Patient Perspective

The vicious circle of fear

Research Spotlight

Why pulmonary rehabilitation improves confidence

Why this matters if you have aspergillosis

What's New?

Version 0.1 – July 2026

Next planned update

Help Shape Future Editions

This Knowledge Hub has evolved thanks to our readers

Further reading and references