Shortness of breath is one of the most common symptoms of the lung disease called chronic obstructive pulmonary disease (COPD). You might also notice lung sounds like wheezing, bluish skin, and a cough that doesn’t go away. Feeling short of breath can be a sign of a COPD flare-up — or it may mean your COPD may be getting worse and you should talk to your doctor.

Shortness of breath can feel scary, but it helps to understand what’s happening. Here’s what you need to know about shortness of breath and COPD so you can protect your health and maintain your quality of life.

What Causes Shortness of Breath With COPD?

COPD refers to several lung diseases that damage or obstruct your lungs. Both emphysema and chronic bronchitis are types of COPD. This damage can make it hard to breathe or feel like you’re getting enough air. That feeling is called shortness of breath. Shortness of breath is especially common with emphysema, because it damages the parts of your lungs that exchange carbon dioxide and oxygen.

Respiratory infections, including pneumonia, can make shortness of breath even worse. If you’re diagnosed with both asthma and COPD, you may have more severe symptoms in addition to shortness of breath.

Managing Shortness of Breath With COPD

If you’re living with COPD and feel breathless, there are steps you can take to stay safe and get the medical care you need.

1. Assess Your Condition

The first thing you should do is figure out how bad your shortness of breath is. Is your shortness of breath getting worse slowly? Are you using your treatments more often or waking up at night struggling to breathe? If this is the case, you may need to make an appointment with your healthcare provider. While you may not need emergency care, these are signs that your COPD may be getting worse and needs medical attention soon.

Use a pulse oximeter if you have one. These small devices, now widely available since the COVID-19 pandemic, can help measure your blood oxygen level. Seek immediate attention if you get a reading below 90 percent.

On the other hand, if you’re gasping, choking, unable to speak, or your lips are turning blue, that’s a medical emergency. You may also feel chest tightness, confusion, or significant pain. These are all signs that you need emergency medical care right away. Call 911 immediately or have someone call it for you. If you’re wondering whether you should go to the hospital for COPD, severe shortness of breath is definitely reason enough.

Likewise, if you’re a caregiver and someone with COPD can’t breathe, calling emergency services is the safest response.

2. Get the Help You Need

Once you’ve assessed your breathing, it’s important to follow through and seek care — even if your symptoms improve. It can be tempting to skip a doctor’s appointment if your shortness of breath goes away, but shortness of breath can return or worsen quickly. Getting medical attention early may help prevent a more serious episode.

If you need to go to the hospital, make sure you understand the tests they’re running and the treatments they’re offering. You may get a chest X-ray or tests to check for other health conditions. If you’re feeling tired or confused, make sure you have a friend or family member with you who can keep track of what the doctors say.

3. Try Pursed Lip Breathing

If you’re managing everyday shortness of breath at home, a breathing technique called pursed lip breathing can help you feel more in control and reduce air trapping in your lungs.

Start by breathing in slowly through your nose for about two seconds. If it helps, pretend that you're smelling something pleasant and take in a deep breath. Next, purse your lips, as if you're about to blow out a candle. Exhale out of your pursed lips for about four to six seconds — twice as long as you inhale. Repeat a few times.

Pursed lip breathing can help you get more oxygen and release more carbon dioxide every time you breathe. This can be especially helpful for people with COPD since difficulty breathing is often caused by problems with this air exchange. Pursed lip breathing also helps release air trapped in your lungs and can ease the feeling of breathlessness.

4. Breathe From Your Diaphragm

Breathing from your diaphragm (a large muscle beneath the lungs), or belly breathing, is another exercise that can help with shortness of breath. While it’s a little more advanced than pursed lip breathing, it’s worth practicing — ideally with the guidance of a healthcare provider before you’re comfortable doing it on your own.

This kind of breathing helps you use your diaphragm rather than relying on the muscles in your back, neck, and shoulders.

Start by getting comfortable. Lie on your back or recline in a chair. Place one hand on your chest and the other one just below your ribs. Breathe in slowly through your nose focusing on making the hand on your belly rise — your chest should stay still. Exhale through pursed lips, letting the hand on your belly fall.

Repeat for five to 10 minutes, two to three times a day (or as recommended by your doctor). Over time, practice diaphragmatic breathing in different positions — sitting, standing, or even while doing something else.

5. Use Your Rescue Pack

Some doctors give people diagnosed with COPD something called a rescue pack. A rescue pack may contain medications you should take if you have a bad COPD flare-up.

If you start having symptoms that your doctor has warned you about, take the rescue pack medications immediately. Once your symptoms are under control, call your doctor. They’ll want to follow up, adjust your treatment if needed, and make sure you have another rescue pack ready.

How To Avoid Becoming Short of Breath When Living With COPD

While you can’t completely eliminate shortness of breath with COPD, there are important steps you can take to help reduce flare-ups and slow disease progression:

• Quit smoking — Your doctor can help you make a plan that will work for you.
• Follow your treatment regimen — Taking medications at the right times and using inhalers correctly can help keep shortness of breath at bay.
• Talk to your doctor about a pulmonary rehabilitation program — These classes, if they're right for you, can help improve lung function and stamina.
• Stay up to date on vaccines — This helps avoid respiratory illnesses that can make COPD worse.
• Avoid things that irritate your lungs — It may take some trial and error to figure out your triggers (examples include air pollution, fragrances, or smoke).
• Make a treatment plan — Work with your doctor to make a plan for what you’ll do when you have a flare.

Follow through with these steps to breathe as well as you can, for as long as you can.

What Is the Best Thing To Do for COPD?

There’s no single best treatment for COPD. The best approach for you will depend on the type of COPD you have, how severe it is, and other factors. Your doctor will work with you to figure out which of the available treatment options might be best for you.

Talk With Others Who Understand

MyCOPDTeam is the social network for people with COPD and their loved ones. On MyCOPDTeam, members come together to ask questions, give advice, and share their stories with others who understand life with COPD.

Do you experience shortness of breath with COPD? What steps have you taken to get it under control? Share your experience in the comments below, or start a conversation by posting on your Activities page.