Members of MyCOPDTeam often talk about the sounds their lungs make. “I started off the day with lots of noises, squeals, squeaks, and other sounds of wheezing,” shared one member. “Just no orangutan noises, darn!” Another responded, “I’ve got some pops and cracks to join you, LOL!”
Chronic obstructive pulmonary disease (COPD) can change the way your breathing sounds. Several different respiratory sounds are associated with lung changes in COPD. Some of these abnormal breath sounds — also called adventitious breath sounds — are noticeable during everyday life. Others can be heard only with a stethoscope or other medical instruments.
The process of listening to the lungs through a stethoscope is called auscultation, and it’s an important skill pulmonologists and other doctors may use to better understand your lung condition. The sounds caused by COPD can provide critical clues about COPD, its progression, and whether there are any COPD complications. These sounds can also reveal which parts of the respiratory system are most affected by COPD.
Keep reading to learn about six different lung sounds that may be associated with COPD.
Wheezing is the breath sound most commonly associated with COPD. Wheezes are whistling sounds that happen during breathing. Some people liken it to the sound of a deflating balloon. Wheezes are usually expiratory sounds, meaning they occur when air is exhaled. However, some wheezes are inspiratory sounds, produced when air is inhaled.
Wheezing is often a clue for a COPD diagnosis. It’s a common symptom of chronic (long-term) bronchitis, one type of COPD. In chronic bronchitis, inflammation and mucus block the bronchioles (bronchial tubes), which are small airways in the lungs. Wheezing occurs when airflow is forced in and out through these clogged airways.
Wheezing sounds may vary by the stage of COPD. In early-stage COPD, you might hear wheezing only when you exhale heavily. By stage 2, wheezing may be continual, along with shortness of breath.
Wheezing sounds might be associated with worsening COPD. In a study of more than 1,000 people with COPD, those who experienced wheezing were more likely to experience COPD exacerbation (getting worse). This may be because wheezing itself can worsen lung inflammation by vibrating lung tissue.
Wheezing can also affect your quality of life and make sleeping difficult. “Some chest wheezing woke me up occasionally,” wrote one member of MyCOPDTeam. Another shared, “Not so good today. Up all night coughing and wheezing.”
Fortunately, COPD-related wheezing can be treated. Quitting smoking — or getting rid of sources of secondhand smoke — can help ease wheezing, as can staying inside when the air quality is bad. Breathing exercises can also help. Make sure you get enough fluids — drink enough water and use a humidifier in your house or at work. Hot beverages, like tea, can also help relax the airway.
Bronchodilator inhalers and nebulizers can ease wheezing by relaxing the bronchial tubes. “Wheezing, so back on my two puffers,” wrote one MyCOPDTeam member.
Just like wheezes, rhonchi are a kind of breath sound caused by constricted (narrowed) airways. Unlike wheezes, which are high-pitched, rhonchi are lower-pitched and hoarser, and they can sound like snoring. Rhonchi happen when larger airways in the lungs are partially blocked, possibly by secretions (mucus).
As with wheezes, rhonchi can be treated with bronchodilator inhalers and nebulizers. Rhonchi caused by air moving through thick mucus can be treated with expectorants (to help clear mucus) and mucolytics (for breaking up mucus). Antibiotics may also be used if there’s an infection.
“I don't think this cold weather is good for me,” wrote one MyCOPDTeam member. “Now I have crackles in my lungs.”
Crackles, also called rales, are a breath sound that happens when lung airways unclog as you inhale. They often go away when you cough. Crackles usually occur when there’s too much fluid in the lung.
Unlike wheezing, crackles can be heard only through a stethoscope. Your health care provider will hear sounds similar to popping or Velcro being unfastened.
Crackles are separated into coarse crackle and fine crackle sounds. Coarse crackles are louder and have a lower pitch, and fine crackles are softer and higher-pitched and occur more frequently. The crackling sound becomes more coarse when the lung airway opens up more.
Stridor is similar to wheezing but is usually caused when there’s a blockage or narrowing in the upper airway, like the windpipe or throat. The breath sound comes when you breathe in and out. Stridor might indicate a collapsed airway or something stuck in your lungs. Regular COPD (like emphysema or chronic bronchitis) doesn’t cause stridor. However, stridor might occur when airways collapse (called tracheobronchomalacia), which can be linked to COPD and asthma.
“The stridor monster and his buddy COPD were busy trying to kill me,” said a MyCOPDTeam member, reporting they had to go to the emergency room three times.
Pleural friction rub isn’t a sign of COPD, but it can be caused by COPD-related conditions like congestive heart failure. This sound isn’t caused by blockages in the lungs or airways. Rather, when pleura — the tissue around the lungs and in the chest cavity — is inflamed, it can rub against the chest wall, producing sounds like grating, creaking, or crunching snow. Pleural friction rub can be detected through a stethoscope and can be heard during both inhalation and exhalation.
People with COPD have weaker lungs, which can make the sounds of their breathing or coughing quieter than normal. A health care provider can perform a physical examination and measure the strength of the sounds in different areas, such as the upper and lower portions of the chest.
“I found out I have double pneumonia,” reported one MyCOPDTeam member. “I’ve never heard such weird noises come out of my lungs.”
Keep in contact with your COPD specialist and let them know about any new or changing lung sounds. Information about lung sounds could help your doctor detect an important health problem early and potentially update your treatment plan to avoid serious complications.
MyCOPDTeam is the social network for people with chronic obstructive pulmonary disease and their loved ones. On MyCOPDTeam, more than 119,000 members come together to ask questions, give advice, and share their stories with others who understand life with COPD.
Have you noticed different sounds with your COPD? Share your experience in the comments below, or start a conversation by posting on your Activities page.