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. 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.

Why Are Lung Sounds Important?

The process of listening to the lungs through a stethoscope is called auscultation. It’s an important skill pulmonologists and other doctors may use to better understand your lung disease. The sounds caused by COPD can provide critical clues about your 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 lung sounds that may be associated with COPD.

1. Wheezing

Wheezing is a breath sound commonly associated with COPD. Wheezes are whistling sounds that happen during breathing. Some people liken it to the sound of the air coming out of a balloon. Wheezes are usually expiratory sounds, meaning they occur when air is exhaled. However, some people will also wheeze when they inhale, though it doesn’t occur with inhalation alone.

Wheezing is often a clue that leads to 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 small airways in the lungs. Wheezing occurs when airflow is forced in and out through airways that are partly blocked.

Wheezing is often a clue to a COPD diagnosis.

When Wheezing Gets Worse

Wheezing sounds may vary depending on the stage of COPD. In early-stage COPD, you might not wheeze at all. By stage 2, wheezing may be persistent, along with shortness of breath. It may get worse when COPD flares up.

Wheezing is a sign of narrowed airways. Its presence is associated with a higher risk of exacerbations (flare-ups).

Wheezing can affect your quality of life and make sleeping difficult. “Some chest wheezing wakes me up occasionally,” wrote one member of MyCOPDTeam. Another shared, “Not so good today. Up all night coughing and wheezing.”

Treatment for Wheezing

Fortunately, treating your COPD can help with any wheezing. 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 your airways.

Bronchodilator inhalers and nebulizers can ease wheezing by relaxing the bronchial tubes. “Wheezing, so back on my two puffers,” wrote one MyCOPDTeam member.

2. Rhonchi

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 you have an infection.

3. Crackles

“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. Crackles in COPD usually mean that small air passages close briefly, then reopen. They are also associated with lung secretions. If your healthcare provider thinks your crackles are related to fluid in your lungs, there may be something else going on, like pneumonia or heart failure.

Unlike wheezing, crackles can usually only be heard through a stethoscope. Your healthcare provider will hear sounds similar to popping or Velcro being unfastened.

Crackles are categorized as either coarse or fine. Coarse crackles are louder and have a lower pitch, and fine crackles are softer and higher-pitched and occur more frequently. The crackling sound may get louder and lower as the airway opening gets larger.

Unlike wheezing, crackles can be heard only through a stethoscope.

In a study of 3,684 people, “early” crackles (crackles that happen when you start drawing a breath) were more highly associated with a COPD diagnosis than coarse crackles.

4. Stridor

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. This breath sound can happen when you breathe in, when you breathe out, or during both phases of breathing. The part of your breath that includes stridor can help healthcare providers know where the blockage in your airway is located.

Stridor might indicate a collapsed airway or something blocking the airway. Regular COPD (like emphysema or chronic bronchitis) doesn’t cause stridor. However, stridor might occur in a condition called tracheobronchomalacia (when airways collapse), which can be linked to COPD and asthma.

5. Pleural Friction Rub

Pleural friction rub isn’t a sign of COPD, but it can occasionally be caused by COPD-related conditions. 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 — are inflamed, they can rub against the chest wall, producing sounds like grating, creaking, or crunching snow.

Pleural friction rub is most commonly caused by an infection like pneumonia, an autoimmune disease, or a pulmonary embolism. Pleural friction rub can be detected through a stethoscope and can be heard during both inhalation and exhalation.

6. Weaker Lung Sounds

People with COPD have weaker lungs, which can make the sounds of their breathing or coughing quieter than normal. A healthcare 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. They can tell you whether you have normal breath sounds.

Keep Your Doctor Informed

“I found out I have double pneumonia,” reported one MyCOPDTeam member. “I’ve never heard such weird noises come out of my lungs.”

“I found out I have double pneumonia. I’ve never heard such weird noises come out of my lungs.”

— A MyCOPDTeam member

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.

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