Managing COPD Exacerbations: Essential Tips for Prevention and Relief
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How to Manage COPD Exacerbations

Learn practical tips to handle COPD exacerbations and experience quicker recovery with our expert-vetted guide.
How to Manage COPD Exacerbations
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Published on July 22, 2024
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If you have COPD, you may have experienced your share of flare-ups. In fact, COPD flares play a lead role in this progressive lung disease, and usually result in increased trouble breathing, a chronic cough, and wheezing.

Almost 16 million adults have COPD in the United States and about 3 in 4 people with this condition have at least one flare (exacerbation) a year, cites a review.

But you don’t have to sit and wait for your next COPD flare to hit — you can follow the strategies below to avoid an exacerbation and manage worsening symptoms as they come.

Identifying Triggers

No matter the cause of your COPD, flare symptoms arise from lung inflammation (swelling and irritation). Quite a few factors can trigger inflammation and increased mucus production, which narrow your airways and lead to a COPD flare.

 These triggers fall into a few different categories.
Infections About 50 to 70 percent of COPD exacerbations come from respiratory infections, according to a study, which reports the most common flare-causing infections include bacteria and viruses like the common cold (rhinovirus) and the flu.

Newer on the scene, the COVID-19 virus can also lead to COPD flares, according to the NHLBI.

 This virus damages the air sacs in the your lungs, which can trigger additional COPD symptoms.

 In general, viral infections come with a longer flare recovery, according to a study.

 Although researchers aren’t sure why, they suspect viruses may hit harder because they target the same lung cells as COPD.

Environmental Factors Only 10 percent of COPD flares arise from environmental factors, like air temperature and pollution.

 Anyone with COPD may experience slightly different environmental triggers, and it’s important to note which seem to irritate your lungs. Some common triggers in this category include:

Other Health Conditions When you have other health conditions, they can also trigger COPD flares. Congestive heart failure (CHF), for example, not only shares symptoms with COPD (like shortness of breath), but in people with both, almost one fourth of flares are triggered by cardiovascular symptoms, according to a small study.

Mental health disorders like anxiety and depression can also increase your risk for COPD flares by weakening your immune system and making medications less effective.


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Tips to Prevent Flare-Ups

You can do a lot to prevent COPD flare-ups by taking medicines, protecting against illness with vaccinations, and avoiding known triggers.

Stick with your medications. Your COPD can flare quickly if you don’t take your long-term medications, per Cleveland Clinic.

 “Remember to take your inhalers. Inhalers are sometimes difficult to use, and so contact your doctor or pharmacy if you need help with an inhaler,” says Uddalak Majumdar, MD, a pulmonary specialist at Cleveland Clinic in Ohio.
Consider vaccinations. Regular flu, pneumonia, and COVID-19 vaccinations can keep you protected against the most common COPD flare trigger: infection.

 Not sure what you’ve had and what you need? Discuss vaccination with your healthcare provider and they can help you make a plan, says Dr. Majumdar.

Avoid triggers. Make note of environmental triggers that are affecting your condition. Over time, you’ll more easily anticipate what will irritate your lungs, and know how best to avoid those situations. One important trigger for many is cigarette smoke, says Majumdar.

“Quitting smoking is the most important step to help with COPD,” says Majumdar. When you’ve smoked over many years, it’s not easy to stop. But you don’t have to do it alone. The Centers for Disease Control and Prevention offers free support to help you say goodbye to cigarettes.

How to Recognize Flare-Ups

“The key symptoms of a flare-up or exacerbation are an increase in shortness of breath or coughing. You may also cough up more mucus and the color of the mucus can change,” says Majumdar, who adds that many people also feel feverish, fatigued, and need to use their inhalers more often.

Symptom Check The American Lung Association offers a free COPD action plan to help you monitor your symptoms and recognize flares. This guide lists symptoms to watch for and tells you when it’s time to call your healthcare provider or go to the emergency room.

Peak Flow Meter Once you get a COPD diagnosis, your healthcare provider may send you home with a peak flow meter, which is designed to measure the force and amount of exhaled air. This hollow, narrow, clear tube comes with markings to help you identify your “score,” which can give you an early sign of an imminent flare.

What to Do During a COPD Episode

If you’re feeling symptoms of a possible COPD exacerbation, it’s always a good idea to give your healthcare provider a call right away. The earlier you can catch a flare, the faster you can get on top of it.

Follow your action plan. If you follow the steps laid out in your action plan, you may be able to tackle your COPD flare at home, cites the American Lung Association. Your action plan may include things like:

  • Use prescribed quick relief inhalers or nebulizers.
  • Use prescribed oxygen.
  • Try pursed lip breathing exercises (breathing in through your nose and out through pursed lips).

Go to the hospital if necessary. No matter what, if you experience severe symptoms, you should go to the ER immediately, advises Majumdar, who reports these symptoms as:

  • Shortness of breath even without moving
  • Severe shortness of breath preventing any activity
  • Fever with chills
  • Not being able to sleep or lie down because of shortness of breath or coughing
  • Coughing up blood
  • Chest pains
  • Feeling confused or drowsy
The NHLBI also recommends an ER visit if you’re not as mentally alert, you have a fast heartbeat, or your lips or fingernails look blue or gray.

How to Manage COPD for the Long-Term

Flares aside, COPD management takes consistency and frequent check-ins with your provider. “COPD can be a tricky disease with ups and downs, and a doctor needs to keep an eye on the course of disease,” says Majumdar. “It is crucial to follow up with doctors' appointments and take your meds.”

Majumdar recognizes frequent follow-ups can pose challenges in terms of transportation, time, and taking time off work, which is why he recommends virtual visits for some check-ins.

When you see your provider often, they can stay on top of your lung function testing, adjust your treatments as necessary, and stay ahead of any exacerbations more easily.

If you experience frequent COPD flares, your provider may recommend additional treatment options, like pulmonary rehabilitation, oxygen therapy, additional medications and (more rarely) surgery.

But overall, long-term COPD management means taking your prescribed medications, following your action plan, and avoiding your triggers.

The Takeaway

COPD flares can be triggered by infections, environmental irritants, and other health conditions. To prevent COPD flare-ups, take your medications as prescribed, get vaccinated against common illnesses, and avoid your triggers.

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Philip Diaz, MD

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Philip Diaz, MD, is a board-certified pulmonologist and critical care specialist and a professor of medicine at The Ohio State University. He specializes in caring for patients with chronic obstructive pulmonary disease (COPD) and in pulmonary rehabilitation for all patients who suffer from lung disease.

Dr. Diaz is passionate about patient education and feels very strongly about providing patients an opportunity to participate fully in their own care. His goal is to work together with his patients to achieve the best quality of life possible for them.

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Abby McCoy is an experienced registered nurse who has worked with adults and pediatric patients encompassing trauma, orthopedics, home care, transplant, and case management. She is a married mother of four and loves the circus — that is her home! She has family all over the world, and loves to travel as much as possible.

McCoy has written for publications like Remedy Health Media, Sleepopolis, and Expectful. She is passionate about health education and loves using her experience and knowledge in her writing.

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Resources
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