Medications like inhaled bronchodilators and steroids are vital to helping you breathe easier when you have COPD. But they're only part of the picture. You have many nonmedication management options for COPD that can improve your symptoms and slow the progression of the disease.
Chronic obstructive pulmonary disease (COPD) is a group of conditions that cause inflammation and damage in the air sacs of your lungs and breathing passages. Emphysema and chronic bronchitis are the most common. They make it hard to breathe and for your body to get enough oxygen.
While this may limit your activities, you can take steps to maintain and even improve your quality of life.
Pulmonary Rehabilitation
Your health care team will encourage you to take part in a pulmonary rehab program, which takes a multipronged approach to improving your COPD symptoms and your overall health, and helping you manage day-to-day living. Most hospitals and medical centers have them, and you can also do them online from home.
They're run by several types of specialists who offer:
Education: You learn about how the disease affects your respiratory system and the rest of your body. You may also learn:
- The correct way to take your medication
- How to use inhalers and breathing equipment
- Early signs of symptom flare-ups and what to do about them
- Tips for making daily activities easier
- Planning for the future with a will and advance directives
Exercise training. You start with a fitness assessment, then a therapist designs a workout program for you. They work with you to make sure you're doing the exercises correctly and safely.
Breathing techniques. Certain types of breathing, including pursed-lip breathing and diaphragm or belly breathing, can help you get more air and more oxygen. A respiratory therapist will teach these to you and help you recognize when to use them.
Nutrition advice. Pulmonary rehab typically offers classes with a registered dietitian. You learn diet strategies to help you stay strong and protect your overall health, plus handle the specific nutritional challenges of people with COPD.
Mental health counseling. You may have group or individual sessions with a therapist or counselor to address the mental health issues that can come from living with COPD.
Another benefit of pulmonary rehab is the opportunity to connect with others who are living with COPD.
Programs usually include two or three weekly sessions over a period of weeks or months. But you can take what you learn and continue to practice it on your own. Some programs have ongoing maintenance plans where you can come back for exercise or counseling sessions.
Pulmonary rehab is often covered by insurance, but you should check with your plan.
Oxygen Therapy
Over time, the damage to your lungs makes it hard to get enough oxygen into your blood. Oxygen therapy, or supplemental oxygen, can make up for that. It helps relieve symptoms like fatigue, weakness, and thinking and memory problems.
You get the oxygen from a tank or a machine, either through small tubes that fit into your nose (called a cannula) or a mask. You may use this all the time or just at certain times, like when you're sleeping or when you're exerting yourself. A respiratory therapist can teach you how to check your blood oxygen level with a small sensor that fits over a fingertip. You want the reading to be 90% or higher.
You can take oxygen wherever you go, even when you travel. Some equipment has a wheeled carrier, while a smaller tank can fit in a shoulder bag or backpack.
Using supplemental oxygen can cause some uncomfortable side effects, such as:
- Dryness in your nasal passages
- Bloody nose
- Tiredness
- Headaches in the morning
You can get a humidifier attachment to help with the dryness. It's also important to keep the equipment clean and remember to never smoke while you're using oxygen, or use it around an open flame or heat source.
Breathing Exercises
Your doctor will probably prescribe a medication for you to use when you're suddenly short of breath. But a respiratory therapist can also teach you ways to breathe more effectively.
Pursed lip breathing. You can use this technique to slow down your breathing and more fully empty your lungs. It can help you get more oxygen when you're exercising and stay calm if a flare-up is making you anxious.
- Breathe in through your nose for two counts.
- Pucker your lips like you're whistling.
- Breathe out slowly for four or six counts.
- Repeat as necessary.
Diaphragmatic (belly) breathing. This helps train the muscle that sits below your lungs (diaphragm) to work harder to help you breathe. It's best to practice this while you're sitting or lying down. Once you have the hang of it, you can do it any time you feel short of breath.
- Place one hand on your belly and the other on your chest.
- Breathe in through your nose, expanding your belly so that hand rises. (The hand on your chest should stay still.)
- Briefly hold your breath.
- Breathe out slowly through your mouth, contracting your belly so that the hand on your belly lowers.
Certain positions can help your lungs expand more fully, like sitting while you lean slightly forward and rest your hands on your knees, and lying on your side with your head and shoulders propped up on pillows and your legs bent at the hips and knees.
Airway Clearance Techniques
When you have COPD, cells in your airways make extra mucus to try to protect your lungs from inflammation. But then you have trouble coughing it out. Trapped mucus can clog your breathing and lead to an infection.
Several strategies can help, including:
More effective coughing. A respiratory therapist can teach you ways to make coughs more productive, like controlled coughing or the huff technique.
Postural drainage. You lie in different positions while you breathe deeply to get gravity to help move the mucus.
Percussion. Gentle tapping on your chest and back can loosen mucus. A vibrating vest works in a similar way.
Positive expiratory pressure (PEP) devices. These are handheld gadgets you blow into that create gentle resistance to help move the mucus.
To keep mucus thinner, drink plenty of water. Your doctor might recommend a medication like guaifenesin.
Breathing Devices
When you can't get enough air in and out of your lungs, you can end up with a condition called hypercapnia. That means too much carbon dioxide is being left in your lungs when you exhale, which can lead to respiratory failure.
A strategy called noninvasive ventilation can help with that. This uses a machine that provides the air pressure you need to get full breaths – like the devices that people with sleep apnea use to keep their airways open when they sleep.
The most common type of noninvasive ventilation used in COPD is called bilevel positive airway pressure (BiPAP). These devices include a mask that fits over your nose and mouth, or just your nose. Tubes attach to a machine that sends pressurized air through the mask. The BiPAP uses a higher level of pressure when you inhale and a lower level of pressure when you exhale. You might use this machine all the time, or just when you sleep.
Lifestyle Changes That Support Breathing
Stop smoking. This is the No. 1 step you can take to slow the progression of COPD. If you've tried before without success, talk to your doctor about classes, medications, or other resources that can help. You also need to stay away from secondhand smoke and other sources, like a wood-burning fireplace, campfire, or burning yard waste.
Avoid triggers. Make note of things that cause your symptoms to flare and try to avoid them. Besides smoke, some common triggers are:
- Chemical fumes
- Strong smells from perfumes or cleaning products
- Air pollution
- Pollen
- Dust
- Cold or hot air
It can help to use a mask or respirator, run a fan or open windows when you're using cleaning products or chemicals, and consider a whole-home air filter.
Get vaccinated. Colds, the flu, and other respiratory infections are the main cause of COPD symptom flares and can land you in the hospital. Vaccines can help keep you from getting many kinds of infections, or make them less serious if you do get one. Experts recommend people with COPD get vaccinated against:
- Flu
- Pneumococcal pneumonia
- COVID-19
- RSV
- Whooping cough (Tdap)
- Shingles
Check with your doctor to make sure you're up to date.
Protect yourself from infections. Beyond keeping up with your vaccines, you can avoid infections by washing your hands often, staying away from sick people, and wearing a mask if you're in a large group.
Exercise. If you're in a pulmonary rehab program, you'll learn safe ways to exercise. It may seem too hard when you already feel fatigued and out of breath, but if you avoid physical activity, those symptoms will only get worse as you get more and more out of shape.
It's important to talk to your doctor before you start an exercise program and know the signs that you're pushing yourself too hard. You can modify exercises to suit your abilities, like sitting down to do aerobics or strength training.
Eat right. People with COPD use much more energy to breathe, so it's vital to get enough calories and nutrients. That can be a challenge because you may not have an appetite or have the energy to fix meals. Being underweight can make you more likely to get infections, and being overweight can make breathing harder.
A registered dietitian can help you create an eating plan focused on nutrient-dense foods. Other tips:
- Rest before you eat.
- Choose soft foods that are easier to chew.
- Avoid things that can cause bloating, like cabbage, dairy, and carbonated drinks.
- Get help cooking from friends or family, or a service like Meals on Wheels.
Save your energy. COPD can make you so tired, it's hard to do everyday activities. Set a reasonable schedule for yourself that allows you plenty of time to rest. An occupational therapist can teach you adjustments that make tasks easier. Some things to try:
- Get organized so items you need are in easy reach and you make fewer trips.
- Sit – don’t stand – to do things like shaving or washing dishes.
- Choose outfits that are easy to put on and take off.
- Take advantage of assistive devices and mobility aids like a shower chair or a wheeled cart.
- Ask for help.
Keep up with your treatment plan. Take your medication as scheduled and have refills ready. Make sure you understand how to use equipment correctly, like your inhaler or BiPAP. See your doctor when you're supposed to so they can keep track of how well your treatment is working.
Pay attention to your overall health. COPD makes you more likely to have other health problems, like heart disease. At the same time, those other conditions can make COPD symptoms worse. Have regular health checkups, including dental visits, and get treatment for things like asthma, allergies, and reflux, which can cause flare-ups.
Get support. When you have a chronic health condition like COPD, it's common to struggle with feelings of sadness, anxiety, and isolation. Tell your doctor about your mood. They can connect you with a mental health professional like a therapist or counselor, or recommend medication for anxiety or depression.
You can also:
- Join a support group, like the American Lung Association's Better Breathers Club.
- Let your family and friends know you need help.
- Practice stress relief techniques like meditation or journaling.
When to Talk to Your Doctor
You should have regular appointments with your doctor to keep an eye on your lung function and adjust your treatment if necessary. In between, let them know if your COPD seems to be getting worse, or if you have signs of an infection. That can include:
- More frequent symptom flare-ups
- Needing to use rescue medications more often
- Changes in the color or amount of mucus you cough up
- Fever or chills
- Unexplained weight loss or gain
- Swelling in your legs or feet
- Extreme tiredness or weakness
Call 911 if you have severe chest pain, you can't catch your breath even after you use a rescue inhaler, your lips or fingers are turning blue or gray, or if you're disoriented or slurring your words.
Show Sources
Photo Credit: iStock/Getty Images
SOURCES:
American Lung Association: "Learn About COPD," "Treating COPD," "Understanding Your COPD Medications," "How Pulmonary Rehab Helps You Breathe," "Pulmonary Rehabilitation," "Oxygen Therapy," "Oxygen Therapy: Things to Know When Using Oxygen Therapy," "Pulse Oximetry," "Oxygen Therapy: Oxygen Delivery Devices and Accessories," "Prevent a COPD Exacerbation or Flare Up," "Vaccines that Protect Against Infectious Respiratory Diseases," "Physical Activity and COPD," "Nutrition and COPD," "Conserving Energy and Managing Your Daily Activities," "COPD and Emotional Health."
National Heart, Lung, and Blood Institute: "COPD: What Is COPD?" "COPD: Treatment," "Pulmonary Rehabilitation," "COPD: Prevention," "COPD: Living With," "COPD: Symptoms."
Mayo Clinic: "COPD."
COPD Foundation: "What is Pulmonary Rehabilitation?" "Oxygen Therapy," "Breathing Techniques," "Coping with Airway Mucus," "Quitting Smoking," "What is an Exacerbation or Flare-up?" "Exercise for Someone with COPD," "Nutrition for Someone with COPD," "Living and Coping with COPD."
Cleveland Clinic: "Pulmonary Rehabilitation," "Chronic Obstructive Pulmonary Disease (COPD)."
UCSF Health: "The Need For Supplemental Oxygen," "Your Oxygen Equipment."
Johns Hopkins Medicine: "Breathing Techniques," "Pulmonary Rehabilitation," "BiPap."
Frontiers in Medicine: "Airway Clearance Techniques: The Right Choice for the Right Patient."
StatPearls: "Noninvasive Ventilation."
Journal of Clinical Medicine: "Non-Invasive Ventilation: When, Where, How to Start, and How to Stop."
American Thoracic Society: "Exacerbation of COPD."
