5 Signs Your COPD May Be More Severe Than You Think

Medically Reviewed By Adithya Cattamanchi, M.D.

When you notice your shortness of breath increases or your cough worsens, avoid assuming it’s a temporary flare-up. When symptoms don’t improve, it’s time to talk with your doctor about a possible treatment change.


Chronic obstructive pulmonary disease (COPD) is a serious respiratory condition that includes emphysema and chronic bronchitis. Because there is currently no cure, the treatment goal is to manage symptoms and slow the disease progression.

When COPD symptoms suddenly worsen, it’s called a flare-up or an exacerbation, and it sometimes results from an infection of the lungs or the airways leading to and from the lungs. Allergies can also cause exacerbations and temporary changes in symptoms.

However, it’s important to understand that when certain symptoms become more frequent or severe, they may be signs that your COPD is worsening. These symptoms may include the following:

1. Worsening shortness of breath

Shortness of breath is a major symptom of COPD. If you notice you have an increasingly difficult time catching your breath while doing the same activities you managed to do recently without much of a challenge, take that as a sign that your COPD is becoming more serious.

A stronger medication dosage or a medication change may be all it takes to improve your breathing. You may also need to make certain lifestyle adjustments, too. In any event, avoid ignoring worsening shortness of breath.

2. More coughing

If you develop a new cough or an existing one worsens or becomes more frequent for more than a few weeks, you may have worse COPD or a new infection.

Your doctor may order a chest X-ray to help determine whether the cough relates to physical changes in your lungs or whether you need a physical evaluation of your heart. Conditions such as heart failure can include coughing among their symptoms. Tests for other conditions, such as COVID-19, may also be appropriate.

3. Increased phlegm production

If your cough produces more phlegm or sputum, it could mean that your COPD is worsening or that you have a respiratory infection. This is particularly true if your phlegm turns from clear to yellow or green.

According to the American Thoracic Society, a change in the thickness, color, or amount of phlegm is usually an early indication of a worsening lung health condition.

4. Increased wheezing

Wheezing is common among people with COPD, but not everyone with the condition wheezes. Inflammation of the airways can cause them to constrict, which then causes wheezing when inhaling and exhaling.

A 2015 study Trusted Source PubMed Central Highly respected database from the National Institutes of Health Go to source suggested that if wheezing becomes worse or if new-onset wheezing begins, it could indicate worsening breathing function in people with COPD. Asthma can also cause wheezing, and sometimes asthma and COPD are present at the same time.

5. Feeling more fatigued than usual

Daytime sleepiness or just an overall sense of exhaustion and reduced energy could signal that your muscles, organs, and other tissues are not getting enough oxygen due to COPD complications.

Finding care

If you notice worsening COPD, contact your doctor to talk about the symptom changes. You can reduce the damage to your lungs or airways if a doctor evaluates and treats your symptoms promptly.

You can also talk with your doctor about pulmonary rehabilitation, a program that teaches helpful breathing techniques and other strategies to improve your exercise tolerance. Not everyone with COPD needs pulmonary rehabilitation, but it may be helpful to know more about it.

Reduce your risk

For some people with COPD, symptoms can worsen because they have challenges following their treatment guidelines and doctor recommendations closely. Worsening symptoms may also develop from not using a bronchodilator inhaler properly.

The appropriate amount of medication must reach your airways to reduce inflammation and help them relax. Review inhaler techniques with a nurse or even a pharmacist.

If you smoke, you can lower your risk of COPD exacerbations by reducing or quitting smoking. If you do not smoke, avoiding secondhand smoke and air pollution, when possible, can also help lower your risk of COPD exacerbations.

Getting an annual flu shot, staying up to date with COVID-19 vaccines, and getting a pneumonia vaccine can also help lower your risk of COPD exacerbations. Talk with your doctor first to see if these vaccines are right for you.

You can also reduce your infection risk by avoiding close physical contact with people with the flu or other contagious respiratory conditions and regularly washing your hands.


There is currently no cure for COPD, but with proper treatment and healthy lifestyle choices, you can manage symptoms Trusted Source World Health Organization Highly respected international organization Go to source and maintain your respiratory health. The key is to pay close attention to your health and changing symptoms and quickly get medical attention when changes occur or your symptoms worsen.

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  1. Chronic obstructive pulmonary disease. (2023). https://www.nhsinform.scot/illnesses-and-conditions/lungs-and-airways/copd/chronic-obstructive-pulmonary-disease
  2. Chronic obstructive pulmonary disease (COPD) [Fact sheet]. (2023). https://www.who.int/news-room/fact-sheets/detail/chronic-obstructive-pulmonary-disease-(copd)
  3. Chronic obstructive pulmonary disease (COPD). (n.d.). https://www.lung.org/lung-health-diseases/lung-disease-lookup/copd
  4. Signs and symptoms of COPD. (2019). https://www.thoracic.org/patients/patient-resources/resources/signs-symptoms-of-COPD.pdf
  5. Wheezing, a significant clinical phenotype of COPD: Experience from the Taiwan Obstructive Lung Disease Study. (2015). https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4603716/

Medical Reviewer: Adithya Cattamanchi, M.D.
Last Review Date: 2023 Mar 31
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