Chronic Obstructive Pulmonary Disease (COPD) Flare-Up

Medically Reviewed By Nick Villalobos, MD

A chronic obstructive pulmonary disease (COPD) flare-up is when your COPD symptoms worsen. Triggers can include weather changes, physical activity, and infections. COPD is a group of conditions that make breathing difficult. It includes emphysema and chronic bronchitis.

If you have COPD, your symptoms may not always feel the same day to day. Some days, you may feel good, and other days your symptoms worsen. A COPD flare-up is when you feel worse.

What are the symptoms of COPD flare-ups?

Someone holds a blue inhaler to their mouth.
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A COPD flare-up may cause your symptoms to become more severe and frequent or affect your quality of life. Symptoms may include:

  • more coughing
  • difficulty sleeping
  • being short of breath or having difficulty breathing
  • wheezing or making noises while breathing
  • fatigue
  • lower oxygen levels
  • headaches
  • changes in the mucus or phlegm you cough up, such as changes in the:
    • amount
    • color
    • thickness

Knowing your symptoms on typical days can help you know when your symptoms may be changing or worsening. Keeping a symptom diary can help you keep track of:

  • your symptoms and their severity
  • when symptoms appear
  • when symptoms are at their best and worst throughout the day
  • your habits and activities before periods of particularly good or bad symptoms
  • when you take your treatment

How long does a COPD flare-up last?

The length of a flare-up can vary.

A 2021 study suggests that most flare-ups take 2–3 days Trusted Source Wiley Peer reviewed journal Go to source to develop and last for around 7–14 days. Some may even last for more or less time.

Some flare-ups don’t return to how they were before. However, effective treatment and prevention can help reduce this likelihood.

In studies, researchers say people with COPD experienced an average of 0.85–1.30 Trusted Source American Journal of Clinical Nutrition Peer reviewed journal Go to source yearly.

What causes a COPD flare-up?

Specific triggers increase levels of inflammation in the airways, which causes flare-ups. Triggers can include:

  • respiratory infections, such as the common cold or sinus infections
  • physical activity
  • wind
  • changes in weather or extreme temperatures, such as stormy, cold, or humid weather
  • allergens, such as pollen or dust
  • air pollution
  • fumes, gases, and other irritating chemicals, such as cleaning products
  • fragrances and aerosols
  • smoke, such as from tobacco or other burning substances

Sometimes the cause of a flare-up is unknown.

When should I see a doctor?

If your symptoms change or worsen, contact a doctor. If you have any severe or concerning symptoms, such as severe difficulty breathing, call 911 or local emergency services.

If you’ve received a COPD diagnosis, be sure to follow your doctor’s instructions.

How is a COPD flare-up diagnosed?

Your doctor will want to know about your symptoms and medical history. If you’ve experienced a flare-up, it may be likely you’ll have another. They will also perform a physical exam.

Also, your doctor will want to rule out other possible causes, such as Trusted Source PubMed Central Highly respected database from the National Institutes of Health Go to source pneumonia or heart failure. These conditions can be common Trusted Source PubMed Central Highly respected database from the National Institutes of Health Go to source alongside COPD. Your medical team may ask you to complete surveys about your symptoms. Your answers can help rule out other conditions and confirm a flare-up.

How do you treat COPD flare-ups?

Treatment will depend on the severity of your flare-up.

The American Thoracic Society says some cases can be treated at home. Treatment can include:

  • preventive and quick-relief inhalers containing:
    • corticosteroids
    • long-acting beta-agonists
  • antibiotics for bacterial infections

Severe cases may require emergency or hospital care if they don’t respond to at-home treatment. This can include:

  • intravenous (IV) steroids given through a vein
  • nebulized medications, which use a machine to create a medicated vapor for you to breathe in
  • oxygen therapy, such as with a mask or nasal tubes
  • positive airway pressure (PAP) machine to help you breathe
  • mechanical ventilation, a machine that breathes for you

Learn more about medications and treatments for COPD.

How do you prevent COPD flare-ups?

Not all flare-ups can be prevented, but some approaches may help you reduce the risk of a flare-up or its severity. These include:

  • quitting smoking if you smoke
  • avoiding close contact or wearing an N95 respiratory mask when around people with respiratory infections
  • washing your hands thoroughly and regularly
  • staying up to date with your vaccinations, such as getting the flu vaccine each year
  • monitoring your symptoms with a pulse oximeter
  • talking with your doctor about using a PAP device at home
  • following your prescribed treatment plan and keeping all scheduled appointments
  • checking in with your doctor if you notice any symptom changes or have any questions

Some treatments, such as preventive inhalers, can also help you manage symptoms and reduce the risk of flare-ups.

Read more advice for preventing infections such as the flu.

What is the outlook for COPD flare-ups?

Some COPD flare-ups are mild, and others are severe and may become long term or life threatening.

Your outlook may vary depending on many factors and differ with each flare-up. A 2022 literature review suggests that the following factors may increase the likelihood of having a moderate or severe flare-up:

  • having had a flare-up before
  • having more severe COPD even when not experiencing flare-ups
  • having other health conditions in addition to COPD
  • being older
  • having higher levels of white blood cells called eosinophils, a sign of inflammation
  • smoking
  • having a lower body mass index (BMI)
  • being exposed to colder temperatures and air pollution

Treatment can prevent or reduce the severity of flare-ups. Be sure to talk with a doctor to determine the best course of treatment.


A COPD flare-up is when your symptoms worsen. Irritants — such as respiratory infections, smoke, and allergens — can trigger airway inflammation, which makes breathing difficult.

You may notice wheezing, more mucus production, and more frequent coughing when symptoms worsen.

Treatment for flare-ups includes following your doctor’s instructions and hospital support, such as oxygen therapy and IV steroids. The exact treatment can depend on the severity of the flare-up.

Call 911 for severe or concerning symptoms, or contact a doctor if you experience mild changes.

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Medical Reviewer: Nick Villalobos, MD
Last Review Date: 2023 Jul 28
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