Flare-Ups: When COPD Suddenly Gets Worse

Symptoms, Triggers, Prevention, and Management of Flare-Ups

COPD is a lung disease that makes it difficult to breathe. Although there isn’t a cure, it can be managed with appropriate therapy including diet, exercise, sleep, and medication.

But sometimes, the symptoms of COPD suddenly get worse. You find it even harder to breathe, you cough up more mucus, you have trouble sleeping. This condition is known as a COPD flare-up or COPD exacerbation

Flare-ups can last for days or even weeks. Without the proper treatment, you may even have to go to the hospital. Research shows that the more flare-ups you have, the more hospitalizations you’ll need. And flare-ups in people In the later stages of COPD may cause irreversible lung damage.

Lesley Williams, Apria’s Market Clinical Trainer and registered respiratory therapist, says, “Recognizing the symptoms of a COPD flare-up is critical in order to get the appropriate treatment quickly.”

Symptoms of Flare-Ups

It’s important to be aware of your day-to-day COPD symptoms and to recognize the symptoms specifically of a flare-up. These may include:

  • More coughing, wheezing, or breathlessness than usual
  • Increased production of mucus, which may be green, yellow, or brown
  • Fatigue or trouble sleeping
  • Morning headaches
  • Abdominal pain
  • Anxiety
  • Swelling of the legs or ankles
  • Gray or pale skin
  • Confusion and memory lapses
  • Fever, scratchy throat, or other cold or flu symptoms

Some symptoms may indicate a more serious flare-up. You should call your doctor or 911 immediately if you experience the following:

  • Extreme shortness of breath
  • Chest pains
  • Blue or purple lips or fingernails
  • Confusion, inability to think clearly
  • Extreme drowsiness

Triggers of a Flare-Up

Causes of a COPD flare-up include:

  • Certain illnesses and lung infections due to bacteria or viruses
  • Exposure to pollen, dust, and allergens such as ragweed
  • Cigarette or cigar smoke
  • Smog and other kinds of air pollution
  • Strong scents such as perfumes
  • Anxiety or stress
  • Being overly active
  • Changes in the weather or season
  • Hot, cold, or humid air

What to Do During a Flare-Up

All COPD flare-ups aren’t the same. Some are mild, where you are more breathless than usual. Some are moderate, where you cough up mucus more than usual. And some are severe, where your symptoms get worse, even if you are taking your medication as prescribed. That’s when it’s time to call your doctor or 911.

Apria’s Lesley Williams adds, “Fortunately, most people recover from a flare-up with proper and timely treatment.

Generally, here are some rules to follow to manage a COPD flare-up.

Be prepared. Have all your emergency information close at hand. That includes the names and numbers of your loved ones, your doctor, a list of medications you take, (including your oxygen prescription) and your healthcare insurance information.

Remain calm. Getting panicky may worsen your symptoms. Use a quick-acting rescue inhaler, which sends the medicine directly to your lungs. Rescue inhalers help relax your airways to allow you to breathe more easily. Other treatments include antibiotics or steroids taken by mouth, anti-anxiety medicines, or medicine taken through a nebulizer.

If prescribed by your doctor, take an oral corticosteroid. These reduce inflammation to allow air to flow more freely in and out of your lungs

Use an oxygen tank. Again, if your doctor has prescribed an oxygen tank, use it to get more oxygen into your body more quickly to help treat your symptoms.

If symptoms are severe, call 911. If the rescue inhaler, corticosteroids, or oxygen therapy don’t bring your symptoms under control, call 911; an ambulance will come and take you to the hospital. The doctors there will decide on the best treatment for you, which may be either mechanical intervention (where a machine helps you breathe), an intravenous (IV, meaning “into the vein”) bronchodilator, or an IV to deliver antibiotics and fluids to ensure you are well hydrated.

How to Prevent Flare-Ups

There are many things you can do to reduce your risk of having a COPD flare-up:

  • Speak with your doctor about beginning a pulmonary rehabilitation program
  • Take your medicines as directed
  • Use oxygen if prescribed by your doctor
  • Use Bi-PAP or Non-Invasive Ventilation (NIV) if prescribed by your doctor
  • Go to all your regular health checkups
  • Get all your recommended vaccines, including flu shots
  • Ask your doctor about a shot to protect you from pneumonia
  • Get plenty of sleep
  • Eat a nutritious, well-balanced diet rich in lean proteins, fish, fruits, and vegetables
  • Exercise—talk to your doctor about a routine right for you
  • Stay away from people with colds and other contagious viral infections
  • Wash your hands often
  • Refrain from touching your mouth, nose, or eyes to prevent germs from entering your body
  • Quit smoking and avoid secondhand smoke, pollutants, or strong scents or odors
  • Throughout the day, take breaks in activity to give your lungs time to recover
  • Stay away from crowds, especially during cold and flu season
  • Be careful outdoors. If it’s too cold, wear a scarf over your mouth or nose. If it’s hot and humid, remain inside with air conditioning
  • Practice breathing exercises and other relaxation techniques

You Can Manage COPD Flare-Ups

By recognizing the symptoms, understanding the triggers, knowing what to do during COPD flare-ups, and how to prevent them in the future, you will be better able to control them and reduce their severity.

Apria’s Lesley Williams advises, “If you have questions or need more information, speak with your doctor, who can work with you to create a COPD flare-up plan specifically for you.”

Apria is a leader in COPD management

We offer custom treatment plans, work closely with your physician’s office care team to manage your COPD through its many stages, deliver a wide range of treatment options, and provide ongoing monitoring to optimize your treatment. Learn more.

1. Hadjiliadis, D, et al. (2021, December 6). COPD flare-ups. Medline Plus.
2. WebMD Editorial Contributors. (2021, March 18). What Is a COPD Flare-up? WebMD. https://www.webmd.com/lung/copd/what-is-a-copd-flare-up.
3. Weatherspoon, D. (Updated 2019, January 14). 4 Steps for Managing a COPD Flare-Up. Healthline. https://www.healthline.com/health/copd/steps-for-managing-copd-flare.
4. Understanding COPD exacerbations. COPD.com. https://www.copd.com/copd-progression/copd-exacerbations/.
5. Geng, C. (Updated 2022, July 21). What to know about COPD flare-ups. Medical News Today. https://www.medicalnewstoday.com/articles/copd-flare-up.

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About the AuthorApria

Apria is a leading provider of home healthcare equipment and related services across the USA, offering a comprehensive range of products and services for in-home care and delivery of respiratory therapy, obstructive sleep apnea treatment, and negative pressure wound therapy, along with additional equipment and services.