COPD and Cough: How They’re Related and What You Should Know

Medically reviewed by Suzanne Falck, MD on June 9, 2017Written by Debra Stang and Christine Case-Lo

How are chronic obstructive pulmonary disease and cough related?

If you have chronic obstructive pulmonary disease (COPD), you’ll likely experience one or more of the following four symptoms:

  • shortness of breath, especially with activity
  • wheezing or producing a gasping, whistling sound when you try to breathe
  • feeling tight or constricted in your chest area
  • coughing that produces moderate to large amounts of mucus or sputum

People tend to find coughing the most disruptive of these symptoms. Coughing can interfere with social events, such as going to the movies, and it can prevent you from falling asleep at night. Many people go to their doctor or an urgent care center seeking relief from the chronic coughing associated with COPD.

As annoying as this coughing may be, it actually serves a useful function. Deep coughing clears the mucus that clogs your airways, allowing you to breathe more easily.

Some doctors teach their patients how to cough and encourage them to do so often. Some experts even go a step further and advise against doing anything to stop the coughing, as a clear airway means easier breathing in the long run.

What causes coughing with chronic obstructive pulmonary disease?

If you’ve had COPD for a while, you probably know how much you usually cough. If you find yourself coughing more than usual, or coughing up sputum that looks different than it normally does, it may be time to go to the doctor to make sure you’re not having a flare-up or an exacerbation.

An increase in coughing can have several causes. Your body may be producing more sputum or mucus. Exposure to irritants, especially cigarette smoke or harsh fumes, can also increase coughing.

You may also be coughing more because you’ve developed a comorbidity, which means another illness exists alongside your COPD. Examples of comorbidities include infections such as pneumonia or influenza, or issues like gastroesophageal reflux disease (GERD). When you lie down, GERD can push stomach acid into your throat and mouth and cause you to cough.

If your increased coughing is due to a comorbidity, you can use antibiotics or medications to return to your regular level of coughing. Don’t make any assumptions, though — speak to your doctor, who will make a diagnosis and prescribe you the right medication.

What are the treatments for coughing?

Most importantly, stop smoking to put an end to “smoker’s cough,” the dry, hacking cough common among people who smoke tobacco. A deep, productive cough that clears the airways of mucus may replace this dry cough.

Long-acting inhaled beta-agonists such as salmeterol sometimes decrease coughing. Beta-agonists are another type of bronchodilator, which help open your airways and get more oxygen into your lungs.

Some researchers have studied the effectiveness of cough syrup with codeine. Although a few small studies showed a significant reduction in coughing, other studies were unable to reproduce that result. Using cough syrup and codeine to control coughing is a decision for you and your doctor to make together.

There are other medications that are important for COPD control but that don’t affect the cough. These include:

  • corticosteroids such as prednisone (Rayos, Prednisone Intensol)
  • long-acting anticholinergics such as tiotropium (Spiriva), which can actually make the cough reflex more sensitive

Learn more: COPD drugs: A list of medications to help relieve your symptoms »

Can you have COPD without a cough?

COPD results in coughing and excess mucus production, but not in the case of emphysema. Emphysema is one of the diseases classified as COPD. It’s a progressive disease in which the alveoli, or air sacs, in your lungs begin to collapse.

Emphysema may have no symptoms other than shortness of breath. Many people who develop emphysema can have no cough or excess mucus production. Some people have both emphysema and chronic bronchitis.

Emphysema is a serious disease with the potential for severe complications. If you have shortness of breath during even simple activity, see your doctor for an evaluation. You may have a form of COPD, even without an annoying cough.

What is the long-term outlook?

Although coughing is a primary symptom of COPD, surprisingly little research has been done on controlling it or even on whether or not it should be controlled. If coughing interferes with your quality of life, talk to your doctor to find treatment options.

Q&A: How to cough

Q:

What coughing technique can help bring up mucus in chronic cough?

A:

Here is a coughing technique, called huff cough, to bring up mucus that won’t wear you out. This can be helpful in those with an ongoing cough due to COPD or other chronic lung conditions. It’s helpful to work with your doctor or respiratory therapist when learning this technique.

  1. Sit up straight in a chair with your head up. 
  2. Breathe in using your abdomen and hold for 2 or 3 seconds.
  3. With the back of your throat open let out your air in a burst, making a “ha” sound.
  4. Do 2 to 3 huff breaths, then rest for 5 to 10 breaths.
  5. Repeat this in cycles.

The larger the breath, the more effective it is for smaller airways.

Judith Marcin, MDAnswers represent the opinions of our medical experts. All content is strictly informational and should not be considered medical advice.
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