If you’ve been living with chronic obstructive pulmonary disease (COPD) for a long time, you may have experienced exacerbations or sudden flare-ups of respiratory symptoms. Symptoms of breathlessness, coughing, and wheezing are indications of COPD exacerbations. Without quick and careful treatment, these symptoms could make it necessary to seek emergency treatment.

COPD flares can be frightening and uncomfortable, but their effects go beyond the attack itself. Research shows that the more exacerbations you experience, the more hospitalizations you’ll need.

Learning to prevent and manage exacerbations can help you stay on top of initial signs of an attack, be healthier, and avoid urgent trips to the doctor.

Signs of a COPD flare

During a COPD exacerbation, your airway and lung functions change quickly and dramatically. You may suddenly experience more mucus clogging your bronchial tubes, or the muscles around your airways may constrict significantly, cutting off your air supply.

Symptoms of a COPD flare are:

  • Breathlessness or shortness of breath. Either feeling like you can’t breathe deeply or gasping for air.
  • Increase in coughing attacks. Coughing helps to rid your lungs and airways of blockages and irritants.
  • Wheezing. Hearing a wheeze or whistling noise when you breathe means that air is being forced through a narrower passageway.
  • Increase of mucus. You may begin to cough up more mucus, and it may be a different color than usual.
  • Fatigue or sleep problems. Sleep disturbances or exhaustion can indicate less oxygen is getting to your lungs and through your body.
  • Cognitive impairment. Confusion, slowed down thought processing, depression, or memory lapses can mean the brain isn’t receiving enough oxygen.

Do not wait to see if your COPD symptoms improve. If you’re struggling to breathe and your symptoms are getting worse, you need to medicate appropriately and right away.

4 steps to manage your COPD flare

When you experience a COPD flare, the first thing to do is review the COPD action plan that you created with your doctor. It likely outlines specific actions, doses, or medications around these steps to manage a flare.

1. Use a quick-acting inhaler

Relief or rescue inhalers work by sending a powerful stream of medicine straight to your constricted lungs. An inhaler should help relax the tissues in your airways quickly, helping you breathe a little easier.

Common short-acting bronchodilators are anticholinergics and beta2-agonists. They’ll get to work more effectively if you use them with either a spacer or nebulizer.

2. Take oral corticosteroids to reduce inflammation

Corticosteroids reduce swelling and may help to widen your airways to let more air in and out of your lungs. If you don’t already include them in your treatment plan, your doctor may prescribe corticosteroids for a week or more after a flare to help get the inflammation under control.

3. Use an oxygen tank to get more oxygen into your body

If you use supplemental oxygen at home, you may want to take advantage of the supply during a flare. It’s best to follow the COPD action plan designed by your doctor and attempt to relax to control your breathing while you’re breathing in oxygen.

4. Shift to a mechanical intervention

In some situations, rescue medication, anti-inflammatory steroids, and oxygen therapy won’t bring your exacerbation symptoms back down to a manageable state.

In this instance, you may need a machine to help you breathe through a process known as a mechanical intervention.

If you notice that your at-home treatment isn’t bringing you relief, it’s best for you to reach out for help. Call an ambulance, or have a loved one make the call for you. Once you arrive at the hospital, you may need an intravenous bronchodilator like theophylline to help bring your symptoms under control.

You may also need an IV to rehydrate your body, as well as antibiotics to prevent respiratory infections like pneumonia.

Prevention and preparation can make the difference between an uncomfortable COPD flare and hospitalization.

It’s important to talk to your doctor about rescue medication to take when an unexpected situation triggers your symptoms.

Fortunately, most people recover their breathing after taking steps to contain their symptoms.

During an episode, try to stay calm to minimize your symptoms. But if you feel overwhelmed, reach out for help right away.


NewLifeOutlook aims to empower people living with chronic mental and physical health conditions, encouraging them to embrace a positive outlook despite their circumstances. Their articles are full of practical advice from people who have firsthand experience of COPD.