How to live healthily with COPD

What is COPD?

COPD is a group of lung conditions, like chronic bronchitis and emphysema, that make it difficult to empty air out of your lungs because the airways have become narrowed.

"When this happens, it can cause symptoms like persistent cough, getting short of breath easily when walking or doing everyday things, wheezing in cold weather, or producing more phlegm than usual," explains Jessica Kirby, head of health advice at the  British Lung Foundation.

"These COPD symptoms can happen all the time, or they can get worse if you get an infection or breathe in smoke or fumes," she says. "COPD mostly develops because of long-term damage to your lungs from breathing in a harmful substance. This is often cigarette smoke, as well as smoke from other sources and air pollution.

Jobs where people are exposed to dust, fumes and chemicals can also contribute to developing COPD. You're most likely to develop COPD if you're over 35 and are, or have been, a smoker or had chest problems as a child. However, this isn't always the case."

According to a 2020 US study, up to 30% of cases occur in people who have never smoked. Furthermore, only a minority of heavy smokers develop the disease, suggesting that there are other risk factors at play. The research found people with small airways relative to the size of their lungs may have a lower breathing capacity and, consequently, an increased risk for COPD.

An inherited condition called alpha1-antitrypsin deficiency also increases the risk of developing COPD, including in people who have never smoked.

Patient picks for Chronic obstructive pulmonary disease

Chest and lungs

Acute exacerbations of COPD

An acute exacerbation is more commonly known as a 'flare-up'. An acute exacerbation of chronic obstructive pulmonary disease (COPD) is a sudden worsening of COPD symptoms compared with the usual severity of symptoms. This often means a worsening of breathlessness and an increase in coughing, with more phlegm (sputum).

by Dr Colin Tidy, MRCGP

How to be more healthy living with COPD

While there is no cure for COPD, the condition can be managed to help keep COPD symptoms under control, to reduce the risk of flare-ups and help people breathe more easily.

Create a plan with your healthcare professional

"It's really important to have a self-management plan, that's filled out with your doctor or specialist nurse, so you know how you can stay well and what to do if your symptoms worsen," says Kirby.

"Depending on how severe the condition is, you may be offered medicines such as an inhaler that helps open the airways, called a bronchodilator, or steroid inhalers. It's important to take your inhalers and medicines exactly as prescribed as this can reduce the risk of a flare-up."

At the more severe end of the spectrum, some people benefit from oxygen therapy if their blood oxygen levels are low, or non-invasive ventilation: this involves wearing a mask connected to a machine that pushes air into your lungs.

Keep active

Regular exercise can help improve your COPD symptoms and quality of life, but the amount you can do will depend on your individual circumstances. If you haven't exercised for a long time or you want to try a new type of exercise, it's a good idea to speak to your doctor first. In time, you should be able to build up the amount you do.

You may be advised to participate in a pulmonary rehabilitation programme, which will include a structured exercise plan tailored to your needs and ability. "Pulmonary rehabilitation is one of the methods used to help control symptoms," says Kirby.

"It  is designed specifically for people diagnosed with lung conditions and comprises a team of trained healthcare professionals who provide a physical exercise plan, information on looking after the body and lungs, and advice on managing COPD."

Courses are held in groups in local hospitals, community halls, leisure centres and health centres and last around eight weeks. There are many other ways to be active, including joining an exercise class, walking, gardening or taking up sports and activities like dancing or yoga. "All movement counts and is a great way to strengthen the lungs," Kirby adds.

Eat well

"If you have a long-term lung condition, eating a balanced diet with lots of variety can also help keep you feeling well," says Kirby. "Fruits and vegetables have vitamins and minerals that support your immune system to help you fight off chest infections. Starchy carbohydrates such as brown pasta or rice, give your body energy for breathing."

Proteins like chicken and oats can help to keep the chest muscles strong, Kirby adds. "Dairy foods are a good source of calcium and vitamin D for healthy bones - important if you take long-term steroids as these increase the risk of brittle bones or osteoporosis," she says. "Finally, oils contain vitamins A and E, which are important for fighting infections."

It's also important to drink plenty of fluids - around six to eight glasses each day - to help maintain hydration and keeps mucus moving, which helps prevent chest infections.

Try to avoid triggers

Although it's not always possible, avoiding certain triggers can help reduce COPD symptoms and the chances of a flare-up. This includes car exhaust fumes, smoke, air freshener sprays or plug ins, strong-smelling cleaning products, hairspray and perfume. Ventilating your home well can help reduce symptoms too.

Stop smoking

If you smoke, stopping can help slow down or prevent further damage to your lungs. Help is available from your GP and NHS stop smoking services. "If you smoke, you'll be offered support to stop smoking as this is a key way to stay well and manage COPD," says Kirby.

Get your jabs

Getting a flu jab is important - people with COPD are at much higher risk of becoming seriously unwell if they're infected. These are free for those with COPD, so as soon as autumn arrives, arrange one with your GP or pharmacist. People with COPD are also recommended to get a one-off pneumonia vaccination.

Be careful over winter

"Winter can be a difficult time for those with COPD. There tend to be more bugs around, and catching a cold or another infection can cause COPD symptoms to get worse and flare up," says Kirby. "Try to ensure your home is warm enough throughout the winter - it should be heated to at least 18°C to help you stay well."

"Try to avoid contact with people who have cold or flu symptoms, even if this means telling family and friends that if they are unwell they shouldn't visit," says Kirby. "Cover your mouth and nose with a tissue when you cough or sneeze, and encourage other people around you to do the same, to reduce the spread of germs."

Washing hands regularly for at least 20 seconds or using a hand sanitiser gel can also help prevent bugs.

Try breathing techniques

There are various breathing techniques that some people find helpful for breathlessness. These include breathing control, which involves breathing gently using the least effort, with the shoulders supported.

Breathing techniques for people who are more active include: relaxed, slow, deep breathing and breathing through pursed lips. Paced breathing involves using a rhythm in time with the activity, such as climbing stairs or walking.

If you have a chesty cough that produces a lot of phlegm, you may be taught a technique to help you clear your airways, called the active cycle breathing technique. The British Lung Foundation has more information about breathing control techniques for COPD.

Talk to other people

Living with a chronic illness can be very difficult, so it's important to speak to trusted friends and family about the way you feel. You may also find it helpful to talk to a trained counsellor or access NHS talking therapies. There are also peer support groups for people living with COPD, which you can often find on social media or via your doctor.