Signs that COPD is Getting Worse

Helpful Highlights

• COPD can get worse acutely, such as with an exacerbation (flare).

• It is also important to remember that it is a progressive illness and will worsen over time.

• Know the signs and symptoms and what to communicate with their provider.

The following may be signs that your loved one's COPD is progressing and are reasons to get an appointment with their provider.

Increased shortness of breath.  May require increasing or adding medications, and may require an initial ER visit or hospitalization.  

Wheezing. Not everyone with COPD has wheezing, so if it comes one or if existing wheezing gets worse, it could be a sign that damage in the lungs is getting worse. If it gets worse suddenly or gets worse over time but doesn't resolve, get advice from the provider.

Changes in phlegm/mucus. If there is a color change (for example, off-white to green) or if it is thicker than usual, this may indicate the presence of infection.

Worsening cough. If the cough is new or different, or it persists over several weeks, there could be another health issue contributing to the problem that needs checking, though it is also likely the COPD is getting worse.

Fatigue and muscle weakness. Lots of people with COPD are tired much of the time; however, increasing fatigue and muscle weakness likely means the COPD is worsening.

Swelling and/or weight gain. These indicate that the body is unable to shed excess fluid, much of which is exhaled from the lungs. The more difficult it gets to push air out of the lungs, the less fluid is breathed off. Though the swelling may be due to another health condition like heart failure, this is considered a definitive indicator of worsening COPD. (Worrisome weight gain is 2 pounds in one day or 5 pounds in a week.)

Feeling groggy upon waking.  This is more than a desire to stay in bed or the need for a couple of minutes to wake up. The feeling of grogginess comes from low oxygen overnight and may be due to worsening COPD and potentially the onset of obstructive sleep apnea (OSA), which is common in the advanced stages of COPD.