It’s been just over two months since we first heard reports of the coronavirus (COVID-19) entering the United States. During this time, we’ve learned an astonishing amount of information about where the virus came from, what it does to the body, and most importantly, how to protect ourselves and our loved ones.

While there’s still no cure in sight and it will likely be some time before medical specialists fully understand COVID-19, we have been given five clear and strict rules by the World Health Organization (WHO) that each and every person should follow. 

• Wash your hands often with soap and water for at least 20 seconds
• Avoid touching your face
• Stay home when possible, especially if you’re sick
• Cover your cough with your shoulder or a kleenex
• Practice social distancing

Unfortunately, the above list does not take into account age, medical conditions, or susceptibility; these are simply guidelines that everyone should follow in order to slow the spread of the coronavirus. So, if you’re someone who’s suffering from a chronic illness that makes you more vulnerable to the effects of the virus, you’ll need to take extra precautions.

In this post, we’ll take a look at seven facts you should know about the coronavirus if you or a loved one is coping with chronic obstructive pulmonary disease (COPD). COPD is an illness that affects around 15.7 million Americans, so it’s imperative that these people are fully aware of how the COVID-19 pandemic affects them. If you have any questions, be sure to leave them in the comment sections or fill out the contact form so we can reach out to you.

What is the Coronavirus?

SARS-CoV-2 is a type of coronavirus that causes coronavirus disease 2019, also called COVID-19 for short. This new type of coronavirus was first discovered in Wuhan, China, a large city in the province of Hubei last December. Since then, it has gone on to infect more than 1,000,000 people worldwide and is responsible for over 70,000 deaths. Since COVID-19 has spread across the whole world at this point, it has earned the title “pandemic.”

In the past, coronaviruses have only been known to infect animals. However, a few have been known to pass onto humans and these are referred to as “alpha” and “beta” coronaviruses. The term “SARS” in SARS-CoV-2 stands for “severe respiratory distress syndrome” which is the primary symptom of most coronaviruses.

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It’s a “Novel” Disease

One of the most important things to know about COVID-19 is that it is considered “novel.” What this means is that it’s a new type of coronavirus that has never been seen before. In other words, we don’t have the decades of experience dealing with it like we do with influenza and other common diseases.

Another problem with it being a new disease is that we don’t have an immunity built up for it. Your body has two types of immunity that it uses to protect your body from harm; these include natural or “innate” immunity and “adaptive” immunity. Innate immunity is something that you’re born with. An example of this is mucus, a sticky substance that lines your sinuses, throat, and lungs which protects your body from infection.

Adaptive immunity, on the other hand, is immunity that your body develops over the course of your life. At a young age, you’re very vulnerable to infections like strep throat and ear infections, but as you age, your body develops a natural immunity to these things. Unfortunately, since COVID-19 is new to everyone, nobody has had the chance to build up an immunity to it. 

Typically, when there is an outbreak of any type of disease in a particular region, there is enough scientific data from previous outbreaks in order to direct resources and efforts effectively. However, in the case of a new type of disease like COVID-19, it becomes very difficult for medical professionals to make decisions about where and when to divert their resources. We can see this in the United States through the shortage of ventilators and medical face masks which could help to prevent the spread of the virus.

Lastly, the fact that COVID-19 is a new virus means that it’s difficult to accurately depict its severity. While we now know that there are over 370,000 cases and over 12,000 deaths in the United States, back in January when it first entered the country, it would have been impossible to predict just how bad it would get. With that being said, it’s difficult for us to predict how much damage COVID-19 will cause in the near and distant future, so it’s best to be prepared for the worst.

COPD Patients are at a Higher Risk

Since COVID-19 is a respiratory illness, it goes without saying that people who already suffer from a chronic respiratory disease will experience more severe symptoms. Chronic obstructive pulmonary disease (COPD) is primarily caused by smoking and it’s characterized by symptoms such as shortness of breath, chest pain, coughing, and wheezing. Millions of Americans already have COPD but experts estimate that as many as 81% of cases worldwide may be undiagnosed.

One of the primary ways COPD affects a patient’s ability to cope with the novel coronavirus is through lung inflammation and a weakened immune system. Most COPD patients develop a condition called immune dysfunction which puts them at a higher risk for exacerbations and compromises their ability to fight off common lung infections. When it comes to a virus that has never been introduced to the general population like COVID-19, the risk of contracting it is even more pronounced.

COPD News Today advises that patients with chronic lung illnesses take the following precautions in addition to the preventive measures listed by the World Health Organization:

• If you are using any type of medication like corticosteroids, bronchodilators, or methylxanthines, you’ll ideally want to stock up on these as much as possible. The more you can limit leaving the house to refill a prescription, the better. Doctors aren’t always able to prescribe a large quantity of a particular drug, but due to the circumstances, they might make an exception. Prescription deliveries are also becoming more common, so those might be worth considering as well.
• Secondly, COPD News Today advises that all COPD patients avoid unnecessary travel and large crowds. Necessary travel means leaving the house to get food or other essential supplies or to visit a friend or loved one. However, COPD patients should have their groceries delivered if at all possible and practice social distancing when visiting family.
• When it comes to medical treatment, it’s important to seek help as soon as possible and be prepared in case of an emergency. COVID-19 exhibits some of the same symptoms as COPD, so if you notice an unusual flare up or you shouldn’t wait to receive medical attention. Keep a list of emergency contacts on hand at all times.
• Last but certainly not least, you should take care to disinfect your home regularly. According to a study published in the New England Journal of Medicine, SARS-CoV-2 can live on surfaces for several days depending on the surface and the climate. This study found that it can survive 3 hours in the air, 4 hours on copper, 24 hours on cardboard, 48 hours on stainless steel, and 72 hours on plastic. You should take time to disinfect surfaces like door handles, computer keyboards, your cellphone, and tables or counters at least once a day. Also, be sure to use organic cleaners rather than ones filled with chemicals that can exacerbate COPD symptoms.

It’s worth noting that anyone with a chronic health condition is more prone to severe coronavirus disease, not just COPD patients. While there is still limited information on the risk factors of COVID-19, the Centers for Disease Control and Prevention (CDC) warns that people with moderate to severe asthma are more likely to experience an asthma attack, pneumonia, or acute respiratory disease.

The CDC lists several other conditions that could lead to a higher risk of experiencing severe symptoms from COVID-19. They include the following:

• People with serious heart conditions
• People with diabetes
• People with liver or kidney disease
• People with an immunosuppressive condition (many conditions can lead to a compromised immune system)
• People with a body mass index of 40 or higher 

Older Adults Experience More Severe Symptoms

Another risk factor we’ve been told to watch out for is age. According to CDC reports, fatality is highest among people 85 years of age and older, from 10% to 27%. People between the ages of 65 to 85 had between a 1% and 5% fatality rate and people under the age of 65 have under 1% fatality rates.

You’ve likely heard about fatality rates being unusually high in places like Italy, and this is largely due to the fact that the general population is much older than in other parts of the world. Stat News, a health and medicine news website, notes that the median age in Italy is 47 which is the highest in Europe. What’s more, 23% of the population is over the age of 65 and Italy has reported that 7.2% of people who contracted COVID-19 have died. This is significantly higher than the 1.8% to 3.4% fatality rate reported in the United States.

In many instances, fatality among the older population has less to do with their age and more to do with the fact that older people are more likely to have a chronic illness. According to the National Council on Aging, about 80% of older adults have at least one chronic disease and 77% of older adults have at least two chronic diseases. What’s more, four illnesses cause two-thirds of all deaths in any given year — diabetes, stroke, cancer, and heart disease. When you look at these numbers, it’s not hard to see why COVID-19 is such a significant threat to older generations.

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Safety Compliance is Important Regardless of Age

Despite the fact that COVID-19 is more severe in older adults with chronic illnesses, that doesn’t change the fact that slowing the progression of the virus is the responsibility of everyone. While you may have heard individual cases of younger people contracting the virus and not experiencing any symptoms, these people are definitely the minority, so people of all ages and health conditions should take it seriously.

In addition to COVID-19 being a threat to younger generations, contracting the virus could mean passing it on to older generations, because the majority of cases are passed from person-to-person rather than from objects to people. Hospitals and nursing homes are particularly vulnerable to outbreaks so if younger people want to visit their parents or grandparents, it’s best to do so through video conference programs like Skype or Facetime.

Your COPD Treatment Plan is Still Important

We understand that times like these can be stressful and filled with uncertainty. And even when we don’t have a pandemic to deal with, it can be challenging to keep up with everything in your COPD treatment plan including pulmonary rehabilitation, an improved diet, and oxygen therapy. However, if history has taught us anything, it’s that we can achieve better outcomes if we focus on a healthy daily routine.

If your pulmonologist has already set you up with a COPD treatment plan, it’s best to stick with it unless he/she tells you to make adjustments. The reason it’s so important to do this is because it gives you the best odds of coping with COVID-19 if you were to contract it. It’s important to note, however, that simply following your COPD treatment plan won’t prevent the virus; you’ll still need to follow all the safety precautions listed above to prevent getting sick.

Pulmonary rehabilitation is the backbone of any good COPD treatment plan. Most often, your pulmonologist will set you up with a one-on-one exercise training course with a physical therapist. However, due to the current circumstances, it’s unlikely that you will be set up with an in-person pulmonary rehab program. Instead, you will likely be offered some type of online pulmonary rehab like Thrive eLearning where you’ll have access to important information for managing your disease. You’ll also be able to speak with respiratory therapists wherever and whenever you need.

Another aspect of your COPD treatment plan, your diet, can be very difficult to maintain with the spread of COVID-19. Grocery stores are a bad place to be right now because they are full of people and it’s difficult to maintain good social distancing practices. What’s more, grocery stores are on low supply of a lot of foods, so it can be difficult to find exactly what you’re looking for. Sites like Fresh Direct are great options for anyone with a chronic health condition like COPD because you can have groceries delivered directly to your door. If online grocery shopping is not an option, you may want to get a friend or loved one to go shopping for you.

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Last but certainly not least, you’re going to want to continue with your oxygen therapy treatment program as advised by your pulmonologist. Oxygen therapy helps to keep your respiratory condition stable, reduce feelings of breathlessness, and most importantly, helps prevent exacerbations and hospitalization due to COPD symptoms. There are many types of oxygen generator on the market, but most doctors recommend portable oxygen concentrators like the Inogen One G5, because they’re lightweight, easy to use, and provide a high oxygen output.

Pay Attention to the News

Whenever there’s a pandemic or any other type of national emergency, you often get two different types of people: the ones who have the news on 24/7 and the ones who try to avoid the news as much as possible in order to avoid anxiety. While we certainly don’t want anyone to sit at their TV all day and stress about the current circumstances, it is important to keep up with what’s going on and understand what the recommended safety guidelines are for dealing with COVID-19.

If you don’t want to tune into the news everyday, that’s understandable. However, be sure to bookmark these pages by the Centers for Disease Control and Prevention and the World Health Organization. Check these sites regularly and they will provide you with up-to-date information about COVID-19 prevention, travel guidance, as well as correcting some misinformation that’s out there in the public.

Conclusion

For many people, these are difficult times. The novel coronavirus has taken a pretty large toll not just on the health of the public but on the economy as well. It’s imperative that everyone — young or old, healthy or not — does their part to limit its spread. This means practicing good hygiene, keeping at least 6 feet of space between you and the nearest person, and staying home as much as possible.

As a COPD patient, you’ll need to take some additional precautions like stocking up on medical supplies, disinfecting your home regularly, and avoiding any form of unnecessary travel. You should continue to follow your COPD treatment plan unless otherwise advised by your pulmonologist. 

In order to maintain a healthy and well-balanced diet, it’s essential to consume a wide variety of nutrients. Most of these nutrients can be found in the food that we eat, but occasionally it’s advised that you take dietary supplements in order to boost your intake of certain vitamins and minerals.

While everyone needs the same nutrients, it’s usually a matter of what quantity you should consume them in. For example, babies need to consume a lot of vitamin D which helps regulate calcium and phosphate in the body. In turn, this aids in the development of strong bones, teeth, and muscles.

Similarly, a healthy adult may need to consume different quantities of nutrients than an adult with a chronic disease. COPD patients, in particular, are reported to have deficiencies in vitamin D and other nutrients with antioxidant capacity such as vitamins A, C, and E.  

But getting the right nutrients isn’t as simple as it sounds. You’ll need to consult with your doctor and maybe even a dietitian who can examine your condition and compile a dietary plan that will work best for you. 

In this post, we’ll take a look at some of the supplements that are most commonly used in COPD patients and we’ll provide you with all the information you need to know to start discussing supplements with your doctor. If you have any questions, don’t hesitate to leave them in the comment section so we can reach out to you.

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The Good and the Bad of Dietary Supplements

According to a 2017 survey by the Council for Responsible Nutrition (CRN), 76 percent of U.S. adults use dietary supplements. And while supplements are widely available and easily accessible, they aren’t always used in a responsible way.

Unfortunately, just like drugs, dietary supplements have well-known and well-documented side-effects. Supplements contain active ingredients and if they aren’t used in moderation, they can have strong adverse effects on the body.

One of the greatest dangers of supplements is that they aren’t regulated the same way many drugs are. According to the American Cancer Society, both supplements and drugs are regulated by the United States Food and Drug Administration (FDA). However, drugs are often considered unsafe until proven safe, whereas supplements are considered safe until proven unsafe.

The reason this happens is that supplements are categorized as a “food product” making them immune to many of the tests that are required to bring drugs to store shelves. Drug manufacturers are required to put their products through a series of clinical trials that test their safety and efficacy. On the other hand, supplement manufacturers only need to prove that their products do not result in “a significant or unreasonable risk of illness or injury.”

Because supplements are “self-prescribed,” it’s a lot more difficult for health professionals to track their use. Rather than being able to prescribe each vitamin and mineral that their patient takes, doctors and nutritionists need to rely on their patients to do their own research and address any concerns they have before purchasing any type of dietary supplement.

Lastly, supplement manufacturers do not need to seek approval from the FDA in order to market their products. Supplement advertisements often tout anecdotal evidence rather than empirical evidence as proof that their supplements work. In other words, their evidence is based on an individual’s experience instead of proven facts and statistics.

Dietary Supplements and COPD

With all of this being said, the best advice for COPD patients interested in dietary supplements is to be cautious about what you read. While supplements don’t typically have side-effects as severe as drugs, they still contain powerful active ingredients that can make COPD more difficult to manage if you don’t know what you’re doing.

Another thing to note is that supplements are not a “cure-all” and they’re not intended to treat a specific disease or illness. They’re most commonly used to treat nutrient deficiencies in your body, and you won’t know what these deficiencies are unless you discuss your symptoms with your doctor.

COPD is a progressive and irreversible lung disease characterized by chronic inflammation and obstructed airflow. COPD varies widely in terms of severity and many patients will experience comorbidities such as sleep apnea, osteoporosis, cardiac disease, as well as mental health disorders like anxiety or depression.   

As a result, it’s impossible for a pulmonologist to provide a “one-size-fits-all” treatment plan for a COPD patient. Each patient is considered a unique case, so even if something works for one COPD patient, it doesn’t necessarily mean it will work for all of them. Without further ado, let’s take a look at some of the most commonly recommended supplements for COPD.

Vitamins

Every day, your body works around the clock to produce skin, bone, and muscle. It sends nerve signals throughout the body and creates rich red blood cells that nurture every organ in the body. But without essential nutrients like vitamins, your body would not be able to do any of this.

Your body requires about 30 different types of vitamins, minerals, and dietary components. But the problem is, many of these components are not produced by the body naturally, so you need to get them from either the food you eat or dietary supplements.

Vitamin D

Vitamin D plays a number of important roles in the body. First and foremost, it promotes healthy calcium absorption. Calcium is a mineral that’s responsible for muscle function, hormonal secretion, nerve transmission, and vascular vasodilation and contraction. Vitamin D also plays an important role in the reduction of inflammation, immune function, and the modulation of cell growth.

Vitamin D deficiency is one of the most common side-effects associated with COPD. It’s estimated that about 25 percent of people with COPD have low levels of vitamin D. This occurs for two main reasons: COPD patients often don’t eat the recommended amount of meals each day because eating can be physically exhausting and lead to difficulty breathing.

Secondly, many COPD patients, especially those with stage 3 or stage 4 COPD, don’t get outside very much. Since a large portion of our vitamin D intake is absorbed from sunlight, respiratory patients are often deprived of this. 

While COPD patients can take regular vitamin D supplements or vitamin D with calcium, vitamin D3 is a better alternative for many people. The reason for this is because vitamin D3 contains both sunlight and dietary-activated vitamins — both of which COPD patients lack.

Generally, vitamin D is believed to reduce the rate of lung decline for people with severe lung disease. Because vitamin D helps regulate inflammation, COPD patients may experience fewer exacerbations that are less severe. Regular vitamin D levels will also help prevent osteoporosis and other bone conditions that can make living with COPD even more difficult.

Too much vitamin D may result in vitamin D toxicity. This can cause too much calcium to build up in the blood (hypercalcemia), which can cause fatigue, weakness, and nausea. If hypercalcemia progresses, it can lead to the formation of calcium stones and pain in the bones and kidney. 

Minerals

Like vitamins, minerals are one of the essential nutrients for your body. Minerals are naturally occurring inorganic materials that play a number of important roles like maintaining healthy brain function, muscle function, and heart function. There are two types of minerals: trace minerals and macrominerals.

Macrominerals include magnesium, phosphorus, sodium, potassium, chloride, sulfur, and calcium. Generally speaking, macrominerals are needed in much higher doses than trace minerals and they play a larger role in your body functions. Trace minerals, on the other hand, include fluoride, selenium, cobalt, zinc, iodine, copper, and iron. 

Magnesium Sulfate

Magnesium sulfate (MS) is widely used as a treatment for asthma due to its bronchodilatory effects. What this means is that it can help widen the airways in the event of a severe asthma exacerbation. Unfortunately, MS has not been tested as widely when it comes to treating COPD, so its efficacy is still up for debate.

Several placebo-controlled trials have been conducted to test the benefits of magnesium sulfate in treating COPD. However, they have yielded mixed results and didn’t present enough evidence to indicate that COPD patients should adjust their treatment plan to accommodate for oral or nebulized magnesium sulfate supplements.

Zinc

Zinc is an essential trace element that plays an important role in immunity. While zinc can be found naturally in foods like whole grains, red meat, and poultry, it can also be taken in the form of dietary supplements. Zinc is an antioxidant, meaning it protects your cells against dangerous free radicals that are produced when your body breaks down food or you’re exposed to tobacco smoke.  

An imbalance between antioxidant capacity and oxidative stress is believed to play a major role in the development of COPD, so zinc may have beneficial effects when it comes to regulating this. Since zinc plays such an important role in regulating the immune system, COPD patients with zinc deficiency will be at a higher risk of experiencing lung infections that can lead to exacerbations.   

Omega-3 Fatty Acids

Omega-3 fatty acids are not one nutrient, but rather, a whole family of essential fatty acids. Since your body cannot produce these fatty acids on its own, you need to get them through your diet. Some examples of food that contain omega-3 include fish (salmon), flax seeds, chia seeds, and walnuts. 

Omega-3 supplements are very popular nowadays and for good reason. It’s been proven to lower blood pressure, slow plaque development in the arteries, improve heart health, and even help you manage anxiety or depression. Omega-3 supplements, in particular, are great for people who don’t consume a lot of fish or other foods that contain omega-3.

One of the ways omega-3 helps COPD patients is by fighting inflammation. According to Richard Phipps, Ph.D. professor of Environmental Medicine and director of URSMD Lung Biology and Disease Program, “We never really knew why diets high in omega fatty acids seemed good, but now we know it’s because they provide the precursors for molecules that help shut down excessive inflammation.” 

While many people take omega-3 supplements like fish oil without consulting their doctor, it’s recommended that COPD patients ask their pulmonologist first. There are three different types of omega-3s including alpha-linolenic acid (ALA), eicosapentaenoic acid (EPA), and docosahexaenoic acid (DHA), all of which have different uses. What’s more, it’s important to consume the correct ratio of omega-3 to omega-6 fatty acids. 

If you have a shellfish allergy, be aware that omega-3 supplements may contain trace amounts of shellfish. Be sure to address this with your doctor if you’re concerned about it.

NAC (N-Acetylcysteine)

N-acetylcysteine is an antioxidant that potentially has beneficial effects for people with COPD. While NAC has been shown to reduce cough and phlegm and thin mucus in some patients, it has shown little to no effect in others. More studies are needed to fully understand the pros and cons of using NAC to treat COPD.

From what we know so far, however, NAC seems very safe to use. What’s more, it can be taken either orally, or through a nebulizer which gives COPD patients plenty of options. NAC is typically prescribed in tandem with other treatment options rather than being used as a primary treatment for COPD.  

Ginseng

Aside from vitamin D, ginseng is one of the most common supplements used for COPD. Ginseng is a root that’s found in many places around the world, but the most popular are American ginseng and Asian ginseng, the latter of which has been used in medicine for centuries.

While ginseng has many benefits for people with different conditions, for COPD patients, it has powerful antioxidants and anti-inflammatory properties. Another benefit of ginseng is that it’s an all-natural herbal supplement. So, unlike manmade vitamin and mineral supplements, it’s much easier for patients to verify that they are receiving a pure product without any additives. 

Questions to Ask Your Doctor

Everyone needs to maintain a healthy balance of vitamins and minerals to be healthy. However, like drugs, taking too many dietary supplements can have adverse side-effects. Many people take a daily “multivitamin” which contains a variety of vitamins and minerals. And while these have some proven health benefits for some people, they don’t target specific nutrients that will benefit COPD patients.

If you want to do what’s best for your health, especially if you have COPD or another chronic illness, it’s best to consult your doctor. He/she will help you understand how dietary supplements fit into your overall COPD treatment regimen and give you an idea of what side-effects to expect. Ask your doctor the following questions to get you started:

• Are there any tests I can take to see if I have vitamin deficiencies?
• How will supplements affect my COPD diet?
• What are the benefits and risks of the supplements I’m taking?
• How can I ensure the supplements I’m using are safe?
• Are there any effective alternatives to the supplements I’m taking?
• How will supplements affect my comorbidities such as sleep apnea, heart problems, or anxiety?  
  
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Conclusion

Nutrition plays a fundamental role in our overall health. By getting our recommended daily value of vitamins and minerals, we provide our bodies with the raw materials they need to perform functions such as regulating blood production and blood flow, building strong healthy bones, and regulating metabolism. Dietary supplements are a great way to fine-tune our diet, but they can be equally destructive if they aren’t used correctly. 

Similar to drugs, every dietary supplement has side-effects. If you’re someone with COPD or any other chronic illness, this could make your symptoms worse and even increase your chance of experiencing exacerbations. This is why it’s important to first discuss with your doctor so that he/she can recommend supplements that will work in tandem with your COPD treatment regimen, rather than working against it.

One of the most common questions we hear COPD patients ask is, “how can I clear my airways when they get congested?” As a COPD patient, you’re likely to experience coughing fits that are brought on by the buildup of mucus and sputum in the airways and lungs. And sometimes, no matter how hard you try, you feel like you can’t clear them in order to catch a breath of fresh air. This is far more common than you might expect and it can be a frustrating and sometimes even scary experience.

Another thing that many people don’t realize is that airway clearance can be a lot more complicated than learning how to cough correctly. There are many different techniques that can be applied, and it’s also helpful to know why your airways are becoming congested in the first place. In this post, we’ll help you understand some of these concepts and provide you with a step-by-step guide on how to clear your airways safely.

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As always, it’s imperative that you speak to your doctor if you experience ongoing issues with coughing, wheezing, or shortness of breath. These symptoms tend to get worse over time unless the root cause is dealt with. What’s more, coughing fits can lead to flare-ups and exacerbations which can put you in the hospital.

Why does COPD Make it Difficult to Clear Your Airways?

There are two different types of chronic lung disease: obstructive and restrictive. A restrictive lung disease like pulmonary fibrosis or interstitial lung disease is one that affects the lungs’ ability to expand. An obstructive lung disease like COPD or bronchiectasis, however, prevents you from fully expelling air from the lungs. This is especially problematic when the patient tries to cough because they may not have the force necessary to clear mucus and other substances from the airways.

Another reason that COPD makes it more difficult to clear your airways is that this disease is associated with changes in the way that mucus and sputum are produced in the body. In a healthy individual, mucus plays a vital role in the body’s immune function. The body carefully regulates the mucus lining the airways and lungs so that there is enough to trap bacteria but not so much that you choke or can’t breathe naturally. However, in COPD patients, there is usually an overproduction of mucus due to oversized mucus glands and an overabundance of goblet cells. 

If you’re a current smoker, this could be another reason that you’re experiencing issues with airway obstruction. According to the Centers for Disease Control and Prevention (CDC), as many as 38 percent of COPD patients are current smokers. This study published in the Karger medical journal found that moderate and heavy smokers have a higher impairment in mucociliary clearance than their non-smoking counterparts. One of the key ways that smoking affects airway clearance is by damaging and killing cilia. These are tiny hair-like organelles that help to push mucus and other debris out of the airways. 

Since there are so many different causes of airway obstruction in COPD, it’s important to have a comprehensive treatment plan to deal with these symptoms. Airway clearance therapy can and should be used, but it won’t be as effective if you aren’t following all other aspects of your treatment plan that your doctor has designed for you. Ideally, if you’re following your treatment plan carefully, you won’t experience mucus buildup as frequently and you’ll only need to use airway clearance techniques in rare circumstances. 

What is Airway Clearance Therapy (ACT)

Airway clearance therapy, or sometimes called airway clearance techniques, is a group of scientifically backed methods used for clearing mucus from the airways. These techniques were developed as a more controlled version of our body’s natural airway clearance techniques like coughing and wheezing. A chronic and persistent cough or episodes of wheezing can be extremely unhealthy, especially if they lead to you losing sleep or feeling lightheaded or fatigued. Airway clearance techniques aim to not only make COPD patients more aware of how they’re coughing, but also provide them with some entirely new methods that may be more effective.

Generally speaking, airway clearance techniques are divided into seven different categories. Everyone has a slightly different way of practicing these techniques, so don’t be alarmed if your pulmonologist tells you something that differs from what you have read here. Our goal is simply to provide you with an overview so that you can better understand how airway clearance therapy works.

1.) Controlled Coughing 

Like we mentioned before, uncontrolled coughing is problematic in COPD patients. Without understanding how your lungs, airways, and mucus work, simply expelling air in an attempt to dislodge any obstruction can be more effort than it’s worth. One of the biggest problems associated with normal coughing or wheezing is that it often causes the airways to collapse, meaning that no matter how hard you cough, the mucus will be stuck. If you hear a wheezing or whistling noise when you cough, this is a sure sign that your airways collapse when you cough.  Controlled coughing is focused on keeping the airways open so that you’re not wasting valuable energy and oxygen.

The first rule of controlled coughing is to avoid inhaling sharply through your mouth. This can send mucus back down the airways and be very counterproductive. Instead, inhale slowly but deeply through your nose. This way you have enough oxygen to cough correctly. It’s best to practice controlled coughing while sitting down and you should try to relax as much as possible. Especially try to eliminate the tension in your shoulders and chest because this can contribute to the airways becoming narrow.

Once you’re seated, lean forward slightly and place your hands on your abdomen. You’re going to cough three times and you should really focus on the quality of each one to ensure that the mucus is moving out of your airways rather than back down into your lungs. Be sure to take a deep breath through your nose between each cough to ensure that you move enough air. If you need to take a moment to relax between each cough, this can be helpful.

Another technique that’s similar to controlled coughing is huff coughing. For the most part, you will follow the same steps as you would for controlled coughing. However, instead of coughing, you’re going to be forcing air through your airways similar to how you would fog up a mirror or how you would clean a phone screen or your glasses. In other words, you’re expelling air out your mouth without creating any vibrations in your chest or throat.

2.) Autogenic Drainage (AD)

The aim of autogenic drainage is to move mucus from the smaller airways into the larger airways (peripheral airways into central airways). By doing this, it is much easier to dislodge the mucus because it’s all in one area. The rationale for autogenic drainage is based on a principle of solid mechanics called shear force. This is when unaligned forces are applied to an object causing it to bend in two different directions. In the case of autogenic drainage, the mucus and other secretions in the airways are the object that’s being manipulated. This is done through a series of carefully monitored breathing techniques.

3.) Postural Drainage and Percussion (PDP)

Postural drainage and percussion, also known as chest physical therapy (CPT), is a technique that involves using your hands to assist with airway drainage. While you can do PDP on your own, it’s often recommended that you have someone assist you with it, whether it’s a friend, loved one, or your physical therapist. Like autogenic drainage, PDP is a technique that will take some time to perfect so it helps to be patient as you learn the ins and outs of this method.

The reason this method is called “postural” drainage is that you are going to use different positions that leverage gravity in order to drain the mucus from your airways. The general rule of thumb is that your hips should be higher than your chest. Whether this means laying on your back, side, or stomach, you can do whatever is most comfortable for you. Many people prefer to use pillows or blankets to elevate their hips. 

Once you’ve found a comfortable position you can begin the percussion. Most specialists recommend cupping your hand and placing it palm down on your chest. This will allow you to break up the mucus in your chest without hurting yourself. The percussion can also be done on your back but it’s best to have a partner to help you out with this.  

4.) Positive Expiratory Pressure (PEP) Therapy

Essentially, the term positive expiratory pressure means experiencing greater resistance when you’re exhaling than when you’re inhaling. This is done with a PEP device which you hold to your mouth and breath into. The device allows you to inhale normally, but when you go to exhale, you experience resistance about four times greater than what you would normally experience. What this does is keeps your airways open as you exhale and allow the force of your air to get behind the mucus and push it out of the airways.

5.) Oscillating Positive Expiratory Pressure

Oscillating positive expiratory pressure therapy is very similar to the method above. However, an oscillating PEP device uses high-frequency oscillations that break up mucus as you exhale. Oscillating PEP devices look similar to traditional PEP devices but they have a ball inside that rattles around as you exhale. This is what creates the vibrations in your upper chest. After blowing into the device several times, you can take a break to clear out any mucus that the device brought up. Then simply repeat the process.

6.) High-Frequency Oscillating Vest

A high-frequency oscillating vest is another tool that can be used for airway clearance. This is an inflatable device that looks a lot like a life vest. The oscillating vest is connected to an air compressor via two hoses. Once it’s turned on, the vest inflates and deflates in rapid succession. The basic principle is that it uses positive and negative pressure changes in the chest to augment peripheral and tracheal mucus movement towards the airway opening. After a set period of time, the device is stopped and the patient can cough to bring up the mucus.

While high-frequency oscillating vests are very effective, they aren’t without disadvantages. These vests can be very expensive to purchase and maintain. What’s more, they’re not very portable in comparison to the PEP devices which we discussed earlier. If you’re someone who travels a lot you might find that high-frequency oscillating vests are more trouble than they’re worth.   

7.) Active Cycle of Breathing Technique (ACBT)

The active cycle of breathing technique is an airway clearance method that combines positioning, breathing, and coughing. Since this is the most complex airway clearance technique it’s also the most flexible when it comes to being adapted to fit a variety of patient’s needs. The goals of ACBT include improving the effectiveness of your coughs, improving lung ventilation, and clearing secretions from the lungs. Below are the three different phases of ACBT:

Phase 1 - Breathing Control and Relaxation

The first step in ACBT is to bring your breathing under control and completely relax your body. The majority of the tension in your body will be located in your shoulders, chest, and back, and many people are unaware of how much this can affect the way you breathe. Start by closing your eyes and placing your hands on your stomach. Sit with your back straight and begin to practice pursed lips breathing. This is where you inhale slowly through your nose and exhale fully through pursed lips.

Phase 2 - Thoracic Expansion Exercises

As the title suggests, the aim of phase 2 in the active cycle of breathing technique is to expand the chest. During this step, you will take 3 to 5 deep breaths in through your nose and out through your mouth while keeping your shoulders and chest relaxed. At the peak of each inspiration, you will hold your breath for 2 to 3 seconds. After the allotted time, simply release the air rather than trying to force it out.

Phase 3 - Forced Expiratory Technique (FET)

The forced expiratory technique is another way of saying “huff” cough. Like we described under the “controlled coughing” section, a huff cough is a way of clearing mucus without allowing the airways to collapse. You’re simply pushing air out the lungs but putting more air behind it than you would with a normal breath. You should repeat this after each thoracic expansion that you do.

Other Ways to Prevent Airway Obstruction With COPD

Drink Plenty of Water

Your ability to prevent airway obstruction depends heavily on your level of hydration. Mucus is made up of about 97 percent water. However, slight variations in this can cause it to become extremely thick and difficult to clear from the airways. Since every organ in your body uses water, it’s imperative that you aren’t starving yourself of this vital resource. According to COPD.net, the average COPD patient should drink between 8 and 12 glasses of water every day.

As you work to increase your water intake, it’s also important to reduce your intake of other types of fluid. Milk, and dairy products in general, are known for thickening your mucus so you’re going to want to avoid these as much as possible. Much like salt, sugar has the ability to dehydrate you, so you should avoid sugary sodas, fruit juices, or sweetened tea. If you absolutely have to drink something other than water, try unsweetened hot green tea which will not only thin your mucus but has a number of other health benefits as well.

Maintain a Balanced Diet

Healthy eating is all about getting the right balance of nutrients that your body needs to stay healthy. For COPD patients and people with other respiratory illnesses, this could mean consuming less sodium and salt which contributes to problems like airway obstruction. You should also avoid highly processed foods which can contribute to bloating and thus making it more difficult to breathe. Most COPD patients tend to do better with a diet that is high in protein and healthy fat which is easy to digest and will support healthy lung function.  

Use COPD Medications Effectively

Depending on how severe your COPD is, your doctor has likely prescribed you some medication for coping with your symptoms. One of the most common medications for COPD is called bronchodilators. These medications open up the airways so that you can breathe easier and they can make it easier for you to perform the airway clearance techniques listed above. Ask your doctor about changing up your treatment schedule to assist with airway clearance. 

Another medication that can help with airway clearance is a class of drugs called expectorants. These are medications are designed to thin the mucus in your airways making it easier to clear. Expectorants aren’t designed specifically for COPD patients because they’re also used to treat congestion associated with the common cold and the flu. While expectorants are available for over-the-counter purchase, you should be sure to ask your doctor before using them because they may have adverse interactions with the COPD medications you already take.

Pulmonary Rehabilitation

Pulmonary rehabilitation (PR) is an exercise and education program focused on improving lung strength and function. COPD patients should begin pulmonary rehabilitation right after they’re diagnosed so that they learn the best way to take care of their lungs and slow the progression of COPD. Another benefit of PR that many people don’t realize is that it can help with airway clearance. According to a study published in the European Respiratory Journal, exercise improves mucosal clearance in the small airways by releasing moderators that increase fluid secretion and stimulate cilia beat frequency. What’s more, PR increases lung strength and endurance which can help you perform the airway clearance techniques listed above.

Get More Restful Sleep

Getting restful sleep is a problem that many people face for their whole lives. According to the Sleep Association, around 50 to 70 million people suffer from a sleep disorder in the United States. So, as you can imagine, there is a lot of overlap between people suffering from COPD and people suffering from sleep disorders. If you’ve never been diagnosed with a sleep disorder or provided with treatment for your sleep disorder, now is the best time to seek help. Addressing your sleep problems will have undeniable benefits when it comes to helping you manage your COPD. If you’d like to learn more about getting restful sleep with COPD, please read through this article.

Conclusion

Airway clearance therapy is an incredibly important skill for all COPD patients to learn. However, it’s not an all-in-one solution. Drinking enough water, getting enough sleep, eating right, and exercising are all great ways to prevent airway obstruction and prevent the need for alternative therapies. If you’re experiencing frequent coughing or wheezing, we recommend contacting your pulmonologist immediately so that you can address your concerns.

Here at LPT Medical, we specialize in life-saving oxygen equipment which can help you maintain your oxygen levels if you are experiencing a coughing fit or COPD exacerbation. We will help you get the best deal on the market for portable oxygen concentrators like the Caire FreeStyle Comfort or the Inogen One G5. These devices are much lighter and reliable than traditional oxygen delivery devices allowing you to go more places without worrying about whether or not you’re getting enough oxygen. Since the oxygen is administered through a nasal cannula you can still do all of the airway clearance techniques above while you’re receiving oxygen.

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It’s very important to us that you receive the oxygen concentrator that’s right for you. When you reach out to us, you will be connected with a respiratory specialist who will ask you questions about your oxygen use and lifestyle. If cost is a concern for you, we also have a variety of different buying options including new, used, and refurbished concentrators. We also have financing options available if you’d like to pay in easy monthly installments. Reach out to us either by phone or email for more information.

Supplemental oxygen therapy, or simply oxygen therapy, is a treatment that has been around since the late 1800s. It was primarily used to treat the symptoms of pneumonia, but doctors were uncertain how much to administer, how long to keep patients on oxygen, and if there were any serious side-effects. It wasn’t until the late 1900s that there was a significant amount of research on the use of medical oxygen and doctors became more aware of how to use it.

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But the usage of medical oxygen is not the only thing that developed over this time. There were also a number of scientific advancements that revolutionized the way oxygen was administered. For example, the invention of the lithium-ion battery in 1991 made it possible for oxygen manufacturers to produce extremely small, lightweight, and powerful oxygen devices called portable oxygen concentrators. These devices replaced the heavy and bulky oxygen tanks that came before them.

In this post, we’re going to help you understand supplemental oxygen better by outlining some of the conditions that may require its use. Remember that oxygen is a controlled substance in the United States, so if you believe you may need it for medical purposes, you’ll need to get a prescription from your doctor first. If you have one of the following conditions, reach out to your doctor to find out what your oxygen requirements are. Then you can look into the various oxygen devices on the market.

Chronic Obstructive Pulmonary Disease (COPD)

COPD is probably the first condition you think of when you hear the words “supplemental oxygen.” Not only because most COPD patients are on oxygen, but because COPD is one of the most common chronic respiratory conditions in the world. According to the Centers for Disease Control and Prevention (CDC), there are around 16 million people with COPD in the United States alone. Worldwide, there are more than 65 million people with COPD.

COPD is actually an umbrella term that denotes two separate but similar diseases: chronic bronchitis and emphysema. The former is a disease that affects the airways leading to the lungs called bronchioles. These airways become inflamed and hardened making it difficult to breathe and to clear mucus out of the lungs and throat. Trapped mucus can lead to frequent and recurring lung infections. Chronic bronchitis differs from acute bronchitis in that the damage is permanent and irreversible.

Emphysema, the other condition under the COPD umbrella, is characterized by damage to the alveoli. These are the tiny air sacs in the lungs where the exchange of oxygen and carbon dioxide takes place. When lung damage occurs, usually due to cigarette smoking or the inhalation of air pollution, the alveoli begin to swell and fill with fluid. This makes the lungs much less efficient at transferring oxygen to the blood and the lungs also become less elastic meaning it’s physically harder to breathe.

When is Supplemental Oxygen Needed?

COPD is a disease that develops slowly over the course of many years. In fact, the disease is divided into four different stages, each marked by progressively worsening symptoms. Stage one COPD is very mild and may even go unnoticed by the patient. Many people ignore the signs of stage one COPD because they simply view it as a sign of aging. According to COPD.net, it’s estimated that about 12 million people have COPD that has not been diagnosed. Most of whom are in stage one COPD. 

What this means in terms of supplemental oxygen is that most people will not need it during the early stages of the disease. However, as your symptoms progress, you’ll need to communicate closely with your doctor so that he or she knows when it’s best for you to begin oxygen therapy. Before giving you a prescription for oxygen, your doctor will likely perform a test called an arterial blood gas analysis (ABG test). This test will tell you and your doctor the amount of oxygen and carbon dioxide in your blood so that you can determine if supplemental oxygen will benefit you or not.

Since arterial blood gas analysis requires you to draw blood, there is another less invasive option called pulse oximetry. A pulse oximeter is a small device that slips over your finger. It passes rays of light through your finger in order to approximate your blood oxygen saturation levels. While these tend to be less accurate than ABG tests, they can be extremely convenient, especially for checking your oxygen levels at home without the help of a doctor.

Cystic Fibrosis (CF)

Cystic fibrosis is a disease that’s characterized primarily by damage to the lungs and digestive system. It’s a hereditary condition meaning that it’s passed on from parents to their offspring. Around 75 percent of people diagnosed with CF are diagnosed under the age of two. This is in stark contrast to COPD where most cases are diagnosed in patients over the age of 40. According to Medical News Today, all newborns in the United States are screened for cystic fibrosis. 

Cystic fibrosis patients have a mutation in the gene that creates the cystic fibrosis transmembrane conductance regulator (CFTR). This is a protein that helps regulate fluids and salt throughout the body. This is why CF patients often struggle with overproduction of mucus and sweat inside and outside their body which can lead to blockages and frequent infections, especially in the lungs and the digestive tract. Like COPD, CF is a progressive disease meaning there is no cure and will likely get worse without effective treatment.

When is Supplemental Oxygen Needed?

Supplemental oxygen therapy is a very common treatment option for cystic fibrosis patients. Unfortunately, since cystic fibrosis is so rare, there are far fewer studies to go off of when determining if supplemental oxygen is right for each patient. However, clinical trials have shown that oxygen therapy can stabilize CF and allow patients to sleep better, exercise effectively, and maintain an otherwise normal life. But since CF causes thick mucus, treating this disease is usually focused on reversing these effects. So, mucus thinners are usually the most important treatment option for CF patients.

Supplemental oxygen can be prescribed for either short- or long-term use in cystic fibrosis. If the patient is experiencing chronic low blood oxygen levels, you might be required to use oxygen for several hours a day or more. On the other hand, if your low blood oxygen levels are intermittent and caused by things like flare-ups you might be prescribed the use of oxygen only when your respiratory symptoms are elevated.  

Pulmonary Fibrosis (PF)

Pulmonary fibrosis is a condition that is commonly confused with chronic obstructive pulmonary disease, but they are not the same thing. While they certainly exhibit some of the same symptoms, they differ greatly in terms of what causes them, the type of damage that’s done to the lungs, and the long-term outlook for patients. Like the name suggests, COPD is an “obstructive” disease. This means that it impairs your ability to expel air from the lungs. Pulmonary fibrosis, on the other hand, is a restrictive lung disease meaning it prevents the lungs from fully expanding. 

Another difference between the two is that COPD results in inflammation in the lungs due to exposure to cigarette smoke whereas pulmonary fibrosis is characterized by fibrosis or “scar tissue” in the lungs from years of exposure to pollution. In COPD, the airways become narrowed preventing you from expelling air and leading to a buildup of carbon dioxide in the blood. In pulmonary fibrosis, the lungs themselves may be stiff or too weak to inhale and exhale fully. On the surface, these things are indistinguishable, but there are some significant differences in the way they are treated.

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Whereas COPD is mainly caused by cigarette smoking or alpha-1 antitrypsin deficiency, there are many potential causes of pulmonary fibrosis. Idiopathic pulmonary fibrosis (IPF) is the most common type. The term “idiopathic” simply means that the disease developed with no known cause. IPF is most common among people between the ages of 50 and 70. Pulmonary can be caused by other diseases, most commonly autoimmune diseases like rheumatoid arthritis, Sjogren’s syndrome, or scleroderma. Gastroesophageal reflux disease (GERD) and viral infections can also lead to an increased risk of contracting pulmonary fibrosis.

There is also a genetic component to cystic fibrosis. Studies have shown that genes play a role in determining whether someone contracts pulmonary fibrosis. But more research is needed to say exactly how it contributes. Pulmonary fibrosis that is believed to have genetic cause is referred to as “familial PF.”

Lastly, pulmonary fibrosis can be caused by exposure to hazardous materials. Occupational hazards like silica and asbestos are most likely to cause PF. It can also be caused by radiation treatments and certain types of medications. Cigarette smoking is not a cause of pulmonary fibrosis but it can be a risk factor meaning it makes someone more likely to contract pulmonary fibrosis.

When is Supplemental Oxygen Needed?

As you can imagine, prescribing supplemental oxygen for pulmonary fibrosis can be a little more challenging than with other conditions. There are many different causes of fibrosis in the lungs so it’s more difficult to determine if additional oxygen is needed. Regardless, supplemental oxygen is still widely in use by people with pulmonary fibrosis and many people say that it helps them live an active lifestyle and feel better in their day-to-day lives.

According to UCSF Health, pulmonary fibrosis patients need oxygen when their saturation falls below 89 percent or arterial oxygen pressure falls below 60 mmHg. This is regardless of whether the patient is at rest, active, or asleep. Oxygen is a vital resource for your body and it’s used by every organ in the body so maintaining the proper oxygen levels in the blood at all times can go a long way towards preventing pulmonary fibrosis symptoms.

Severe Asthma

Asthma is the world’s most common respiratory condition. According to the Asthma and Allergy Foundation of America, 7.7 percent of American adults and 8.4 percent of American children have it. The number of people who have it has also been increasing since the 1980s likely due to an increase in environmental pollutions like airborne pollens, car pollution, and even changes in the climate.

Asthma is a condition where a patient’s airways become narrowed, inflamed, and filled with mucus which makes it difficult to breathe as well as causing chest pain and fatigue. While COPD and asthma attacks are very similar events, the main difference between the two is that asthma is not a progressive disease so the airways typically go back to normal after an attack rather than becoming increasingly more inflamed like they would in a COPD patient. Asthma is also not caused by smoking, however, it is a risk factor.

The good news when it comes to asthma is that only about 5 to 10 percent of cases are severe and life-threatening. The majority of asthma patients find themselves limited in their exercise ability and they might experience more frequent and severe allergic reactions, especially to seasonal allergies. But most people with asthma are able to live normal lives without a major reduction in their life expectancy.

When is Supplemental Oxygen Needed

Unlike with the other conditions listed above, supplemental oxygen is really only prescribed in rare cases of asthma. In chronic bronchitis, the airways are always inflamed and damaged and in emphysema, the lungs are always inflamed, so this explains why many COPD patients need to be on oxygen 24 hours a day. However, in asthma, the airways are mostly healthy when the patient is not experiencing an asthma attack. 

Generally, rescue inhalers and nebulizers are used to treat asthma attacks. These medications are designed to open up the airways and reduce inflammation so that the patient can breathe normally. However, there is a type of asthma attack often referred to as “acute severe asthma” or a “severe asthma exacerbation” where supplemental oxygen is almost certainly needed. These types of asthma attacks do not react the same way to traditional asthma medications like bronchodilators so patients need to receive supplemental oxygen in order to maintain healthy blood oxygen saturation.

Congestive Heart Failure

Congestive heart failure, also known as heart failure, is a disease where your heart doesn’t pump blood in the way that it should. This is usually brought on by a number of conditions such as narrowed heart arteries (coronary artery disease) or high blood pressure. What results in your heart muscle being too weak or stiff to pump blood as effectively as it did when you were healthy. According to the Cleveland Clinic, heart failure is the leading cause of hospitalization in people 65 years and older.

Just like your lungs, your heart plays an important role in your systemic health. When your body isn’t able to pump blood effectively, other areas of your body may suffer just as greatly. Edema is one sign that you’re experiencing heart failure. This is when your extremities such as your hands, feet, or legs begin to fill with fluid, usually turning a purple color. And while edema on its own is not usually a serious problem, it’s a sign that you could be suffering from heart failure or some other heart-related problem.

Another area of the body that’s affected by your heart health is your lungs. This is because your heart and lungs work together to circulate oxygen-rich blood throughout your body. When your heart is unable to circulate blood properly it can lead to symptoms like shortness of breath, problems exercising, and chronic fatigue. This is often caused by either congestion in the lungs or a lack of oxygen in the tissues throughout your body which can make you feel tired and weak. You might also experience dizziness, confusion, or problems concentrating.

When is Supplemental Oxygen Needed?

Since congestive heart failure is a disease that affects the heart, it’s hard to compare to the other diseases on this list which are all lung diseases. However, despite this fact, congestive heart failure still sometimes requires the use of supplemental oxygen. More often than not, your doctor will prescribe you with supplemental oxygen when your heart failure causes low levels of oxygen in your blood. According to Web MD, you’re less likely to be prescribed oxygen if you just have mild symptoms because too much oxygen can be very dangerous in heart failure patients.  

All things considered, supplemental oxygen is not a cure-all when it comes to heart disease. In reality, it won’t do a lot to help you manage heart disease symptoms. What it aims to do is prevent collateral issues caused by heart disease. In other words, it prevents further damage from being done to your body.

Conclusion

Supplemental oxygen therapy is a treatment with a long history. It’s been used for hundreds of years to help pneumonia patients manage their symptoms and over the years, researchers have discovered many other conditions that can benefit from supplemental oxygen. If you have one of the conditions listed above, it may be worth asking your doctor if you could benefit from using supplemental oxygen.

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If your doctor prescribes you supplemental oxygen, you’re going to need an oxygen device that’s right for you and your needs. Here at LPT Medical, we have a wide selection of stationary oxygen concentrators, portable continuous flow oxygen concentrators, and portable pulse dose oxygen concentrators. These devices are significantly less bulky and heavy than traditional oxygen delivery methods such as oxygen tanks and liquid oxygen tanks, but they provide you the same medical-grade oxygen. Feel free to reach out to us either by email or by phone to speak with an oxygen concentrator specialist.

Asthma and COPD are often confused, but they are two very different diseases. Even though they both cause similar respiratory symptoms, they affect the lungs in distinct and different ways.

COPD is an age-related disease that usually affects smokers and people with long-term exposure to toxins that damage their lungs. Asthma, on the other hand, is often inherited and affects children, teens, and adults of all ages.

Understanding the differences between these two respiratory conditions is important for adults who experience chronic respiratory symptoms, especially if they have already been diagnosed with asthma. While asthma and COPD are separate conditions, in some cases, asthma can cause or contribute to COPD.

COPD is one of the most under-diagnosed and commonly mis-diagnosed diseases, so it's important for doctors and patients alike to be knowledgeable about what sets it apart. That's why, in this article, we're going to show you how to recognize and distinguish the differences between asthma and COPD.

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Asthma Versus COPD

It is difficult to tell asthma and COPD apart by symptoms alone. Serious symptoms like coughing and difficulty breathing can be caused by asthma, COPD, or a combination of both at the same time.

Here are some of the symptoms that asthma and COPD share:

• Coughing
• Wheezing
• Shortness of breath
• Rapid breathing
• Bronchial spasms
• Chest tightness and discomfort

Despite their similarities, from a medical standpoint, it's vital to be able to tell the two diseases apart. Both asthma and COPD require different medical approaches and respond to different treatments and medications.

Moreover, in some cases, people with asthma are actually more prone to developing COPD later in life. Studies show that about forty percent of people with COPD also have asthma, so it's vital for patients to understand the relationship between the two conditions.

In this next section we're going to help you do just that by explaining the causes and symptoms of asthma and COPD. Next, we'll break down the many differences between asthma and COPD and explain the characteristics that distinguish them from one another.

By the end of this article, you'll have a much better understanding of how the diseases are similar and different and be better able to tell the two conditions apart.

Understanding COPD

COPD can be a difficult disease to understand, partially because it is an umbrella term that encompasses two separate but related conditions: emphysema and chronic bronchitis. Both are chronic, incurable lung conditions, usually caused by smoking.

Emphysema occurs when the air sacs (alveoli) in the lungs get damaged, causing lung function decline and over-inflation in the lungs. People with emphysema have difficulty absorbing enough oxygen and pushing all of the air out of their lungs.

Chronic bronchitis occurs when the airways become inflamed, thickened, and narrowed due to inflammation and excess mucus. Most people with COPD have some combination of both emphysema and chronic bronchitis.

Both chronic bronchitis and emphysema cause similar symptoms that get worse and worse over time. While proper treatment and a healthy lifestyle can slow down disease progression, they can't stop COPD from inevitably getting worse.

Over time, COPD leads to more serious complications like pulmonary hypertension, heart failure, respiratory failure, and death. But with a healthy lifestyle and high-quality medical treatment, many people with COPD are able to live and stay active for many years.

Common Symptoms of COPD:

• Coughing
• Wheezing
• Chest Tightness
• Shortness of breath
• Thick or excess mucus
• A chronic cough that produces phlegm (especially in the morning)
• Frequent respiratory illnesses and infections
• Fatigue
• Unintended weight loss
• Swelling in hand, ankles, feet, and legs (edema)

Understanding Asthma

Unlike COPD, which usually shows up later in life, asthma can be inherited and often shows up in early childhood. Most people discover they have asthma after they experience an exacerbation, often in reaction to an allergen or respiratory infection.

People with asthma don't have symptoms all the time. Asthma symptoms usually only show up in response to an environmental trigger, which is often pollen, smoke, or cold air. Because of this, asthma is often considered to be an allergic disorder.

When someone with asthma is affected by a trigger, it causes the muscles in their lungs and airways to violently constrict in an attempt to keep irritating molecules out. This causes a fit of coughing and wheezing that often requires medication to stop.

Asthma attacks can be life-threatening if not treated quickly. Most of the time, treatment involves inhaling bronchodilators and corticosteroids to control inflammation.

Common Symptoms of Asthma:

• Coughing
• Wheezing
• Shortness of breath
• Chest pain and tightness
• “Asthma attacks” consisting of coughing and wheezing that are worsened by illnesses and allergies

How to Tell Asthma and COPD Apart

Differences in Age of Onset

Many people first start to show symptoms of asthma in early childhood and get diagnosed with the disease at an early age. Some people grow out of their asthma symptoms, but many people continue to have the condition throughout their adult life.

COPD, on the other hand, is an acquired disease that doesn't show up until later in life. It's a result of cumulative damage to the lungs and airways over many years, and is usually diagnosed after the age of forty.

Symptoms are usually mild in the early stages of COPD, but get more and more severe with time. In the later stages of the disease, people with COPD usually exhibit severe respiratory decline and need supplemental oxygen to breathe.

While asthma symptoms might be exacerbated by allergies and other triggers for short periods of time, the symptoms don't usually get worse with time. In-between exacerbations the symptoms usually disappear, and the disease doesn't usually progress into anything more serious.

Differences in Causes

COPD is usually caused by exposure to smoke, pollution, and other substances that damage your lungs.  In fact, about 90% of COPD cases are caused by smoking tobacco.

Common Causes of COPD:

• Smoking cigarettes and other forms of tobacco
  
  
• Long-term exposure to other sources of smoke, including wood-burning stoves, cooking fumes, and secondhand smoke.
  
  
• Long-term exposure to respiratory irritants like bacteria, mold, and chemical fumes (e.g. in the workplace).
  
  
• Exposure to respiratory toxins like asbestos and radon
  
  
• Alpha-1 Antitrypsin Disorder, a genetic disease that causes thickened mucus in the lungs, airways, and other parts of the body.

The causes of asthma, on the other hand, are not as well understood. Like COPD, asthma can result from lung damage due to exposure to respiratory toxins. However, this is actually the least common cause.

Asthma is much more likely to show up early in life, before the lungs have a chance to accumulate any serious damage. Instead, asthma is more likely to be the result of genetics, early childhood respiratory infections, or allergies.

Common Causes of Asthma:

• Genetic-linked Asthma: Asthma linked to a family history of asthma and other allergic disorders like hay fever and eczema
  
  
• Illness-induced Asthma: Asthma caused by recurrent respiratory infections or serious lung infections early in life
  
  
• Allergy-induced Asthma: Asthma caused by airborne irritants and allergens like pollen, mold spores, dust mites, and pet dander
  
  
• Occupational Asthma: Asthma caused by long-term occupational exposure to smoke, dust, or chemical fumes and gases

Differences in Symptoms

As you can see, asthma and COPD symptoms can seem very similar on the surface. However, if you pay closer attention to these symptoms and when they occur, you can better tell the difference between the two diseases.

For example, the most common symptoms of both asthma and COPD are coughing, wheezing, and difficulty breathing. These symptoms tend to show up early on in both diseases, but the frequency of these symptoms differs between the two.

People with asthma tend to only show symptoms when they're triggered by an exacerbation. Once the exacerbation has been treated with medication, the symptoms usually disappear.

People with COPD tend to experience chronic symptoms that don't ever completely go away. While certain triggers and exacerbations can make their symptoms much worse, COPD patients generally face milder symptoms of coughing and breathlessness every day.

Another difference is in the nature of the cough. Asthma tends to cause a dry cough that comes with bouts of breathlessness and wheezing, while COPD tends to cause a wet, phlegm cough that appears every day, independent of breathing difficulties.

Differences in Triggers

Besides examining potential causes and specific symptoms, another way to tell asthma and COPD apart is by their triggers. Some of the triggers for worsened asthma and COPD symptoms are the same, but some are unique.

As we've mentioned, asthma symptoms tend to be severe and show up in response to weather, allergens, and heavy physical activity. COPD symptoms, on the other hand, are chronic and milder, although exposure to extreme weather, exercise, allergens, and other respiratory irritants can worsen symptoms to a degree.

However, these irritants usually only trigger slightly worsened coughing and breathlessness in people with COPD, not an actual exacerbation. True exacerbations are much more serious and are usually only caused by respiratory illnesses and infections.

Severe asthma exacerbations, on the other hand, can be easily triggered by minor environmental irritants like cold air and pollen.

Common Triggers for Asthma Exacerbations:

• Allergens
• Exercise
• Cold air

Common Triggers for COPD Exacerbations:

• Respiratory infections
• Respiratory illnesses like the cold, flu, or pneumonia
• Exposure to pollutants and lung irritants

By paying attention to what activities and environments cause your symptoms to act up, you can often determine whether asthma or COPD is the more likely culprit. Keep a look out for distinguishing triggers and make sure to report any new symptoms or sensitivities to your doctor as they come up.

Asthma Can Increase Your Risk for COPD

Despite being distinct and separate diseases, in some cases asthma and COPD are intimately related. Studies show that up to forty percent of people with COPD also have asthma, which indicates that people with asthma are at a much higher risk for the disease.

Doctors and researchers aren't quite sure what might cause people with asthma to develop COPD (known as asthma-COPD overlap syndrome), but it might have to do with the chronic respiratory inflammation that asthma causes. Severe, untreated asthma, researchers postulate, might cause changes in the lungs and airways that reduce lung function over time.

If their lung function has already been affected, people with severe, untreated asthma may be even more prone to developing COPD. This is especially true if they smoke or are exposed to other respiratory irritants over a long period of time.

To the best of medical knowledge, the best way to prevent asthma-related COPD is early asthma treatment and symptom management. Asthma patients who are diagnosed early and get medicine to treat their symptoms usually don't experience complications later in life.

Diagnosing COPD

COPD symptoms tend to show up later in life, usually after the age of forty. Symptoms often start with coughing and breathlessness during exercise, which prompts many patients to visit their doctor to determine the cause.

The doctor will then do a general physical exam and test the patient's lungs. To do this, doctors use a special lung test called a spirometry test.

To do this simple test, the patient takes a deep breath and then blows as hard as they can into a spirometer. Based on the spirometer's score, the doctor can tell how much the patient's lung function has declined, if at all.

Based on the spirometry results, the physical exam, and the patient's age and smoking history, the doctor will determine whether COPD is an accurate diagnosis. If the patient is over forty, has decreased lung function, and is a current or former smoker, COPD is very likely.

Unlike asthma, COPD does not respond completely to treatment with medications like steroids and bronchodilators. An asthma patient's lung function tends to return to normal after treatment, whereas COPD patients experience a permanent loss in lung function that cannot be restored with medications.

While COPD symptoms can be treated with medicine, they never quite go away completely. The damage that the lungs have already sustained can never be undone.

Diagnosing Asthma

Asthma symptoms often show up by the age of five, starting with bouts of wheezing and dry coughing. These ailments usually prompt a visit to the doctor, who does a general physical exam and listens to the patient's lungs for wheezing and abnormalities.

The doctor will note any allergies the patient has along with any additional respiratory symptoms.  Doctors also use spirometry tests to check overall lung function in suspected asthma patients.

If asthma is suspected, the doctor will then prescribe an inhaled bronchodilator medication (inhaler) for the patient to use if the symptoms show up again. If the patient responds well to the medication and the symptoms disappear quickly after using their inhaler, the doctor will usually diagnose the patient with asthma.

Medical Treatments for Asthma and COPD

Treatment approaches to asthma and COPD are both similar and different. Asthma treatment focuses on using medication to treat asthma symptoms exacerbations when they come. COPD treatment, on the other hand, tend to focus on exercise, diet, and lifestyle changes that can strengthen the lungs and prevent further respiratory decline.

Bronchodilators are a type of inhaled medication used to reduce coughing and wheezing by opening up the airways and making it easier to breathe. Both people with asthma and people with COPD use bronchodilator medications to treat immediate respiratory symptoms, and it's a primary method of treatment for COPD.

People with asthma usually also take inhaled corticosteroid medications on a regular basis to help manage inflammation and prevent exacerbations. While COPD patients sometimes take corticosteroids as well, it's not as common for long-term treatment.

As the disease progresses, people with COPD often end up needing to use supplemental oxygen therapy in order for their lungs to absorb enough oxygen to meet their body's needs. This is rarely needed for people with asthma except in the midst of a severe exacerbation. This is because asthmatic lungs are generally healthy and able to absorb enough oxygen on their own in normal circumstances.

In the latest stages of the disease, some COPD patients are eligible for lung reduction surgery or lung transplant surgery. These are last-resort measures that are usually only used if a patient is unable to survive on their own without them.

Lifestyle Treatments for Asthma and COPD

Treating asthma usually doesn't require any major lifestyle changes besides not smoking and avoiding respiratory irritants. Asthma patients focus mainly on controlling inflammation and preventing exposure to triggers that result in exacerbations.

COPD, on the other hand, requires a myriad of lifestyle changes and a tailored treatment plan. The most important thing to do is to quit smoking, but after that a healthy diet, exercise, and medications take priority. Although continued respiratory decline is inevitable for most people with COPD, these lifestyle changes can slow down the disease's progression and improve their ability to breathe.

Obviously, people with asthma can benefit from a healthy diet and lifestyle, too. Both people with asthma and COPD should never smoke, stay physically active, and eat a balanced diet full of fruits, veggies, and lean protein.

Staying hydrated is also very important for managing a respiratory illness like asthma or COPD. Water thins out the mucus in your airways, making it easier to breathe, and keeps the rest of your body's functions running efficiently.

Exercise is also very important, but especially for people with COPD. People with asthma should get plenty of physical activity too, but for people with COPD it is vital to prevent further physical and respiratory decline.

Disease Outlook for Asthma and COPD

People with asthma generally only have to worry about avoiding their triggers and treating inflammation with medication. While poor lifestyle choices like smoking and exposure to respiratory irritants can sometimes make asthma worse, most people with asthma live healthy lives and experience no decrease in lifespan.

COPD, on the other hand, tends to slowly worsen over time no matter how well it's treated. Quitting smoking and building healthier habits can improve your lifespan and quality of life, but it cannot prevent the disease from continuing to progress.

However, many people with COPD are able to live good, fulfilling lives in spite of their disease. This depends partially on an early diagnosis, but primarily on how well you comply with your COPD treatment plan.

How much physical activity you get, how well you manage your symptoms, and how well you practice other healthy lifestyle and diet habits can have a major effect on your body's strength and ability to cope with the disease.

Conclusion

If you are an adult with worrisome respiratory symptoms, it can be difficult to get an accurate diagnosis. One reason for this is the fact that both asthma and COPD share identical symptoms and sometimes share a common cause.

Both asthma and COPD are relatively common diseases, which makes it all the more important for more people to be able to recognize and seek treatment for both. The relationship between the two conditions can be complicated, and it's important for patients and their loved ones to be aware.

Now that you've learned more about the two diseases, you will be better equipped to help yourself, your friends, and your loved ones get proper diagnosis and treatment for their respiratory symptoms. While you should always defer to a doctor for a final diagnosis, this knowledge is vital to help the estimated thirteen million people with COPD who are still un-diagnosed get the medical attention they need.

While neither disease can be cured, the symptoms of asthma and COPD can be reduced and controlled with the right kind of care. The earlier someone with asthma or COPD gets an accurate diagnosis and begins treating their disease, the easier it is to stay healthy and maintain a good quality of life.