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Signs of Worsening COPD

Nina Ghamrawi, MS, RD, CDE
January 23, 2022
March 9, 2023

We begin our lives with a breath. And throughout life, we breathe passively, without even thinking about it. Our lungs are not only keeping us alive from the moment we come into the world, but also play an important part in our regular bodily functions. If you have Chronic obstructive Pulmonary Disease, or COPD, you probably now realize how important your lung health is in giving you comfort and happiness. But if you are ever having symptoms associated with your lungs, it is important to know what the symptoms are, how your lungs may be suffering, and when to get help.

Some Common Symptoms of COPD are:

  • Chronic cough or a cough that produces a lot of mucus
  • Shortness of breath, especially with physical activity
  • Wheezing
  • Chest tightness
  • Fatigue
  • Cyanosis (blue-ish fingertips, lips, and toes)

If you have repeatedly low blood oxygen levels with COPD, and this is not usual for you, you may develop something called respiratory acidosis, where the environment in the lungs becomes acidic. Symptoms of respiratory acidosis may include:

  • Confusion
  • Anxiety
  • Easy fatigue
  • Lethargy
  • Shortness of breath
  • Sleepiness
  • Tremors (shaking)
  • Warm and flushed skin
  • Sweating

If you have COPD and you develop any of these symptoms, talk to your doctor immediately. If the symptoms go away, still talk to your doctor about this as it may be a serious issue. If a person has respiratory acidosis for a long period, the kidneys will start compensating to keep the balance of acidity at safe levels, and though the acidosis symptoms may go away, this can stress the kidneys and lungs over time.

Monitor Blood Oxygen Regularly

If you are monitoring blood oxygen levels regularly, you’ll get a sense for when you are at risk of developing symptoms. It is crucial to know your typical oxygen range, or baseline. If you don’t know, your pulmonologist can tell you.

Read this about knowing your numbers to get a better sense of where you should be, and how to find a rough baseline.

What to Do If You are Having Symptoms

If you are experiencing low blood oxygen that is below your baseline or atypical for you, consult your doctor on the most acceptable treatment. You may need emergency medical care. If you have oxygen therapy at home, you may be instructed to use it.

Treatment may be in the form of:

  • Medications or medication adjustments
  • Bronchodilator - usually through an inhaler
  • Short-acting bronchodilators last about 4–6 hours and should be used only when needed.
  • Long-acting bronchodilators last about 12 hours or more and are used every day.
  • Anti-Inflammatory - usually corticosteroids or steroids
  • Antibiotics - if there is a bacterial or viral lung infection
  • Oxygen therapy  - for people with severe COPD and low blood oxygen levels
  • Pulmonary Rehabilitation Programs


Regardless of your blood oxygen values right now, the most crucial thing is to monitor your blood oxygen regularly per a schedule, and keep aware of how your body feels from day to day. If you have a low blood oxygen, ask yourself: do I feel less well, or have more symptoms than usual? If so, then you should talk to your doctor for assistance to treat the issue. If you think your symptoms are caused by something else, like an off-balanced meal, exercise, or smoking, then definitely write a note on your reading result to let your care team know.

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