What is the best way to manage COPD?

1. Learn This Breathing Exercise for COPD: “Pursed Lip”

When you are experiencing shortness of breath, “pursed lip” breathing can relax your airways and help you get back to normal, says the American Lung Association (ALA).

Here’s how to do this exercise:

• Sit down and relax your neck and shoulders.
• Take in a deep breath through your nose, keeping your mouth closed and filling up as much of your lungs as you can.
• Purse your lips (like you are trying to whistle) and slowly and gently release the air through your mouth for as long as you can. It’s important that the exhale is longer than the inhale.
• Repeat three or four times.

Try doing this technique once or twice a day, as well as whenever you’re having trouble catching your breath.

2. Drink Plenty of Water

Staying well hydrated is important for everyone, but it is especially important for people with COPD, says Dr. Beuther.

The disease can cause the mucus produced by the lungs to become thick, sticky, and difficult to cough up. Drinking enough water can thin the mucus and make it much easier to remove, easing breathing, Beuther explains.

The ALA recommends that people with COPD aim to get at least six to eight 8-ounce glasses of water a day.

But talk to your doctor about how much water you can safely drink: Some people with COPD have conditions such as heart failure that could be made worse by taking in too much fluid.

3. Sit (or Stand) Correctly

Slouching can make it more difficult to breathe, notes the Canadian Lung Association. Straightening your back, on the other hand, helps open the airways.

If you find yourself experiencing shortness of breath, try shifting into one of these positions:

When Sitting

Place both feet flat on the ground, then lean your head and shoulders forward slightly, keeping your back straight. Rest your arms on your knees and keep them relaxed.

When Standing

Lean your back against a wall, chair, or counter. Keeping your feet slightly apart, relax and lean your head and shoulders forward slightly, keeping your back straight. Rest your hands lightly on your thighs.

4. Wedge More Activity Into Your Day

Regular exercise can make a big difference in breathing ability and COPD symptoms.

“A lot of people with COPD get more and more out of breath, but it’s not because of their lung function — it’s because they’re deconditioned,” explains Beuther.

While exercise can’t undo lung damage, it can strengthen your respiratory muscles, improve your circulation, and help you use oxygen more efficiently, says Daniel Ouellette, MD, a pulmonologist and the associate director of medical critical care at Henry Ford Hospital in Detroit.

At first, any physical activity may cause uncomfortable symptoms, like shortness of breath, but that’s part of the process, Dr. Ouellette notes.

“I try to reassure people that exercise is beneficial and that they’re not going to hurt themselves by trying to exercise — in fact, it will improve their ability to do things,” he says.

While you should always check with your provider before starting an exercise routine, simply getting out for a short walk every day can be a simple, and safe, way to get started.

5. Know — and Avoid — Your Triggers

If you have COPD and allergies or asthma, certain things in the environment — such as dust, mold, and pet dander — may aggravate your COPD symptoms

While it can be hard to avoid airborne allergens entirely, reducing your exposure to triggers, particularly in your home, can help you breathe easier.

This may mean putting dust covers on your pillows and mattress, and keeping your pets out of the bedroom, says Loutfi Aboussouan, MD, a pulmonologist at the Cleveland Clinic Respiratory Institute in Ohio.

You may also want to use high-efficiency particulate air (HEPA) filters to remove dust and other irritants from the air and, if mold is an issue for you, run a dehumidifier in your home.

6. Prioritize Sleep

“When you sleep better, you’ll feel better and breathe better,” Dr. Aboussouan says.

In fact, a study published in November 2019 in the journal Chest found a strong association between poor sleep and worsening of COPD symptoms.

Poor sleep can weaken immune function and increase inflammation throughout the body, which experts believe may impact COPD. Tiredness also impairs memory, which might cause some individuals to take their COPD medications incorrectly.

Many people with COPD have an underlying sleep disorder, like sleep apnea, that makes it difficult to get a good night’s sleep.

If you’re having trouble getting at least eight hours of shut-eye each night, talk to your doctor about ways to improve your sleep.

7. Eat Well

Food is the fuel your body needs to perform all activities, including breathing, says the ALA. Getting the right mix of nutrients each day can help ease breathlessness and also increase your energy level.

Eating a balanced diet also helps you maintain a healthy weight, which is particularly important for people with COPD.

If you’re overweight, your heart and lungs have to work harder, making breathing more difficult. In addition, the extra weight might demand more oxygen, says the Cleveland Clinic.

If you’re underweight, on the other hand, you may feel weak and tired. You might also be more vulnerable to potentially dangerous lung infections.

The best diet plan for you will depend on your current body weight, and whether you need to lose or gain pounds.

Talk to your doctor and a registered dietitian about diet changes that may help ease your COPD symptoms and help you feel better.

8. Get Your Annual Vaccines — and the COVID-19 Shot

Both the flu and pneumonia vaccinations are very important for people with COPD, says Joseph Khabbaza MD, a pulmonologist at the Cleveland Clinic in Ohio.

“The flu shot is recommended every year, and you should be getting the vaccine the moment it becomes available if you have COPD or other chronic lung disease,” he advises.

You should also get immunized against pneumonia because this lung infection poses a high risk to people with COPD. The Centers for Disease Control and Prevention (CDC) recommends the vaccine for all adults who are 65 or older, but if you have COPD you qualify regardless of your age.

Because people with COPD are at a higher risk for developing severe illness from COVID-19, it’s also extremely important to get the COVID-19 vaccine, says Michael Sims, MD, clinical director of the COPD Program at Penn Medicine in Philadelphia.

This vaccine is not only very effective at reducing your risk of contracting COVID-19, it also helps guard against complications of respiratory failure and death — protection that is particularly important for people with COPD, notes Dr. Sims.

RELATED: 15 Ways to Stay Healthy During Cold and Flu Season if You Have COPD

9. Stamp Out Stress

Stress can be a vicious cycle for people with COPD. Not being able to breath well creates anxiety. And, anxiety makes you breathe faster, which makes you even more short of breath, notes the ALA.

On top of your COPD, there may be things in your life — from your relationships to your job — that make you feel anxious and, in turn, cause your COPD symptoms to flare.

Try to identify stressors in your life and strategize about ways to minimize them. Maybe you need to work on problematic relationships, tackle money issues, or do a better job of pacing yourself and setting priorities.

You may want to enlist the help of a therapist or social worker, who can help you through this process.

In addition, start incorporating some relaxation techniques into your daily routine, such as breathing exercises, visualizing, mediation, and yoga, recommends the ALA.

These activities help slow your breathing, and can help prevent stress from kicking off a vicious cycle of increasing anxiety and breathlessness.

RLATED: 7 Stress Management Tips for COPD

10. Avoid Smoking — and Smokers

Smoking and exposure to tobacco smoke are the leading risk factors for COPD disease progression and death, says the World Health Organization.

If you’re currently a smoker, the most important step you can take to ease your symptoms and improve your health is to quit, says Dr. Khabbaza.

Quitting smoking is tough, so ask your doctor about programs they recommend. A good first call is 800-QUIT-NOW, a resource from the CDC that offers free coaching, quit plans, and education materials.

Or, check out the ALA’s Freedom From Smoking program, a seven-week clinic (in-person or online) that takes you through the process of quitting smoking one step at a time.

People with COPD should also try to avoid secondhand smoke (smoke that comes from the end of a lit cigarette or pipe or has been exhaled by a person smoking), as well as third-hand smoke, which refers to the smell of smoke left behind on surfaces, such as clothing, carpets, and in cars, says Aboussouan.

RELATED: The Best and Worst Ways to Quit Smoking

11. Use Your Inhaler Correctly

Regular, correct use of inhaled medicines help control symptoms of COPD symptoms and makes it easier to breathe.

But there are many different types of inhalers, and each requires a different technique.

COPD symptoms can actually get worse if you’re not taking your medication properly, says Robert A. Wise, MD, medical director of the pulmonary function laboratory at Johns Hopkins Asthma and Allergy Center in Baltimore.

To make sure you’re using your inhaler the correct way — and the right dose of medicine is reaching your lungs — it’s a good idea to periodically go over your technique with your doctor, Dr. Wise says.

“Very often if someone is worsening, it’s not a matter of changing their medication, but rather ensuring that they are using their inhaler properly,” he adds.

12. Increase Your COPD Knowledge

Learning about COPD and how your lungs function can help you better understand and manage your condition, says Beuther.

If possible, take advantage of any pulmonary rehabilitation programs offered by your local hospital or respiratory center.

You may find free or low-cost classes in proper nutrition and exercises you can do to improve lung function and boost energy, as well as the correct way to take your COPD medication.

Another good resource is the ALA’s Better Breathers Club program, which connects people living with lung disease to education, support, and COPD peer-support communities around the country.

Additional reporting by Becky Upham.

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