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What makes COPD worse? Here are 4 sneaky causes

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Is your chronic obstructive pulmonary disease acting up? One of these reasons could be to blame. Here’s what to do.

More than 16 million Americans have chronic obstructive pulmonary disease (COPD). It’s a lung problem that makes it hard to breathe. And up to half of people with it have at least one flare-up every year, often landing them in the hospital.1

Those flare-ups can make you feel worse than usual if you have COPD. You might feel extra tired and feel a tightness in your chest. You could have a bad cough and find it hard to catch your breath.

It’s tempting to think there’s nothing you can do for these tough symptoms. But it’s very possible to live a healthy life even with a serious illness that affects your lungs. Even better, small changes can have a big impact on how you feel. You just need to know what to do.

If your COPD has been acting up, one of these often-overlooked causes could be to blame. Get a jump on them now so you can breathe easier later.

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Too much couch time can make COPD symptoms worse

When it’s hard to breathe, you may want to sit back and relax. But that can make your COPD worse. What can make it better? Exercise. It helps your blood circulate and sends oxygen throughout your body. It even makes your breathing muscles stronger.2

A recent study found that people with lung disease who walked less had more flare-ups. They spent more time in the hospital, too.3 Another study showed that adding just 1,000 steps a day reduces the risk of a hospital stay by 20%. Talk to your doctor about the best ways for you to add more movement to your routine.4 You can even ask if pulmonary rehab could be right for you.

Too much soda (or even seltzer) can make it harder to breathe

What’s more refreshing on a hot day than an icy, bubbly soda? But for people with COPD, those bubbles can mean trouble. The carbonation can make your stomach swell up and push up against the diaphragm. That’s the muscle that separates the stomach from the lungs. When that happens, it can make it harder to breathe.5

Still, drink plenty of fluids. This will help keep the mucus in your lungs thin. (Mucus is supposed to protect your nose, mouth and lungs. If it gets too thick, you can have trouble breathing.) But stay away from carbonated beverages. Stick with water, or to mix it up, try a no-sugar-added fruit juice or herbal tea instead.

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Unhealthy eating can worsen COPD symptoms

Turns out, what you eat affects how you breathe. Some foods, such as white bread and pastries, fried foods and red meat, can damage tissue in the body. It’s a process called inflammation. And studies show that it increases your risk of a COPD flare-up.

Here’s a simple way to break unhealthy patterns. Start shifting toward a more Mediterranean diet. This way of eating doesn’t have strict rules. Instead, it encourages you to fill your plate with veggies, whole grains, fruits and healthy fats like olive oil. It also includes healthy proteins (chicken, fish, beans), which help maintain strong breathing muscles. The other bonus? It can cut your inflammation levels.6

Depression and anxiety can lead to COPD flare-ups

When it comes to COPD, your mood matters. Anxiety (worry) and depression can increase COPD flare-ups and lead to more hospital stays.7 It’s a vicious cycle, too. When your breathing is shallow, your brain thinks you’re stressed. And that causes an anxious response in your body that may make breathing difficult.8

That means it’s super important to figure out what’s stressing you and find ways to deal with it. Add calming activities to your day. Try meditation, or talk with a trusted friend. Gentle exercise is a great mood booster, too. Talk to your doctor about the best kinds of movement for you. Need more help coping with stress? Ask your doctor about finding a mental health professional to help you work through your concerns.

Optum has mental health resources that fit with your life. Work one-on-one with a virtual coach or therapist from AbleTo. Find support now.

3 Things to know about COPD


  1. PubMed Central. Frequency and severity of exacerbations of COPD associated with future risk of exacerbations and mortality: A UK routine health care data study. Published March 3, 2022. Accessed June 28, 2022.
  2. American Lung Association. Physical activity and COPD. Last updated March 5, 2021. Accessed June 28, 2022.
  3. Journal of Clinical Medicine. Exacerbations and changes in physical activity and sedentary behaviour in patients with bronchiectasis after 1 year. Published March 12, 2021. Accessed June 27, 2022.
  4. European Respiratory Journal. Benefits of physical activity on COPD hospitalisation depend on intensity. Published November 2015. Accessed June 27, 2022.
  5. American Lung Association. Nutrition and COPD. Last updated June 10, 2021. Accessed June 28, 2022.
  6. Frontiers in Nutrition. Association between diet-related inflammation and COPD: Findings from NHANES III. Published October 18, 2021. Accessed June 28, 2022.
  7. Frontiers in Genetics. The Relationship Between Hospitalization Frequency of Acute Exacerbation of Chronic Obstructive Pulmonary Disease and Anxiety and Depression. Published April 8, 2022. Accessed June 28, 2022.
  8. American Lung Association. Coping with COPD and anxiety. Published November 27, 2018. Accessed June 28, 2022.

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