Early signs of chronic obstructive pulmonary disease (COPD) include a chronic cough, increased mucus, and tiredness. Knowing which symptoms to look out for at home can help a person know when to visit a doctor for tests.

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COPD is the term for a group of lung diseases that tend to worsen over time. Examples of these conditions include emphysema and chronic bronchitis.

COPD obstructs a person’s airways, making it difficult to breathe. It is a progressive condition, meaning it tends to worsen over time. Without treatment, COPD can be life threatening.

According to the World Health Organization (WHO), the Global Burden of Disease Study estimated that COPD caused 3.23 million deaths worldwide in 2019. Additionally, health experts estimate around 16 million people in the United States have the disease.

This article describes the early signs and symptoms of COPD and how it gets worse. It also covers when to speak with a doctor.

The Global Initiative for Chronic Obstructive Lung Disease’s COPD Gold Guidelines can help doctors assess whether a person has COPD according to the nature and degree of their symptoms, their history of symptom progression, and the presence of additional medical diagnoses that might cause or worsen their symptoms.

Additionally, the guidelines classify the severity of airflow limitation in COPD according to forced expiratory volume (FEV). FEV is how much air a person can push out of their lungs in 1 second during a spirometry test. The lower the value, the more breathing difficulties an individual has. Health experts grade the severity of airflow limitation using four categories:

Airflow Limitation SeverityFEV value
Very severe0–29%

However, the organization also recognizes that assessment of airflow limitation alone is not sufficient, as health experts now know COPD affects more than a person’s ability to breathe. With this in mind, a full medical examination by a doctor can best determine whether an individual has COPD and the degree of the disease’s severity.

In its early stages, COPD symptoms may be so mild that the individual does not notice them. The symptoms and severity of COPD can also vary from person to person.

However, because the disease is progressive, symptoms often worsen over time. The early signs and symptoms of COPD can include the below.

Chronic cough

A persistent or chronic cough is often one of the first symptoms of COPD. A person may experience a chesty cough that does not go away on its own.

Doctors generally consider a cough that lasts for longer than 8 weeks to be chronic.

Coughing is a protective mechanism that typically occurs in response to irritants, such as inhaled cigarette or tobacco smoke, getting into the lungs. Coughing also helps remove phlegm, or mucus, from the lungs.

However, if a person has an ongoing cough, this may signify a problem with their lungs.

Excess mucus production

Producing too much mucus can also be an early symptom of COPD. Mucus is essential for keeping the airways moist, and it also captures germs and irritants that get into the lungs.

When a person inhales an irritant, their body produces more mucus, which can lead to coughing. Smoking is a very common cause of excess mucus production and coughing.

Long-term exposure to irritants can damage the lungs and lead to COPD. Other lung irritants can include:

  • chemical fumes, such as those from paints and strong cleaning products
  • dust
  • pollution, including car exhaust fumes
  • perfumes, hairsprays, and other spray cosmetics

Shortness of breath and tiredness

The obstruction of the air passages can make it more difficult for a person to breathe, which can lead to shortness of breath, another common symptom of COPD.

At first, shortness of breath may only occur after exercise, but it can worsen over time. Some people cope with their breathing difficulties by becoming less active, which can lead to them becoming less physically fit.

A person with COPD needs to exert extra effort to breathe. This exertion can result in lower energy levels and feeling tired all the time.

Because their lungs are not functioning as well as they should, people with COPD are more likely to experience chest infections, including the common cold, flu, and pneumonia.

Other symptoms of COPD include:

  • unintentional weight loss, according to an older 2013 study
  • swelling in the lower legs
  • itching
  • dry mouth
  • sexual problems
  • dizziness
  • bladder problems
  • bloating
  • drowsiness
  • fatigue

A person with a COPD diagnosis may experience flare-ups, which are also known as COPD exacerbations, when symptoms suddenly worsen. Triggers of COPD flare-ups can include chest infections and exposure to cigarette smoke and other lung irritants.

Exacerbations may begin as mild, but they can become very serious quickly without prompt medical care. Early warning signs of a COPD flare-up may include:

  • symptoms suddenly becoming more severe within days or even hours
  • coughing becoming stronger, more frequent, or different than usual
  • suddenly becoming out of breath and struggling to do things a person can normally do, such as walking or taking a shower
  • the color of the person’s sputum — the thick mucus that comes from the lungs — changing from clear to a darker color
  • producing more sputum than usual
  • being more tired than usual
  • unusual insomnia, feeling or appearing confused to those around them, or having difficulty waking up, which can indicate high carbon dioxide levels — seek immediate medical attention
  • lower than usual oxygen levels according to pulse oximeter measurements

A person who experiences any of the above symptoms regularly should speak with a doctor. Anyone who experiences signs of COPD exacerbation should also consult their doctor as soon as possible.

Even if people are not sure they have COPD, a healthcare professional can usually distinguish between COPD and other diseases. Early diagnosis of COPD can allow individuals to receive treatment sooner, which can help slow the progression of the disease before it becomes severe or life threatening.

The most common cause of COPD is smoking cigarettes or other tobacco products. According to the National Heart, Lung, and Blood Institute, up to 75% of people with COPD either smoke or have smoked. However, long term exposure to other irritants or harmful fumes may also cause or contribute to the condition.

Genetics may also increase the risk of developing COPD. For example, people with a deficiency in a protein called alpha-1 antitrypsin may be more likely to develop the condition, especially if they smoke or have regular exposure to other lung irritants.

The signs and symptoms of COPD most often start in people aged 40 years or older.

Getting a COPD diagnosis begins with a medical exam. Doctors usually start by asking the individual about their symptoms and medical history, including whether or not they smoke and if they have had exposure to any lung irritants.

They may also perform a physical examination and check for wheezing or other signs of lung problems.

To confirm their diagnosis, a healthcare professional may order some tests, such as:

  • Spirometry: A person breathes into a tube that connects to a machine called a spirometer, which measures how well their lungs are working. To begin the test, the doctor may ask the individual to inhale into a bronchodilator, a type of medication that opens up the airways.
  • Chest X-ray or CT scan: These imaging tests allow a doctor to see inside a person’s chest to check for signs of COPD or other medical conditions.
  • Blood tests: The doctor may order blood tests to check a person’s oxygen levels or rule out other conditions that cause similar signs and symptoms to COPD.

COPD is a common condition. However, some people mistake its symptoms for the normal signs of aging, which can mean they do not get a diagnosis. Without treatment, COPD can become progressively worse over time.

COPD can be a significant cause of disability. An individual with severe COPD may struggle with day-to-day tasks, such as climbing a flight of stairs or standing for prolonged periods to cook a meal. Flare-ups and complications can also severely impact a person’s health and quality of life.

There is no cure for COPD, but early diagnosis and treatment can greatly improve a person’s outlook. Appropriate treatment and lifestyle changes can relieve symptoms and slow or halt the progression of the condition.

Treatment options include medications, oxygen therapy, and pulmonary rehabilitation. Lifestyle changes involve engaging in regular exercise, eating a nutritious diet, and stopping smoking.