Coughing can be an unpleasant symptom of chronic obstructive pulmonary disease (COPD), but it plays a vital role in ridding the lungs of mucus. Learning how to cough correctly can help individuals with COPD to clear their airways and breathe easier.

In this article, we look at the link between COPD and coughing.

We also look at treatments that can help to ease symptoms, and when a person should seek medical attention.

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A chronic cough is a typical symptom of COPD. Usually, the airways and air sacs, or alveoli, in the lungs are elastic and stretchy. As a person breathes in, the alveoli fill up with air. When a person breathes out, the alveoli deflate.

The National Heart, Lung, and Blood Institute (NHLBI) note that COPD results in less airflow, making it difficult to breathe. COPD affects the airways and alveoli in the following ways:

  • They lose their elasticity.
  • The walls between the alveoli are destroyed.
  • The airway walls become inflamed and thick.
  • The airways produce more mucus and become clogged.

The reduced airflow causes airway obstruction and makes it increasingly difficult to move air to and from the lungs.

The inflammation causes the nerves in the lungs to become sensitive, and in response, the body forces out air with rapid, intense muscle contractions, otherwise known as a cough.

The NHLBI note that in the United States there are two main forms of COPD. These include emphysema and chronic bronchitis.

With chronic bronchitis, the lining of the airways is constantly irritated and inflamed. This causes the lining to swell. As a result, large amounts of thick mucus can form, making it difficult to breathe.

Although chronic coughing is disruptive, it has an essential role in clearing mucus from the lungs that can obstruct the airways. Dislodging mucus allows people to breathe easier.

Doctors and pulmonary therapists may teach people with COPD how to cough in a controlled manner, with just enough force to loosen mucus without causing the airways and alveoli to collapse.

If someone with COPD is coughing more than usual, they should visit a doctor. The doctor can check for chest infections or other conditions that may cause worsening symptoms.

There is currently no cure for COPD. But treatment options may help lessen symptoms and slow the disease’s progression.

Medications, coughing techniques, and devices to help clear mucus may provide some relief from a chronic cough.

Medications for COPD help open the airways, increase mucus clearance, and decrease inflammation.

A doctor can personalize each person’s medication to best control their symptoms.

COPD medications include:

Inhaled bronchodilator

An inhaler or nebulizer delivers these medications directly into the lungs as someone breathes. They relax the muscles surrounding the airways, keeping them open and making breathing easier.

Bronchodilators can be long-acting and short-acting. They include beta2-agonists and anticholinergics.

Beta2-agonists relax the tightened muscles around a person’s airways. Short-acting beta-agonists work within minutes, lasting 4–6 hours. Long-acting beta-agonists last longer, but take longer to work.

Anticholinergics prevent the muscles around a person’s airways from tightening. They also help to clear mucus from the lungs. As a result, the cough is able to expel the mucus more easily.

Anti-inflammatories

Inflamed airways lead to swelling and mucus production, which cause breathing difficulties.

Anti-inflammatories, such as corticosteroids or steroids, help control the adverse effects of inflammation. These typically come in the form of an inhaler, although they can also be in the form of a pill.

As steroids can have serious side effects, such as diabetes and increased chance of infection, doctors will monitor their effects carefully.

Antibiotics

Bacterial and viral infections can cause people with COPD to experience flare-ups, resulting in more coughing and more mucus production.

A doctor may prescribe an antibiotic if they suspect an individual has a bacterial chest infection.

People can use a special coughing technique called huffing to help them clear their airways.

A person can perform the following steps:

  1. To begin with, take a deep breath through the nose.
  2. Pull the belly inward toward the spine to force the air from the lungs.
  3. Exhale with three short breaths, making a “huff” sound at the back of the throat.

There are two types of huffing. The first is the small-long huff. This aims to move the mucus from low down in the chest. A person should take a small to medium breath in. They should then huff the air out until the lungs feel empty.

The second type of huffing is the big-short huff. This removes mucus from higher up in the chest. As a result, a person can do this when they feel the mucus begin to come out. They should take a deep breath in then huff the air out quickly.

A person can also try controlled coughing. To do this, they can perform the following steps:

  1. Sit on a chair, relax the shoulders, and keep both feet on the floor.
  2. Fold the arms over the stomach and slowly inhale through the nose.
  3. Exhale slowly while leaning forward and pushing the arms against the stomach.
  4. Cough two or three times during the exhale, keeping the mouth open.
  5. Inhale slowly through the nose.
  6. Repeat as needed.

A doctor may recommend using the huff cough combined with other airway clearing techniques or devices to optimize mucus clearance.

Learn more about ways to clear the lungs here.

The American Lung Association note that a person can use various airway clearance devices to help people clear excess mucus.

Older 2008 research lists the following devices:

  • Intrapulmonary percussive ventilation (IPV) device: The IPV device delivers air cycles into the lungs through a mouthpiece, which vibrates the chest, loosening mucus.
  • Oral high frequency oscillation device: A mouthpiece delivers sound oscillations to the lungs, which help remove carbon dioxide and mucus.
  • Positive expiratory pressure (PEP): During this therapy, an individual can breathe in freely, but there is resistance as they breathe out. This holds the airways open and helps air move mucus from the lungs.
  • Oscillating PEP: This process helps more air enter the airways, which dislodges mucus.
  • Flutter mucus clearance system: This device combines PEP therapy with oscillations that create vibrations as someone exhales to loosen mucus and accelerate the airflow.
  • High frequency chest wall oscillation: An inflatable vest uses air pressure to vibrate the chest wall, which increases airflow to the small airways and mucus clearance.
  • Lung flute acoustic induction device: This handheld device generates low-frequency sound waves that enter the airways as someone forcefully exhales through the mouthpiece. The waves stimulate mucus clearance in the lower airways.

In addition, if people have low levels of oxygen, they may benefit from oxygen therapy delivered through a nasal tube or mask.

Various home remedies can ease COPD symptoms, including:

  • stopping smoking
  • improving air quality in the home
  • doing breathing exercises
  • maintaining a moderate weight
  • steam inhalation

Learn more about home remedies for COPD here.

Coughing is a common symptom of COPD. Two forms of COPD include chronic bronchitis and emphysema.

A chronic cough causes a persistent and productive cough due to the amount of mucus in a person’s lungs and airways.

Key symptoms of emphysema include chronic shortness of breath and a cough. The cough may or may not produce mucus.

But an individual with COPD may display other symptoms of COPD without having a cough.

Learn more about the symptoms of COPD here.

People who are short of breath, wheezing, producing lots of mucus, having frequent respiratory infections, or feeling fatigued should contact a doctor to discuss their symptoms.

The outlook for COPD varies based on the individual, their age, lifestyle, and overall health. There is no cure, and it typically reduces life expectancy.

COPD usually progresses in stages, and people can manage early symptoms with lifestyle changes and medications that help maintain a good quality of life.

As COPD advances, individuals often find the symptoms impact their lives increasingly.

Learn more about the stages of COPD here.

The outlook depends on how an individual responds to treatment and if they can avoid complications. People should talk with a doctor to find out what they can expect.

A person who experiences frequent coughing, wheezing, excess mucus, or breathing problems should contact a doctor.

These symptoms do not necessarily mean someone has COPD, but the doctor will confirm a diagnosis.

People with COPD should contact a doctor if they develop new or worsening symptoms.

Coughing is a typical symptom of COPD. Although it can be unpleasant, coughing serves a purpose and helps the lungs rid themselves of mucus.

People should discuss COPD treatment options with a doctor. These include medications, mucus removing devices, and controlled breathing exercises.

There are also natural remedies that may ease the symptoms of COPD and a cough.