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A COPD exacerbation is defined as a period of time when your usual COPD symptoms worsen. For some people, a COPD exacerbation can become so serious that hospitalization is necessary. The most common cause of COPD exacerbations are viral and bacterial infections and air pollution.
Having a flare-up of your COPD symptoms can be downright scary. That’s why, in 5 Ways to Prevent COPD Exacerbation we shared some important tips on how to nip exacerbations in the bud before they occur. How do you know if you’re having an exacerbation? Thankfully, there are 10 warning signs and symptoms that should alert you to seek emergency care or contact your physician as soon as possible.
According to the Cleveland Clinic, getting help for an exacerbation as soon as you notice symptoms is paramount to a speedy recovery. Waiting too long could lead to serious complications; possibly even death. Even if you don’t feel sick or you don’t think your symptoms are that bad, ignoring them could be life-threatening.
Sometimes, a COPD exacerbation requires immediate emergency treatment. Go to the closest emergency room or call 911 if you experience:
Many times, a COPD exacerbation can be effectively managed at home, under the care of your physician. However, there are times that you will need to alert your doctor to changes in your condition that could indicate that your COPD is worsening. Keep careful track of your symptoms and note anything that is new or that seems to be more severe. Report any of the following warning signs to your physician within 24 hours:
While each of these symptoms warrants a call to your doctor, keep in mind that the severity of the symptom should be the indicator for how quickly you should call. Any symptoms that cause you to experience serious breathlessness that you cannot resolve, that leave you unable to speak, that cause you to feel confused and act intoxicated or that include a blue tint in your skin warrant immediate medical attention. When it comes to a COPD flare-up, things can go wrong quickly, so it is better to err on the side of caution and call. Make sure you create and discuss an action plan with your health care team so you know what to do if you experience worsening COPD symptoms or a COPD exacerbation.
Why is COPD worse at night?
Times at which symptoms are worse can vary for patients, depending on a variety of factors. Though many patients experience more severe symptoms in the morning, some people with COPD experience worse symptoms at night. Nighttime arousals are common for people with COPD and patients can awaken with breathlessness, coughing, heartburn, nasal congestion and wheezing. People with COPD are also at an increased risk of sleep apnea, which can cause awakenings and worsening symptoms. If you are experiencing more COPD symptoms at night, talk to your doctor to find out if you should be screened for sleep apnea or nighttime arousals.
COPD is unique to each patient, so your COPD will progress in a way that is unique to your overall health, your lifestyle and other factors, including genetics, age and treatment. COPD cannot be cured, so it will continue to progress no matter what. However, with treatment and lifestyle changes, including avoiding potential risk factors, many people with COPD can significantly slow the progression of their disease. As such, many people with COPD are able to live a long time.
A COPD exacerbation, also called a COPD flare-up, is a worsening of your COPD symptoms. They can occur slowly over a matter of days, or they can come on quickly, in a matter of hours. Look out for the following signs and symptoms so that you can notify your doctor if you believe you are experiencing a COPD flare-up:
Once you have identified the signs of your COPD exacerbations, make note of them as they may begin to show you when a COPD flare-up is coming on.
For more information about COPD and prevention of COPD exacerbation, read:
 Miravitlles, Marc, et al. “The Variability of Respiratory Symptoms and Associated Factors in COPD.” Respiratory Medicine, W.B. Saunders, 26 June 2017, www.sciencedirect.com/science/article/pii/S0954611117301841.
 Balachandran, Jay, and Mihaela Teodorescu. “Sleep Problems in Asthma and COPD.” American Thoracic Society Patient Education Series, pp.P5-P6, Aug. 2018, https://www.thoracic.org/patients/patient-resources/resources/sleep-problems-asthma-copd.pdf
 Lareau, Suzanne, et al. “Exacerbation Of COPD.” American Thoracic Society, American Thoracic Society Patient Education Series, pp.P21-P22, 2018, https://www.thoracic.org/patients/patient-resources/resources/copd-exacerbation-ecopd.pdf.
“Chronic Obstructive Pulmonary Disease (COPD).” Cedars-Sinai: A Non-Profit Hospital in Los Angeles, Cedars-Sinai, Accessed 13 May 2020, www.cedars-sinai.edu/Patients/Health-Conditions/Chronic-Obstructive-Pulmonary-Disease-COPD.aspx.
“Congestive Heart Failure: From Heart Failure to Heart Success.” Huntsville Hospital, Huntsville Hospital Foundation, P5, https://www.theheartcenter.md/images/pdfs/CHF-Patient-Education-Booklet-English-web.pdf.
“COPD and Heart Failure: What Are the Symptoms and How Are They Related?” Cardiovascular Institute of the South, Cardiovascular Institute of the South, 21 Nov. 2017, www.cardio.com/blog/copd-and-heart-failure-what-are-the-symptoms-and-how-are-they-related.
“COPD Symptoms: When to Call the Doctor.” Cleveland Clinic, Cleveland Clinic, Last reviewed 5 Sept. 2017, my.clevelandclinic.org/health/articles/8704-copd-when-to-call-the-doctor-about-your-symptoms.
“Cough When to See a Doctor.” Mayo Clinic, Mayo Foundation for Medical Education and Research, 21 June 2019, www.mayoclinic.org/symptoms/cough/basics/when-to-see-doctor/sym-20050846.
Johnson, Jon. “COPD and Age: Onset, Life Expectancy, and More.” Medical News Today, MediLexicon International, 16 Oct. 2018, www.medicalnewstoday.com/articles/323350#takeaway.
Lareau, Suzanne, et al. “Exacerbation Of COPD.” American Thoracic Society, American Thoracic Society Patient Education Series, pp.P21-P22, 2018, https://www.thoracic.org/patients/patient-resources/resources/copd-exacerbation-ecopd.pdf.
Leader, Deborah. “COPD Symptoms: Calling Your Doctor vs. 911.” Verywell Health, Verywell Health, 24 Sept. 2018, www.verywellhealth.com/copd-worse-when-to-call-the-doctor-about-your-copd-914747.
Leader, Deborah. “Why COPD Causes Your Legs and Ankles to Swell.” Verywell Health, Verywell Health, 10 Feb. 2020, www.verywellhealth.com/why-does-copd-cause-my-legs-and-ankles-to-swell-91487.
Nicholson, Anna. “Fever.” COPD.net, COPD.net, July 2015, https://copd.net/symptoms/fever/.
Orenstein, Beth W. “10 COPD Symptoms That Need Attention: Everyday Health.” EverydayHealth.com, Everyday Health, 6 May 2013, www.everydayhealth.com/copd/copd-symptoms-that-need-attention.aspx.
“What Are the Risks of Having COPD and Pneumonia?” Healthline, Healthline, Accessed 14 May 2020, www.healthline.com/health/copd/copd-and-pneumonia-understanding-your-risk#symptoms.
“Wheezing When to See a Doctor.” Mayo Clinic, Mayo Foundation for Medical Education and Research, 11 Jan. 2018, www.mayoclinic.org/symptoms/wheezing/basics/when-to-see-doctor/sym-20050764?p=1.