Complications From COPD

COPD makes it hard to breathe in as much air as you need. And without enough oxygen, you may have other problems, too.

Fortunately, there are simple things you can do. Stop smoking, exercise, and closely follow your doctor's instructions about treating your COPD to prevent many of these complications.

Lung Infections

Your disease makes it harder to fight off lung infections like pneumonia. Getting sick can then make it harder for you to breathe.

Prevention is a must. Talk to your doctor about which vaccines to get. Some are for pneumonia, while others target illnesses that can make you more prone to pneumonia, like the flu and whooping cough. Wash your hands often to avoid picking up these germs.

Collapsed Lung (Pneumothorax)

COPD can damage lung tissue. And if air leaks into the space between a lung and your chest wall, that lung can collapse like a deflated balloon. You might have sudden shortness of breath, feel sharp chest pain or tightness, or have a hacking cough.

Treatments range from extra oxygen to surgery. To help prevent a collapsed lung from happening, stop smoking and see your COPD doctor regularly.

Poor Gas Exchange

Blood carries oxygen to cells throughout your body and carbon dioxide away from them. But because you're not breathing in and out fully, you may have less oxygen than you need or more carbon dioxide than you want in your blood. Either of these may be why you have shortness of breath. A high carbon dioxide level can also give you a headache and make you woozy.

A simple device called an oximeter that goes on your fingertip can check your oxygen level. Extra oxygen should help get that level up to where your doctor recommends. But if you're using oxygen, keep the flow within the range your doctor prescribed. Sometimes too much oxygen can cause serious problems.

Heart Problems

Low blood oxygen levels can lead to narrowed arteries and higher blood pressure in the blood vessels that go from your heart to your lungs as well as within your lungs. That can put a lot of stress on your heart, making it work harder than normal. It could become heart failure, a permanent condition where your heart is too weak to do its job well.


The right side of your heart may get bigger. Doctors call this cor pulmonale. It can cause irregular heartbeats, trouble with blood circulation, an enlarged liver, and swelling in your feet and legs.

Being active helps keep your blood moving so you're less likely to get serious blood clots that can travel to your lungs.

COPD can damage nerve fibers that connect to the heart and cause abnormal heartbeats called arrhythmia. Treatments vary from extra oxygen to medication.

Thinning Bones (Osteoporosis)

It's common for people with COPD to get osteoporosis. They've often been smokers, they take steroids, it's hard for them to get enough bone-strengthening exercise, and they can be low on bone-building vitamin D.

Brittle, weak bones break more easily. And a break will sideline you from activity.

Protect your bones with weight-bearing exercise like walking and strength training with stretchy bands. Learn how to prevent falls.

Your doctor may want to check your bone density with the painless X-ray test called a DEXA scan. They might want you to take calcium and vitamin D supplements or possibly bone-building drugs.

Weak Arms and Legs

Some of the same things that cause bone loss can cause muscle loss, too. Those weak muscles make it even harder to do everyday activities.

Ask your doctor to check your limb function. A pulmonary rehab program can help preserve muscle. It may include strength training to build up muscle tissue you've lost.

Weight Issues

When you're overweight, your lungs have to work harder. This can make your COPD worse and complications more likely.

As COPD progresses, you might have the opposite problem -- severe weight loss, sometimes because you're too short of breath to eat enough. Being underweight can also worsen symptoms and make you more vulnerable to bone thinning and infections.

Whether you need to lose or gain weight, your doctor or a registered dietitian can tell you how many calories you should get each day. And you may need supplements, like extra protein and vitamins.


Sleep Problems

COPD symptoms can wake you up during the night, which will leave you tired during the day. Even more serious is sleep apnea, a condition when you have repeated pauses in breathing while you sleep. The pauses, along with low oxygen levels, could make your COPD worse.

Ask your doctor if you should get tested for sleep apnea. If you have it, you can use a breathing device called a CPAP machine when sleeping. Extra oxygen might help, too.

Untreated sleep apnea raises the chance of high blood pressure, heart disease, and stroke.


Many people with COPD have diabetes. The damage caused by one can make the other more likely.

Exercise and quitting smoking help both conditions. Also make sure that all of your doctors know what the others have prescribed.

Depression and Anxiety

At least 1 in 10 people with early COPD get depression or anxiety, and that number climbs as the disease gets worse. Medication can help, along with exercise and even music therapy.

Work with your doctor or a therapist on self-care skills, too. People who problem-solve do better physically and emotionally than people who ignore health issues.

WebMD Medical Reference Reviewed by Carol DerSarkissian on September 11, 2019



Clinical Medicine Insights: Circulatory, Respiratory and Pulmonary Medicine: "Osteoporosis in Chronic Obstructive Pulmonary Disease."

National Heart, Lung, and Blood Institute: "COPD Prevention."

Merck Manual Consumer Version: "Chronic Obstructive Pulmonary Disease (Chronic Bronchitis; Emphysema)."

COPD Foundation: "Staying Healthy and Avoiding Pneumonia."

Johns Hopkins Medicine. Guide to New Treatments for COPD, MediZine LLC, 2009.

Cleveland Clinic: "Collapsed lung," "Nutritional Guidelines for People with COPD."

UpToDate: Patient education: "Chronic obstructive pulmonary disease (COPD) treatments (Beyond the Basics)."

Lung Foundation Australia: "Carbon Dioxide Retention in Patients with Chronic Obstructive Pulmonary Disease."

Chest Foundation: "Learn About Pulmonary Vascular Disease."

"What is Heart Failure?" Answers by Heart Fact Sheet, American Heart Association, 2015.

Merck Manual Professional Version: "Cor Pulmonale."

Current Opinion in Pulmonary Medicine: "Coexisting chronic obstructive pulmonary disease and heart failure: implications for treatment, course and mortality."

Respiratory Medicine: "Cardiovascular autonomic neuropathy in chronic obstructive pulmonary disease," "AIR: Advances in Respiration - Music therapy in the treatment of chronic pulmonary disease."

Proceedings of the American Thoracic Society: "Cardiac Disease in Chronic Obstructive Pulmonary Disease."

Cochrane Database of Systematic Reviews: Plain Language Summaries: "Nutritional supplementation for stable chronic obstructive pulmonary disease."

American Journal of Respiratory and Critical Care Medicine: "Musculoskeletal Effects of Chronic Obstructive Pulmonary Disease Prevalent, Linked, but Ignored," "An Official American Thoracic Society/European Respiratory Society Statement: Update on Limb Muscle Dysfunction in Chronic Obstructive Pulmonary Disease," "Sleep Problems in Asthma and COPD."

International Journal of General Medicine: "Obesity and respiratory diseases."

Journal of Clinical Sleep Medicine: "Impact of CPAP Use and Age on Mortality in Patients with Combined COPD and Obstructive Sleep Apnea: The Overlap Syndrome."

International Journal of Chronic Obstructive Pulmonary Disease: "Managing comorbidities in COPD," "Assessment of illness acceptance by patients with COPD and the prevalence of depression and anxiety in COPD," "The impact of coping on the somatic and mental status of patients with COPD: a cross-sectional study."

COPD Research and Practice: "Chronic obstructive pulmonary disease and diabetes."


Tobacco Induced Diseases: "Depression, anxiety and panic disorders in chronic obstructive pulmonary disease patients: correlations with tobacco use, disease severity and quality of life."

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews: "The effect of complex interventions on depression and anxiety in chronic obstructive pulmonary disease: systematic review and meta-analysis."

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