Stage II (Moderate Stage) COPD

Medically Reviewed by Sabrina Felson, MD on February 05, 2022

As chronic obstructive pulmonary disease (COPD) gets worse, it limits your airflow more and more. By stage II, your symptoms are usually no longer something you can just shrug off. They start to affect your daily life.

Since it's sometimes easy to miss the early signs of COPD, this is the stage where a lot of people go to the doctor to find out what's going on -- and may first learn they actually have the disease.

What Are the Symptoms?

Anything you had in the first stage often gets worse in stage II. Not everyone gets the same symptoms, but you may have:

It can start to affect your mental health, too. You may get forgetful, confused, or have slurred speech.

The most common symptom of COPD is breathlessness, but it isn't the only one. You may also have flare-ups, called exacerbations. This is when your symptoms get worse and may require treatment. About 20% of stage II patients have frequent exacerbations requiring antibiotics or steroids. In addition to worsening shortness of breath, keep an eye out for:

  • Feeling confused
  • Being more breathless than usual
  • Change in color of mucus, which may be the first sign of a flare-up
  • Change in amount of mucus, either more or less
  • More coughing
  • More tiredness
  • New sleep problems

Tell your doctor if you have any of these. Get medical help right away if you feel confused or have trouble breathing.

How Will My Doctor Test for It?

As with stage I, you'll talk to your doctor about your health history and get a physical exam. You'll also take a simple breathing test, which tells you if you have COPD. One of the results from it, known as "forced expiratory volume in one second" (FEV1), tells you the stage you're in.

You have stage II if FEV1 is from 50% to 80%.

From there, you may get blood tests, exercise tests, imaging, and more. They'll reveal important details about how COPD is affecting your body and how your lungs are working. That can help you and your doctor figure out the best treatment.

How Is It Treated?

Managing COPD can be complex, so you'll need to work closely with your doctor. The goal is to relieve your symptoms, keep your lungs working as well as possible, and prevent flare-ups.

For stage II, the main treatments are:

Quitting smoking and avoiding secondhand smoke.

Medicine. Typically, you get drugs called bronchodilators, which make breathing easier. You often get two types:

  • Short-acting ones last 4-6 hours. You take them when you need relief from symptoms.
  • Long-acting ones last 12 or more hours. You take them every day to help keep things in check. You may get more than one of these.

Pulmonary rehab. This is a program aimed at helping you keep up your quality of life. You may work with doctors, nurses, physical therapists, and others to create a plan tailored to your needs.

Your plan might include things like:

  • Counseling to help with the challenges of having a long-term health condition
  • An exercise routine that's safe for you
  • Tips on how to eat a healthy diet
  • Training on ways to best manage COPD

It's important to take an active role in your treatment. When you keep on top of your meds, appointments, and other parts of your program, you lower your odds of having a flare-up or needing to go to the hospital.

Managing flare-ups. Like the disease itself, flare-ups may range from mild to severe. Your doctor will help you come up with a plan for how to handle them.

For a mild flare-up, you may need to take bigger doses of your regular meds. For more serious ones, you may need:

  • More medicine, such as steroids and antibiotics
  • Oxygen, since it usually drops during a flare-up
  • Treatment in the hospital

It's best to deal with flare-ups right away. If you're not sure what to do, call your doctor as soon as possible.

To help prevent them, quit smoking, get the vaccinations that we have to protect you from lung infections. These include the flu vaccine, pneumonia vaccine and Covid-19 vaccine. 

What Other Problems Can COPD Lead To?

Flare-ups can land you in the hospital, and they can be life-threatening. They can cause your oxygen levels to fall sharply, make it very hard to catch your breath, and throw off your heart rhythm.

COPD also raises your odds of having heart disease, lung cancer, and high blood pressure in your lungs (in severe COPD). Check with your doctor to see how you can limit your risks for these other conditions.

Make sure you tend to your overall well-being and keep an eye on your mood, since people with COPD can sometimes get depressed. If you find that you're often sad or feel helpless or hopeless, talk to your doctor.

Show Sources


Oklahoma Department of Human Services: "Stages of COPD and Spirometric Classifications."

Global Initiative for Chronic Obstructive Lung Disease: "What You Can Do About a Lung Disease Called COPD," "Pocket Guide to COPD Diagnosis, Management, and Prevention."

Medscape: "Chronic Obstructive Pulmonary Disease (COPD)."

COPD: Journal of Chronic Obstructive Pulmonary Disease: "Fatigue in COPD and the Impact of Respiratory Symptoms and Heart Disease -- A Population-based Study."

National Jewish Health: "COPD."

National Sleep Foundation: "COPD and Difficulty Breathing."

Mayo Clinic: "COPD."

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

American Thoracic Society: "COPD Today," "Exacerbation of COPD." "Stages of COPD."

American Family Physician: "Management of COPD Exacerbations."

Merck Manual, Professional Version: "Treatment of Acute COPD Exacerbation."

Cleveland Clinic: "4 Biggest Myths About Your COPD -- and How to Cope."

© 2022 WebMD, LLC. All rights reserved. View privacy policy and trust info