by EBSCO Medical Review Board


Chronic obstructive pulmonary disease (COPD) exacerbations are a worsening of symptoms.


Symptoms may be made worse by trouble with the treatment plan, other illness, or progression of disease.

Risk Factors

Factors that increase the risk of COPD exacerbations are:

  • Other exacerbations in the past 12 months
  • Smoking or being around second-hand smoke
  • Exposure to toxins or irritants
  • Being overweight or obese
  • Not being active
  • Having other health problems, such as diabetes


An exacerbation is a worsening of your COPD symptoms. It may include one or more of the following:

  • Problems breathing
  • Coughing
  • Coughing up mucus from deep in the lungs
  • Chest tightness
  • Tiredness
  • Confusion
  • Depression
  • Problems sleeping


The doctor will ask about your symptoms and history of COPD. A physical exam will be done.

Tests will be done to find out how your lungs are working. This can be done with:

  • Lung function tests (spirometry)—to test the force of your breath
  • Blood tests—to measure the oxygen and carbon dioxide levels in your blood

Other tests may be needed to find a cause. For example, a blood or sputum test will show signs of infection.


Treatment steps will depend on what is making your symptoms worse. Infections or other medical conditions will need to be treated.

Your overall treatment plan may also need to be changed. Keep in touch with your care team. Let them know how your treatment plan is working. Some steps include:

Lifestyle Changes

To ease workload on the lungs:

  • Quit smoking. Avoid being around others who smoke.
  • If you are overweight, try to lose weight. Excess weight can make breathing harder.
  • Exercise regularly.


Medicines may need to be changed. New medicines may be started. Options include:

  • Bronchodilators to open your airways
  • Steroids to ease swelling in the airways
  • Antibiotics to fight infection

Oxygen Therapy

COPD makes it hard for oxygen to pass through the lungs and into the body. Oxygen therapy can raise the amount of oxygen that gets into the lungs. It can ease breathing and raise energy levels.

Oxygen may be started. If you are already using oxygen it may be needed more often. Follow your care team’s directions.


Exacerbations cannot always be prevented. Following your care plan can help your lungs stay as healthy as possible.


American Lung Association  

Centers for Disease Control and Prevention 


College of Family Physicians of Canada 

Health Canada 


Acute exacerbation of COPD. EBSCO DynaMed website. Available at: . Updated March 20, 2019. Accessed May 1, 2019.

Chronic obstructive pulmonary disease (COPD): Flare-ups. Lung Association of Canada website. Available at: Updated January 22, 2018. Accessed May 1, 2019.

Revision Information