Asthma and COPD

People often have more than one health problem at a time. If you have COPD (chronic obstructive pulmonary disease), you may also have asthma. They are separate health conditions. When you have both COPD and asthma, you need treatment for both conditions.

Cigarette smoking is the main cause of COPD. Two main conditions of COPD are emphysema and chronic bronchitis. The lungs and airways are damaged in both conditions. The damage is most often caused by breathing in irritants over a long time. Because of this, air doesn’t flow normally through the airways in the lungs. The tubes that carry air in and out of your lungs (airways) can get blocked or collapse. This can cause symptoms that are much the same as asthma. These include shortness of breath, wheezing, chest tightness, and coughing.

Asthma is also an ongoing health problem that affects the airways in your lungs. It most often starts in childhood. But it can affect people of all ages. With asthma, the airways become inflamed and narrowed. The muscles around the airways tighten. This makes it hard for air to pass through the airways.

If you have asthma, your airways are extra sensitive to irritants and to things you are allergic to. These might be tobacco smoke, air pollutants, pollen, pets, and exercise. These are called asthma triggers.

With asthma, you may not feel symptoms even though your airways are affected. When you do feel symptoms, your airways may be extra inflamed. You may even have an asthma attack or a flare-up. This is when your airways close so tightly that air can’t get in and out. A moderate asthma flare-up can cause problems breathing. But a severe asthma flare-up sends you to the hospital. Having an Asthma Action Plan can help you know how to avoid asthma triggers and treat your symptoms.

How does asthma raise your risk for COPD?

Not everyone who has asthma will develop COPD. But you may be more likely to have COPD later in life if you have asthma. Asthma can harm the airways in your lungs. Over time, chronic mild inflammation can scar the airways. You can have lifelong breathing problems. Because of this, the chances of COPD may increase. Smoking increases this risk even more. If you have asthma or COPD symptoms, see a doctor who is an allergy specialist (allergist) or a lung specialist (pulmonologist).

Symptoms

Many COPD symptoms are the same as asthma symptoms. It can be hard to tell which condition is causing them. Some of the most common symptoms of both conditions include:

• Frequent coughing.

• A whistling noise, especially when breathing in or out (wheezing).

• Chest tightness.

• Trouble breathing.

• Shortness of breath during activities.

• Feeling tired.

• Low energy during physical activities.

Treatment

Your doctor or care team will work with you to make a treatment plan. Your treatment plan may include:

• Taking medicine. Medicines help treat the symptoms of both COPD and asthma. They can also lower your chances for serious breathing problems. They can help keep you out of the hospital. Take your medicines every day as directed. If you have asthma, your doctor can help you create an Asthma Action Plan to manage your condition.

• Quitting smoking. If you smoke, quitting is one of the best things you can do for your health. Quitting can help make your symptoms better. This includes not using e-cigarettes or vaping products. Ask your doctor or care team for help quitting.

• Staying away from irritants and triggers. For both COPD and asthma, these can include:

  • Outdoor air pollution.

  • Heating fuels.

  • Chemical fumes.

  • Dust.

  • E-cigarettes.

  • Cigarette smoke, including secondhand smoke.

  • Smoke from burning wood or cooking.

  Other common asthma triggers include:

  • Pollen.

  • Pests, including dust mites and cockroaches.

  • Pets.

  • Mold.

  • Strong smells.

  • Weather changes, especially cold weather.

  • Strong emotions, such as crying or laughing.

  • Exercise.

  For asthma, knowing and staying away from your triggers can reduce symptoms and prevent flare-ups. Always keep your Asthma Action Plan and rescue medicine with you.

• Doing oxygen therapy if you have COPD. When the level of oxygen in the blood is too low, your doctor may prescribe oxygen. Or extra oxygen may be given when the lungs can’t get enough oxygen to the blood.

• Joining pulmonary rehab. Pulmonary rehab is a program that gives you the skills you need to manage both COPD and asthma in your daily life. Rehab can be done in the community, at home, or in the hospital. Talk with your doctor about which rehab program is best for you.

Self-care tips

There are things you can do to help manage both your asthma and COPD:

• Stop smoking. As soon as you quit, you stop further damage to your lungs. If you need help to quit smoking, talk with your doctor. Don't use e-cigarettes or vaping products.

• Stay away from secondhand smoke and other irritants. Try to stay away from smoke, chemicals, fumes, pollen, and dust. Don’t let anyone smoke in your home or use e-cigarettes or vaping products. Stay indoors on smoggy days.

• Prevent lung infections. Having COPD or asthma increases your risk for respiratory infections. Ask your doctor about vaccines, such as the flu, COVID-19, and pneumonia vaccines. Stay away from crowded places during cold and flu season. And avoid people who are sick.

• Wash your hands often. This can help you avoid illness and infection. Use soap and clean, running water. Scrub for 20 seconds. Use hand sanitizer when you can’t wash your hands.

• Drink water. This helps make mucus thinner and easier to cough up. Ask your doctor how much water you should drink. For many people, 6 to 8 glasses (8 ounces each) a day is a good goal unless directed otherwise.

• Clear your airway. When your lungs make a lot of mucus or it's hard to cough up, airway clearing methods can help. These include coughing methods and postural drainage. Keeping your lungs clear of mucus helps prevent shortness of breath and other symptoms. Ask your doctor about these methods.

• Do breathing exercises. Learn how to do belly breathing and pursed-lip breathing. They can help you breathe better. Taking slow, deep breaths at any time can give you more of the oxygen you need.

• Eat well. When you’re tired, you may not be eating as well as you should. Poor nutrition can make symptoms worse. It can also raise your risk for infections. Try resting before eating. Eat smaller meals during the day. Ask your doctor if you should take vitamins or supplements.

• Stay at a healthy weight. Being underweight can limit your energy. Being overweight can make shortness of breath worse. People with COPD who have a low body mass index may have more problems. Work with your doctor to find the best weight for you.

• Balance activity and rest. This can help you from getting overtired. Stop and rest before you feel worn out. If an activity takes a lot of energy, break it into parts. For instance, fold the laundry first. Then have a rest before putting it away. Focus on the things that are most important.

• Save your energy. The way you use your body during a task can help you have more energy. Do activities slowly. Rushing through activities uses more energy. It can also increase shortness of breath. Sit to dress and to do other daily tasks, such as brushing your teeth. Use a cart with wheels to move food, laundry, and other items around your house. Keep the things you use often at waist level, so you can get them easily.

• Don’t be afraid to be active. Being active may make you short of breath. But it's good for your lungs. Exercise can strengthen the muscles that help you breathe. Ask your doctor about safe exercises for you.