7 Common COPD Complications and How To Prevent Them

Even though COPD is a chronic respiratory disease, its effects aren't limited to your lungs and airways. COPD can affect many parts of the body over time and lead to a variety of complications.

If you have COPD, then you are probably concerned about what kinds of health problems the disease can cause and how you can protect yourself from them. The good news is that, by effectively managing your symptoms and living a healthy lifestyle, you can significantly reduce your risk for a variety of COPD complications.

While you cannot stop COPD from progressing altogether, you can make choices that slow the rate at which your symptoms become more serious. By doing so, you reduce your likelihood of developing more serious health complications that result from reduced lung function and the other effects of COPD.

In this article we're going to give you a thorough overview of some of the most common COPD complications and show you how you can prevent them. We'll also explain how each of these complications is treated so you will know what your options are if you happen to develop any of these conditions.

Here are some of the most common complications of COPD:

• Exacerbations
• Pneumonia
• Collapsed Lung (Pneumothorax)
• Osteoporosis
• Hypoxemia & Hypoxia
• Sleep Apnea
• Heart Complications

Most of these conditions are serious and can lead to more health problems, a severely reduced quality of life, or even death over time. By learning the risk factors and causes of potential COPD complications, you can make better decisions about your health and lifestyle that can protect you from these unpleasant and potentially life-threatening conditions.

Exacerbations

Perhaps the most common complication that COPD patients experience is a COPD exacerbation. Exacerbations happen when your COPD symptoms get noticeably worse than normal for an extended period of time.

More serious than a minor flare-up, an exacerbation can cause worsened symptoms that last for days or even weeks. Some exacerbations can be treated at home, while more serious exacerbations require medical attention or even extended hospitalization.

COPD exacerbations are most often caused by illnesses and infections, but they can also be caused by asthma, allergies, or exposure to respiratory irritants. Even a minor sickness, like a cold, can cause someone with COPD to end up with a nasty, prolonged exacerbation.

Unfortunately, one side effect of COPD is that it depresses your immune system and makes it more difficult for your lungs to fight off viruses and bacteria. That means COPD patients are especially prone to getting sick, especially with respiratory illnesses, and have a constant risk of experiencing an exacerbation.

The first sign of an exacerbation is a minor up-tick in symptoms like coughing, wheezing, breathlessness, and fatigue. If these symptoms don't quickly get better on their own, then you are likely experiencing an exacerbation.

Common Symptoms of a COPD Exacerbation:

• Irregular breathing
• Worsened coughing
• Worsened breathlessness
• Noisy breathing (wheezing or rattling may indicate fluid in your lungs)
• Increased mucus in your airways and coughing up phlegm
• Reduced appetite
• Fatigue
• Fever
• Increased difficulty sleeping
• Signs of low blood oxygen levels, including: morning headaches, swollen ankles or legs, a bluish tint to your skin or nails, or an inability to speak or catch your breath

How to Prevent a COPD Exacerbation

The best way to prevent an exacerbation is to avoid getting sick and protect your lungs from respiratory irritants like allergens and pollution. That's why it's so important for people with COPD to wash their hands, keep up with vaccinations, and avoid exposure to germs and sick people, especially during cold and flu season.

Here are some of the best ways to prevent a COPD exacerbation:

• Stop smoking.
  
  
• Drink plenty of fluids. This helps thin your mucus, preventing it from building up in your airways and harboring viruses and bacteria.
  
  
• Avoid large crowds and busy public spaces during cold and flu season.
  
  
• Wash your hands often and use hand sanitizer when you don't have access to a sink.
  
  
• Always follow your COPD treatment plan carefully, especially when your symptoms flare up.
  
  
• Don't skip or miss any doses of your prescribed medications.
  
  
• Make sure you've received all your recommended vaccinations, including the pneumococcal vaccine and a yearly flu shot.
  
  
• Eat a healthy diet and get plenty of sleep to keep your body and immune system in top shape.
  
  
• If you are prescribed supplemental oxygen, always use it as directed.

The next best thing from prevention is early treatment and management to prevent illnesses and exacerbations from getting worse. Because of this, learning to recognize the early warning signs of an exacerbation is a vital skill for anyone who has COPD.

If an exacerbation isn't quickly managed and kept under control, it can cause a permanent damage to your lungs and a permanent worsening of COPD symptoms. However, exacerbations are sometimes difficult to detect when you experience COPD symptoms daily.

This is why it's so important to pay careful attention to your body and look out for times that your symptoms get worse or more frequent than they are on a normal day.

When you notice your symptoms become elevated above your usual baseline for more than a short period of time, you should consult your doctor and your treatment plan for what to do next.

In the most serious cases, severe exacerbations can cause life-threatening complications, like pneumonia, a collapsed lung, or even respiratory failure and death. Because of this, preventing COPD exacerbations is one of the primary goals of COPD treatment.

How to Treat a COPD Exacerbation

How you treat an exacerbation depends on its severity and your unique medical condition. If you have COPD, you should already have a detailed treatment plan from your doctor that includes what medications to take when your symptoms flare up and when to call your doctor.

As soon as you notice the signs or symptoms of a COPD exacerbation, you should immediately consult the instructions laid out in your COPD treatment plan. You may need to use your inhaler more often, reduce your activity levels, or start taking a course of steroids or antibiotics.

One of the most important things to note in your COPD treatment plan is how long you should wait before consulting your doctor or seeking medical attention. The guidelines outlined in your plan should tell you when your symptoms are bad enough to warrant medical attention and how to recognize an emergency.

Here are some general guidelines for managing a COPD exacerbation:

• Use airway clearance techniques (like huff coughing and chest percussion) to clear excess mucus out of your lungs and airways.
  
  
• Your may need to increase how often you use your short-acting bronchodilators to manage your symptoms effectively.
  
  
• Your doctor may put you on a short course of corticosteroid medications to help decrease inflammation and reduce the chances of more serious complications.
  
  
• Your doctor may prescribe you antibiotics to help you recover and reduce the chances of a secondary infection and further complications.
  
  
• Get plenty of rest and drink plenty of fluids.

As we've discussed, early detection and treatment for exacerbations is key for maintaining your health and quality of life with COPD. That's why you should always be monitoring your symptoms and paying special attention to how you feel. Then, when something goes wrong, you will notice right away and be able to begin treatment as early as possible.

Pneumonia

Another common COPD complication is pneumonia, a respiratory infection that causes severe inflammation in the lungs. Pneumonia can be caused by a variety of things, including bacteria, viruses, and fungi, and is particularly dangerous for people with COPD.

Pneumonia often occurs as a secondary infection that happens as a result of another illness, like a cold or (most often) the flu. The symptoms of COPD put patients with the disease at a higher risk for pneumonia because of symptoms like thick, excess mucus, a weakened immune system, and frequent upper respiratory infections.

Pneumonia occurs when the lungs become so inflamed that fluid and pus collect in the lungs. This fluid fills up many of the lung's air sacs, preventing them from absorbing oxygen and transferring it to your blood.

With many alveoli incapacitated, your lungs' have difficulty absorbing enough oxygen with its remaining functional alveoli. For people with COPD, whose lungs have already sustained damage and struggle to absorb enough oxygen, this can severely limit airflow and cause permanent damage to their lungs.

Pneumonia is most commonly diagnosed with a physical exam and chest x-ray. Your doctor may also test a sample of fluid or mucus from your lungs to determine exactly what kind of bacteria, fungus, or virus is causing your illness.

Here are some of the most common symptoms of pneumonia:

• High fever
• Shaking
• Chills
• Fatigue
• Worsened chest pain
• Worsened shortness of breath
• Worsened cough
• Headache and body aches

Although relatively common, pneumonia is not a disease to take lightly; it normally takes up to three weeks to recover and as many as twenty percent of pneumonia cases (about 1 million people each year) require hospitalization. Also, people with COPD who contract pneumonia are at a much higher risk for life-threatening respiratory symptoms such as hypoxia and potentially fatal respiratory failure.

Pneumonia can also lead to other complications, including hypoxemia, sepsis, pleural effusion (fluid in the chest or lungs), respiratory failure, and death. Older adults above the age of 65 and people who have lung diseases like COPD are more prone to contracting and experiencing serious complications from pneumonia.

How to Prevent Pneumonia

You can lower your risk of contracting pneumonia by avoiding getting sick and treating respiratory illnesses promptly and aggressively. However, the best first line of defense against pneumonia is vaccination.

While not 100% effective, the pneumococcal vaccine protects at least 45 out of 100 older adults from pneumococcal pneumonia.  Most people in the US receive the pneumococcal vaccine as children. However, a second dose is usually recommended for people who smoke or who are over the age of 64.

How to Treat Pneumonia

Treatment for pneumonia depends on its cause and how serious the symptoms are. Viral pneumonia can sometimes be treated with antiviral medicine, while fungal and bacterial pneumonia are treated with anti-fungal and antibiotic medications, respectively.

Along with antibiotics, anti-viral, and anti-fungal drugs, rest and home care is often enough to support recovery from pneumonia. Recovery can take time, and until you feel better you should take a break from daily chores and responsibilities and give yourself plenty of time to rest.

Drinking plenty of fluids is also important, because it helps thin and loosen up the mucus so it's easier to cough phlegm up and out of your lungs. It's usually fine to take asprin or NSAIDs for a fever, but you should avoid cough suppressants since coughing to clear the phlegm from your lungs is important for recovery.

If your symptoms are severe, you may need to receive treatment in a hospital until you recover. There, you may receive more targeted antibiotic treatments, supplemental oxygen, intravenous fluids, and general medical support. If your condition is very severe, you may need more intensive treatments in an intensive care unit and breathing support through a ventilator.

You are more likely to require hospitalization if you have one or more of the following conditions:

• You are over the age of 65.
• You have other health problems or chronic diseases like asthma, diabetes, or COPD.
• Your blood oxygen levels drop too low.
• You are so ill that you cannot eat or care for yourself.
• You have severe chest pain.
• You are unable to cough up mucus and clear your lungs on your own.
• You are unable to eat or keep food or fluids down.
• Your pneumonia is not getting better with normal treatment at home.

Collapsed Lung (Pneumothorax)

Lungs damaged by COPD are more prone to collapsing because the damaged tissue can leak air into the open space in between your lungs and your chest wall (your chest cavity). The pressure that the trapped air puts on your lung can cause your lung to collapse (also known as pneumothorax).

A collapsed lung can happen suddenly and spontaneously, without any warning. It is usually accompanied by sudden, sharp pain in the chest and worsened shortness of breath.

Pneumothorax is more common in patients with COPD because damaged, weakened lung tissue is both more likely to leak air and more likely to collapse under pressure. A collapsed lung is a medical emergency, especially for patients with COPD whose lung function is poor. If one lung collapses, the other lung may be unable to supply the body with enough oxygen, causing severe hypoxemia or hypoxia.

Here are some of the most common symptoms of a collapsed lung:

• Sudden chest pain (often described as sharp or stabbing)
• Shortness of breath
• Difficulty breathing
• Rapid breathing
• Rapid heart rate
• Coughing
• Bluish tint to the skin

How to Prevent a Collapsed Lung

The first step to preventing a collapsed lung is always to quit smoking. Smoking is one of the greatest risk factors for pneumothorax and quitting can significantly decrease your risk.

The more advanced your COPD, the more likely you are to experience a collapsed lung. That means that the next best way to prevent a collapsed lung is to follow your COPD treatment plan.

If you manage your COPD symptoms well and protect your lungs from further damage, your lungs will be less likely to leak air into your chest cavity and cause a collapsed lung. That's why it's so important to get regular check-ups from your doctor and follow the diet, exercise plan, and medication schedule that your doctor recommends.

How to Treat a Collapsed Lung

If you suspect that you might have a collapsed lung, you should go to a hospital immediately. A collapsed lung can sometimes be fatal without immediate medical attention.

At the hospital, you will likely receive treatment to remove the air in your chest cavity. This is usually done by inserting a small tube between the ribs and into the chest cavity to allow the trapped air to escape.

In some cases, if the collapse is minor, your lung may recover and re-inflate on its own. However, this determination must be made by a doctor and you should never try to treat a collapsed lung on your own at home.

Osteoporosis

Another complication that affects a large number of COPD patients is osteoporosis. Osteoporosis occurs when your bones become thin and brittle as a result of bone density loss, which significantly increases the risk of bone breaks and injuries.

Osteoporosis can be caused by a variety of factors related to COPD, including poor nutrition, lack of exercise, and increased inflammation throughout the body. All of these factors can result in a loss of bone density in patients with COPD; in fact, studies show that nearly seventy percent of all people with COPD have osteoporosis or at least some level of bone density loss.

Many people with COPD, for example, struggle to maintain a healthy weight and get enough nutrients from their diet. This is in part because people with COPD need extra calories and nutrients to support their over-strained lungs, and in part because COPD symptoms like breathlessness interfere with their ability to eat.

This causes some patients to lose weight and become malnourished, resulting in dangerous nutrient deficiencies that lead to osteoporosis. If you fail to get enough calcium and vitamin C in your diet, your body can no longer strengthen and maintain your bones, and will even cannibalize your bones to get the calcium it needs for other bodily functions.

Lack of exercise, too, can lead to bone density loss and disfigurement of your skeleton. That's because your bones are living tissue, and your body is constantly breaking down bits of your bones and building them back up.

Your body balances this process based on the amount of activity and strain your bones experience, taking density away from bones that are used less often and adding density to the bones that experience the most wear and tear.

When you stop exercising, your body takes bone density away from important bones in your limbs and other places in your body that you aren't using much. This leads to osteoporosis and changes to your skeletal structure so that it becomes even more difficult to stay active and avoid injury.

Finally, COPD patients have other characteristics that put them at a heightened risk of osteoporosis. People with COPD tend to be older, have a history of smoking, and use corticosteroid medications to treat their disease. All of these characteristics are also risk factors for osteoporosis and contribute the high incidence of bone density loss in patients with COPD.

Osteoporosis can be dangerous, painful, and interfere with your ability to exercise and stay active. It can cause even minor bumps and falls to bruise and fracture your bones, and recovery can take much longer than normal.

Here are some of the most common symptoms of osteoporosis:

• Bones that fracture easily from minor injuries or falls
• Loss of height over time
• Stooped posture
• Back pain (often caused by a fractured or collapsed vertebra)
• Receding gums (from reduced bone density in your jaw)
• Weakened grip strength
• Weak and brittle fingernails

How to Prevent Osteoporosis

Quitting smoking is one of the most important things you can do to prevent your COPD from getting worse, and it can help prevent osteoporosis as well. Getting regular physical exercise is also necessary to keep your bones healthy and strong.

It's also important to maintain a healthy diet full of whole, nutritious foods. It's particularly important to ensure that you eat plenty of foods rich in calcium and vitamin D; this ensures your body has the building blocks it needs to build thick, strong bones.

Even though COPD symptoms like breathlessness and fatigue can make it difficult to live a healthy lifestyle, it's important to follow your diet and exercise treatment plan, even when it's hard. It's not only necessary for healthy bones, but for maintaining your muscle strength, lung function, and physical mobility with COPD.

If you are struggling to get enough physical activity or need some extra help managing you disease, talk to your doctor about joining a pulmonary rehabilitation class, where you can learn all about how to better manage your diet, exercise, medications, and daily life with COPD.

How to Treat Osteoporosis

Unfortunately, once you begin losing bone density, it is usually impossible to get it back. Once you have osteoporosis or the early stages of bone density loss, the only thing you can do is manage it and keep it from getting worse.

The good news is that it usually only takes adjusting your diet and increasing exercise to manage osteoporosis and prevent further damage to your bones. Your doctor might also prescribe you a bisphosphonate medication which reduces the rate at which your body naturally breaks down your bones.

Other things you can do to prevent worsening of osteoporosis is to stop smoking and avoid drinking excessive amount of alcohol, which can impair your body's ability to build and repair your bones. You may also need to take special measures to prevent falls that could result in serious injury, for example, taking a fall prevention class or removing fall hazards in and around your home.

Hypoxia and Hypoxemia

Although they are sometimes used interchangeably, hypoxia and hypoxemia are two different conditions. Hypoxia is a life-threatening condition that happens when your body's tissues and organs are starved of oxygen. Hypoxemia happens when your blood oxygen saturation falls below normal levels, but not enough to cause immediate harm.

Having hypoxia means that your blood oxygen saturation levels have dropped so low that it can't support your body's basic functions. Hypoxia is a medical emergency that, if not corrected quickly, can cause serious damage to your brain, liver, heart, and other organs in a very short period of time.

Hypoxia can happen when you experience an extreme or prolonged bout of breathlessness, or if you suffer from heart problems along with COPD. Sometimes, flare-ups, exacerbations, or asthma attacks can cause hypoxia if they aren't quickly managed and brought under control.

Hypoxemia, on the other hand, is slightly less serious. It happens when your lungs can't absorb enough oxygen keep your blood oxygen saturation at normal levels. However, if you experience hypoxemia frequently over a long period of time, it can cause a myriad of life-threatening complications.

Here are some of the common complications of hypoxemia:

• High blood pressure
• Polycythemia, an abnormal increase in the number of red blood cells
• Pulmonary hypertension
• Acute respiratory failure
• Right-sided heart failure

You may experience hypoxemia at times when your lungs are not functioning as well as they normally do, such as when you sleep, when you're exposed to respiratory irritants like pollution, or when you experience a symptom flare-up or exacerbation. Even physical activities that make you feel breathless can cause temporary hypoxemia.

Your doctor should check your blood oxygen levels regularly and, if needed, prescribe you supplemental oxygen to use when you feel breathless or do activities that can cause hypoxemia. If you have severe COPD, you may experience hypoxemia all the time and need supplemental oxygen 24 hours a day.

That's why it's so important to manage your COPD symptoms effectively, follow your treatment plan, and keep your lungs working as efficiently as possible. As soon as your lungs become too damaged or over-strained to absorb enough oxygen, you can develop chronic hypoxemia, acute hypoxia, and all the other health complications they can cause.

Here are the Most Common Symptoms of Hypoxemia:

• Worsened breathlessness
• Fatigue
• Headache
• Increased heart rate
• Depression or other mood disorders
• Reduced ability to exercise
• Severe shortness of breath after exercise
• Wheezing
• Frequent cough

Here are some of the most common symptoms of hypoxia:

• A bluish tint to your skin or nails
• Rapid breathing
• Worsened shortness of breath
• Coughing
• Wheezing
• Rapid heart rate
• Being unable to catch your breath or return your breathing to normal
• Feeling like you are choking or suffocating
• Sweating
• Confusion
• Swelling in your ankles, legs, feet, or abdomen

How to Prevent Hypoxemia and Hypoxia

The best way to prevent hypoxemia and hypoxia is to follow your COPD treatment plan and manage your symptoms as best you can. That means exercising, eating a healthy diet, and always taking your medication as directed to prevent and treat symptom flare-ups.

It's also important to avoid respiratory irritants that can inflame your lungs and make your COPD symptoms worse. That means staying away from smoke, secondhand smoke, dust, fumes, air pollution, allergens, and temperature extremes.

You should also avoid taking certain drugs, like alcohol and sleep medications, that can cause hypoxemia while you sleep. Sedatives like these can relax your breathing muscles and lower your breathing rate, especially if you take them before you go to bed.

If your doctor prescribes it, you may also need to use supplemental oxygen when you exercise to avoid hypoxemia, but it's not a reason to avoid physical activity. Adequate exercise is necessary to keep both your heart and your breathing muscles strong, and it can actually help your lungs work more efficiently and reduce your chances of developing heart problems and hypoxemia.

You should also take special care to avoid COPD exacerbations, which can cause prolonged hypoxemia or even serious hypoxia. Any time you get sick can cause your COPD symptoms to increase significantly, making it more difficult for your lungs to absorb enough oxygen to meet your body's needs.

Traveling to high altitudes or living at a high elevation also puts you at risk for hypoxemia, especially for people with COPD. You should avoid spending extended periods of time at high altitudes and take special precautions, such as avoiding too much physical exertion, to prevent breathlessness and hypoxemia if you do.

Another way you can protect yourself from hypoxemia and hypoxia is by using a personal pulse oximeter, which is a small simple, device for checking your blood oxygen levels at home. Having a home pulse oximeter could be a literal life-saver by giving you early warning of hypoxia and a chance to seek immediate medical attention.

A pulse oximeter is a great investment for anyone with COPD because it allows you to monitor your blood oxygen saturation regularly and take action if your levels fall too low. Pulse oximeters are also inexpensive, non-invasive, and extremely easy to use.

How to Treat Hypoxemia and Hypoxia

The goal of treatment for both hypoxemia and, especially, hypoxia is to get your blood oxygen saturation back up to normal levels as quickly as possible. In the case of hypoxia, which is a medical emergency, you will have to be treated and monitored in a hospital.

At the hospital you will likely receive supplemental oxygen and have your blood oxygen saturation monitored. You may also receive medication to help your lung function return to baseline; you might receive corticosteroid medications to reduce inflammation in your lungs or bronchodilator medications through an inhaler or IV.

In extreme cases, if standard treatments are unable to stabilize your condition, you may need to be placed on a ventilator machine in order to breathe.

Hypoxemia, on the other hand, is generally managed with standard COPD treatments, like bronchodilators, that open up your airways and help you breathe better. In fact, most of the treatments for hypoxemia are probably already outlined in your COPD treatment plan.

The most common treatment for chronic hypoxemia is supplemental oxygen, which your doctor will prescribe to you if he suspects your blood oxygen levels are dipping too low. Otherwise, treating exacerbations, bouts of breathlessness, and other COPD symptoms with standard treatments and medications is usually an effective approach.

Obstructive Sleep Apnea

Obstructive sleep apnea is a serious sleep and breathing disorder that happens to affect a large number of people with COPD. It happens when your airways narrow and become obstructed intermittently while you sleep, repeatedly interfering with your ability to breathe and stay asleep at night.

There are many potential causes of sleep apnea, but the end result is airway obstruction that happens only when you fall asleep. Often, it happens because the muscles lining the throat and other airways become too relaxed while you sleep, causing the walls of your airways to sag and block air from flowing through.

This causes sleep apnea sufferers to choke and suffocate in their sleep, which prompts them to wake up often and suddenly during the night. However, many people with the sleep disorder never even remember being startled awake, although the sleep disturbances still affect their sleep quality and their quality of life during waking hours.

Because of this, many people don't even realize they have sleep apnea until a partner or caretaker notices them gasping and choking while they sleep. As a result, many cases of sleep apnea go undiagnosed for long periods of time.

Unfortunately, undiagnosed sleep apnea is very dangerous and unhealthy, especially for people with COPD. The frequent airway obstruction starves your body of oxygen during the night, which can lower your blood oxygen levels to the point that it causes hypoxemia.

As we've discussed, hypoxemia is extremely dangerous over the long term and is the cause of a myriad of health problems and complications related to COPD. That's why early diagnosis and treatment for sleep apnea is so important, particularly for people with respiratory diseases like COPD who already have breathing problems and a high risk for hypoxemia.

Other COPD-related symptoms, including thickened mucus and excess phlegm in the airways, can worsen airway obstruction at night, resulting in even more sleep disturbances and more severe sleep apnea. The disorder can also make COPD worse through sleep deprivation; poor sleep quality is associated with increased COPD symptoms, worsening of related conditions like anxiety and depression, and an increased risk of death.

Because of this, sleep apnea can be devastating to people with COPD and significantly reduce their quality of life. In fact, studies show that more than fifty percent of COPD patients experience poor sleep quality because of sleep disorders and COPD symptoms like breathlessness and coughing.

Here are some of the most common symptoms of sleep apnea:

• Frequent waking during the night (especially if you wake up feeling like you are gasping or choking)
• Loud snoring while you sleep
• Restless sleep
• Having a sore or dry throat in the morning
• Morning headaches
• Daytime sleepiness despite appearing to get a full night's sleep
• Excessive fatigue during the day
• Difficulty focusing or concentrating during the day
• Forgetfulness
• Changes in mood (especially depression and irritability)

How to Prevent Sleep Apnea

Besides making healthy lifestyle choices, there isn't much else you can do to prevent sleep apnea. However, you can reduce your risk by maintaining a healthy weight, getting regular exercise, and quitting smoking.

You can also reduce your risk and reduce the severity of sleep apnea by avoiding sedatives before bed. For example, drinking alcohol or taking a sleep medication before bed can induce sleep apnea by causing the muscles lining your throat and airways to relax too much.

However, depending on the cause of sleep apnea, there may be nothing you can do to prevent it. However, you can prevent the negative health effects of sleep apnea by detecting and treating it early; which is why you should prioritize getting tested for sleep apnea if you have COPD or any other risk factors for the disorder.

Here are some of the known risk factors for sleep apnea:

• Being overweight or obese
• Having narrowed airways due to genes or respiratory disease
• Having high blood pressure
• Having excess mucus in your airways or chronic nasal congestion
• Having diabetes
• Having asthma
• Being a smoker
• Having a family history of sleep apnea

How to Treat Sleep Apnea

Before you start treatment for sleep apnea, you will first have to undergo a sleep study. This usually requires an overnight stay at a hospital or sleep clinic where doctors can monitor your breathing and heart rate while you sleep.

If you wake frequently and show signs of airway obstruction during the study, you will be diagnosed with sleep apnea and begin treatment right away. The standard treatment for sleep apnea is a CPAP or BiPAP machine, a medical device that helps you breathe while you sleep at night.

CPAP and BiPAP machines work by blowing pressurized air into your airways, which keeps them open and prevents any sagging that could obstruct your breathing. Using your BiPAP or CPAP machine can be uncomfortable at first, but it will ultimately allow you to get much better quality sleep and prevent your blood oxygen levels from falling to unhealthy levels every night.

If you have sleep apnea, it's important to keep up with your treatment and use your BiPAP or CPAP machine every single night. If you don't, you will continue to suffer the effects of poor sleep and hypoxemia, which will only make your COPD worse.

Sleep apnea can be caused by several different types of obstruction, and your sleep apnea treatment may depend on the type of obstruction you have. In some cases sleep apnea can be treated by wearing a mouthpiece at night or through throat surgery to correct the source of the obstruction.

Heart Complications

Low blood oxygen levels caused by reduced lung function can cause a variety of heart problems in people with COPD. In fact, studies show that up to fifty percent of COPD patients above the age of fifty have at least one serious cardiovascular problem: either hypertension, coronary artery disease, heart failure, or a combination of conditions.

In this next section, we will go over the main COPD-related heart complications including coronary artery disease, pulmonary hypertension, and heart failure. We'll help you understand the relationship between these cardiovascular conditions and COPD and what you can do to prevent them.

Coronary Artery Disease

Coronary artery disease (CAD) is extremely common in people with COPD, although it often doesn't receive the attention it deserves. Research shows that CAD is actually one of the leading causes of death for people with COPD.

In fact, while COPD symptoms like breathlessness are often attributed to lung function and respiratory decline, they might actually be caused by underlying coronary artery disease or other cardiovascular problems in many cases.

Coronary artery disease happens when your blood vessels become clogged with plaque, narrowing the space that your blood can flow through. This makes it more difficult for your heart to pump blood around your body, raising your blood pressure and putting extra strain on your heart.

If the blood vessels become so clogged that they cut off blood flow to your heart completely, it causes a heart attack. This can be caused by blood vessels narrowing due to plaque build-up over time, or by a blood clot blocking an artery near your heart.

Here are some of the most common symptoms of coronary artery disease:

• Chest pain (angina) that can feel like pressure, squeezing, fullness, or tightness
• Pain in the chest, shoulders, arms, neck, jaw, or back that worsens with physical activity and lessens with rest
• Shortness of breath
• Irregular heart beat (arrhythmia)

Here are the most common symptoms of a heart attack:

• Pain or discomfort in your chest (the pain sometimes feels like heartburn or indigestion)
• Pain in one or both arms
• Pain the back, neck, jaw, shoulders, or upper part of the stomach
• Nausea or vomiting
• Light-headedness
• Fainting
• Fatigue

There are many potential reasons why people with COPD and other respiratory diseases develop coronary artery disease more often than people who don't have respiratory problems. Smoking, for example, is a significant risk factor for both CAD and COPD. Other COPD symptoms and complications, including inflammation, hypoxemia, and pulmonary hypertension, can also cause CAD.

Poor respiratory function on its own significantly increases your risk of developing coronary artery disease, which puts COPD patients at risk. The symptoms of COPD also discourage many patients from exercising, which is necessary for maintaining a strong, healthy cardiovascular system and preventing CAD.

People with COPD also experience systemic inflammation, or elevated levels of inflammation all throughout their bodies, including in their blood vessels and lungs. This chronic inflammation, experienced over years with COPD, encourages plaque build-up in the arteries and puts patients even at an even greater risk for developing CAD.

Here is a list of the most common risk factors for coronary artery disease:

• Smoking
• High blood pressure
• Inflammation
• Unhealthy cholesterol levels
• Lack of physical activity
• Insulin resistance and diabetes
• An unhealthy diet, especially one high in sugar, salt, cholesterol, and unhealthy fats
• Being above the age of 45
• Having sleep apnea
• A history of heavy drinking
• Chronic stress and anxiety
• A family history of coronary artery disease

Pulmonary Hypertension

Pulmonary hypertension occurs when you have high blood pressure in the blood vessels in your lungs. In COPD patients, this happens as a result of inflammation, low blood oxygen levels, and the loss of capillaries in the lungs caused by COPD.

This is how pulmonary hypertension develops and affects your body:

• COPD-related lung damage makes it difficult for your lungs to absorb enough oxygen. This results in low oxygen levels (hypoxemia) in the arteries in your lungs.
  
  
• In response to low oxygen saturation in the blood, the blood vessels in your lungs narrow.
  
  
• Narrowed vessles make it more difficult for blood to flow through, which increases the blood pressure in your lungs (pulmonary artery pressure).
  
  
• Damage to the lungs caused by emphysema destroys some of the capillaries in the lungs, resulting in an even higher blood pressure in the remaining vessels.
  
  
• Because of the increased back-pressure, the right side of your heart (the side that pumps oxygen-poor blood into the lungs to become oxygenated) has to pump harder in order to push blood through the narrow vessels in your lungs.
  
  
• After a while, this strain causes the right side of your heart to enlarge, which weakens it and leaves it unable to pump as effectively.

The high blood pressure and weakened heart muscle cause most of the symptoms associated with pulmonary hypertension. Over time, the strain that pulmonary hypertension puts on your heart can lead to right-sided heart failure, also known as cor pulmonale.

Here are some of the most common symptoms of pulmonary hypertension:

• Worsened shortness of breath
• Feeling tired or fatigued
• Dizziness or fainting
• Irregular heartbeat or rapid heartbeat
• Worsened chest pain, especially after exercising
• Swelling in the legs, ankles, or abdomen

Pulmonary hypertension is often caused by long-term hypoxemia, which can happen when your lung function declines to the point that it cannot keep your blood oxygen saturation at normal levels. Even if your lungs function well enough on their own in ideal conditions, your blood oxygen levels may still fall when you exercise, when you sleep, and when you experience an exacerbation.

Pulmonary hypertension is a very serious condition; COPD patients with high pulmonary artery pressure are at a much higher risk of heart failure and death. However, if you catch and treat it early, you can better manage pulmonary hypertension and improve your prognosis and quality of life.

That's why it's important to have your lung function and blood oxygen saturation tested regularly by your doctor. If your doctor finds that your lungs cannot supply enough oxygen to your body on their own, he will prescribe supplemental oxygen to help.

Right-sided Heart Failure (Cor Pulmonale)

COPD-related right-sided heart failure is usually the result of blood vessel strain and constriction caused by pulmonary hypertension. High blood pressure in the lungs puts a great amount of strain on the right side of your heart, which is responsible for pumping blood into your lungs.

According to the American Thoracic Society, nearly 30 percent of COPD patients eventually develop right-sided heart failure. This is more than twice the rate in the general population, which is about 13 percent.

Here are some of the most common symptoms of right-sided heart failure (Cor Pulmonale):

• Sudden or worsened shortness of breath
• Chest pain or discomfort
• Dizziness
• Severe weakness
• Fainting
• Rapid or irregular heartbeat
• Signs of hypoxia: bluish tint to your skin or fingernails, swelling in your ankles, legs, feet, or abdomen

How to Prevent Heart Complications Caused by COPD

As you can see, most COPD-related heart problems happen a result of inflammation and poor lung function that leads to low oxygen levels in the blood. The more severe your COPD, the higher your risk is for heart complications resulting from reduced lung function and hypoxemia.

Therefore, the only true way to prevent heart complications if you have COPD is to prevent further lung damage and keep your lungs working as efficiently as possible. That means you should follow your COPD treatment plan and protect your lungs from smoke, allergens, and pollutants as a primary means of prevention.

Here are some of the best ways to prevent heart complications related to COPD:

• Quit smoking. Smoking can raise your blood pressure, damage your blood vessels, and reduce your blood oxygen levels.
  
  
• Manage your COPD symptoms according to your treatment plan and consult with your doctor if you are unable to manage your symptoms on your own.
  
  
• Get tested for sleep apnea. If you have sleep apnea, it's important use your CPAP/BiPAP machine every time you sleep to prevent nighttime hypoxemia.
  
  
• Eat a healthy diet full of whole foods and limit your intake of sugar and salt.
  
  
• Get adequate physical activity to improve blood circulation and keep your heart and breathing muscles strong.
  
  
• Use medications like bronchodilators and corticosteroids as directed by your doctor.
  
  
• Maintain a healthy weight and BMI to reduce strain on your heart.
  
  
• Reduce stress to keep your blood pressure and heart rate at healthy levels. Seek treatment if you suffer from anxiety or depression.

How to Treat Heart Problems Caused by COPD

If you are diagnosed with a COPD-related heart complication, your doctor will likely recommend lifestyle changes and standard COPD treatments, like supplemental oxygen. Healthy habits like a good diet and plenty of exercise can help your lungs work more efficiently, and supplemental oxygen helps your lungs absorb more oxygen when you breathe.

Treatment for COPD-related heart problems usually focuses on treating the underlying cause, which, for COPD patients, is low blood oxygen levels caused by decreased lung function and airway obstruction. Your doctor may also prescribe anti-inflammatory medications or corticosteroids if you have COPD-related coronary artery disease.

If you have a COPD-related heart problem, following your treatment plan and having your blood oxygen levels checked often is more important than ever. You might even want to get a personal pulse oximeter so you can check and track your blood oxygen saturation at home.

Other Potential COPD Complications

There are other complications that seem to be related to COPD that are less well understood than the ones we've discussed so far. Two of these are lung cancer and GERD.

While these diseases tend to show up more often in people who have COPD, the relationship is not clear. Researcher's aren't sure whether or not they are caused by COPD or whether COPD patients have common characteristics or lifestyles that put them at risk for both conditions.

Either way, since these diseases appear so commonly in COPD patients, it's worth familiarizing yourself with their signs, symptoms, and how to prevent them.

GERD

GERD, also known as acid reflux, is a condition in which your stomach acid occasionally leaks out of your stomach and up into your esophagus. This can cause heartburn-like symptoms and pain in your stomach, chest, and throat.

Acid reflux tends to happen more often when you're lying down, which is why symptoms tend to get worse for many people at night. Over time, GERD can damage the lining of your throat and esophagus, putting you at risk for tooth decay, sleep apnea, esophageal cancer, and other throat problems.

For people with COPD, GERD can add to breathing discomfort and make it difficult to eat and maintain a healthy weight. If stomach acid leaks into your lungs, it causes severe irritation and makes COPD symptoms worse.

GERD is particularly common in people with COPD; according to research, about 28 percent of COPD patients also suffer from GERD. The link is not well understood, but smoking is a likely cause, since it's a major shared risk factor for the two conditions.

Here are some of the most common symptoms of GERD:

• A burning sensation in your chest after eating (especially at night when you lie down)
• Chest pain
• Sour, bitter taste of stomach acid in your mouth
• Sensation of a lump in your throat
• Difficulty swallowing
• Chronic cough
• Worsened asthma or COPD symptoms
• Disrupted sleep

How to Prevent GERD

The main risk factors for GERD are smoking and being obese. If you are overweight or smoke cigarettes, losing weight and quitting smoking can reduce your risk of developing GERD.

Other than that, there isn't much you can do to prevent GERD altogether. However, you can manage it by making changes to your eating habits and following a special GERD diet.

Another important preventative measure is avoiding alcohol and sedatives at nighttime, which can induce acid reflux while you sleep by relaxing the muscle that forms the barrier between your stomach and esophagus. You should also keep your head, neck, and shoulders elevated when you lie in bed; this reduces the chance of stomach acid coming up into your throat against the force of gravity.

However, the most effective treatment is a GERD diet, which is primarily about avoiding spicy and acidic foods, including garlic, onions, tomato sauce, and citrus fruits. Often, following this diet alone is enough to relieve most of the uncomfortable symptoms of GERD.

Here are some of the main features of a GERD diet:

• Don't eat too close to bedtime or lie down after eating
• Eat smaller portions of food more often to reduce symptoms
• Avoid fatty and fried foods
• Avoid whole milk and creamy foods
• Avoid acidic fruits and juices (e.g. oranges, pineapple, and tomatoes)
• Avoid caffeinated drinks
• Avoid coffee and tea

Lung Cancer

Having COPD doubles your risk of developing lung cancer and can also make lung cancer more difficult to treat. Researchers don't have a complete understanding of the relationship between COPD and lung cancer, but it's clear that a history of smoking or exposure to other respiratory irritants is a common cause for both.

However, tobacco use alone cannot account for the increased risk of lung cancer, and some researchers suspect that chronic inflammation caused by COPD might be the culprit. COPD not only causes chronic inflammation that affects the whole body, but also makes the lungs more sensitive to respiratory irritants and illnesses that trigger inflammation in the lungs.

Airflow obstruction, too, is associated with certain types of lung cancer. This is in part because COPD patients often produce excess, sticky mucus and have narrow airways that makes it more difficult to move mucus up and out of the lungs. This mucus traps bacteria, irritants, and carcinogens, which may cause lung cancer over time.

Here are some of the most common symptoms of lung cancer:

• Unexplained weight loss
• Fatigue
• Chest pain (unrelated to coughing)
• Hoarseness
• A chronic cough
• Coughing up blood
• Recurring lung infections and illnesses (such as bronchitis or pneumonia)

How to Prevent Lung Cancer

The most important thing you can do to prevent lung cancer is to stop smoking. It's also important to protect your lungs from respiratory irritants like pollution, dust, allergens, chemical fumes, and other hazardous substances.

COPD makes your lungs especially sensitive airborne particles and smog, and you should take special precautions to avoid them. For example, check your local air quality report for pollution hazards before you plan outdoor activities and make sure your house is free from indoor pollutants.

Following your COPD treatment plan and using your medications can also relieve airway obstruction and reduce your risk for lung cancer. If your airways tend to get clogged with mucus, using mucus clearance techniques like huff coughing or chest percussion can help by moving trapped bacteria, carcinogens, and respiratory irritants up and out of your lungs.

Conclusion

In this article we've introduced you to some of the most common COPD complications and discussed ways to prevent and treat them all. However, this is not an exhaustive list; COPD is a complex and multi-faceted disease and is linked to a multitude of other diseases and conditions.

However, with the right diet, a healthy lifestyle, plenty of exercise, and proper medical treatment, you can prevent many of these complications. That's why getting regular check-ups, working closely with your doctor, and carefully following your COPD treatment plan is so incredibly important.

Preventing COPD complications is a vital part of COPD management because it keeps your lungs and body strong, slows disease progression and helps prevent early death. By learning what to look out for and what you can do to prevent COPD-related diseases, you will be much better equipped to maintain your health and live a longer, more active, and more satisfying life.