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How Stress Triggers COPD Flare-Ups

COPD Basics

February 27, 2024

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Photography by Justin Paget/Getty Images

Photography by Justin Paget/Getty Images

by Elizabeth Pratt


Medically Reviewed by:

Adithya Cattamanchi, M.D.


by Elizabeth Pratt


Medically Reviewed by:

Adithya Cattamanchi, M.D.


Stress can be a trigger for COPD flares. It can cause shortness of breath, worsening symptoms, and an increased risk of hospitalization.

Living with a chronic illness like COPD can be challenging and stressful.

For people with COPD, stress can cause shortness of breath. Being out of breath can cause more stress, and spiral into a distressing cycle of not being able to breathe well.

If you’ve found yourself in this position before, you’re not alone. But there are strategies that just might help.

Let’s talk about the link between stress and COPD, as well as ways to reduce your stress while living with COPD.

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Does stress make COPD worse?

Stress is a recognized trigger for COPD flare-ups. Psychological stress can cause difficulties with breathing, shortness of breath, and an exacerbation of COPD symptoms.

Problems with breathing can, in turn, create more stress, leading to further breathing difficulties and faster breathing, creating a distressing cycle.

Research from 2024 suggests that psychological distress has been associated with an acute exacerbation of symptoms for people living with COPD.

The researchers also say that psychological distress can increase the risk of hospitalizations and death related to COPD.

Reducing stress is one way to help prevent shortness of breath and breathing difficulties.

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Tips to reduce stress

It’s not always possible to prevent an exacerbation of COPD, as multiple factors can contribute to a flare-up.

Avoiding triggers that may cause a flare-up could help reduce their frequency. Reducing stress is one way to help prevent shortness of breath and breathing difficulties.

There are a number of ways to reduce stress — some might be personal to you. Here are some strategies to get you started:

1. Practice breathing exercises

Breathing exercises help the lungs work more efficiently and make breathing easier. They can also help reduce stress and interrupt the cycle of stress and breathing difficulties.

Pursed lip breathing and belly breathing (aka diaphragmatic breathing) are two ways of breathing that may help you.

Pursed lip breathing helps keep the airways open for longer, reduces the number of breaths needed, and decreases feelings of breathlessness.

To try pursed lip breathing:

  1. Breathe through your nose for roughly 2 seconds.
  2. Shape your lips as if you’re about to blow out a candle.
  3. Then, breathe slowly for 4–6 seconds.

Belly breathing can help lessen the feeling of being short of breath and help when completing tasks like climbing stairs or walking.

Belly breathing is not as easy as pursed lip breathing. It may be helpful to work with a respiratory or physical therapist and try this for the first time when lying down and relaxed.

  1. Place one hand gently on your stomach.
  2. Breathe in through your nose. When you breathe in, notice your hand rise.
  3. Breathe out slowly through pursed lips. When you exhale, notice your hand lower.
  4. Make sure your neck and shoulders are relaxed.

2. Try tai chi

Tai chi involves focusing on the breath, having an awareness of the body, and practicing mental focus. It requires a slow, repetitive, and gentle movement and is known to be beneficial for people living with COPD.

A 2021 research review found that tai chi can help improve the lung function of people living with COPD. It may also improve your exercise capacity and quality of life.

3. Explore yoga

Yoga can have both physical and mental health benefits for people living with COPD.

As well as being a well-known method of stress reduction, yoga may also be beneficial for people living with COPD due to its effects on the lungs.

A research review from 2019 suggests that yoga can improve pulmonary function and have a positive impact on exercise capacity.

The researchers concluded that yoga that involved breathing techniques could be an additional therapy for people living with COPD when used alongside other treatments.

4. Stay present with mindfulness

Mindfulness is the practice of paying close attention to the present moment. It’s a useful tool to reduce stress, depression, and anxiety.

Mindfulness has also been shown to improve lung function, shortness of breath, and fatigue in those with COPD, according to the American Thoracic Society.

To try a moment of mindfulness:

  1. Sit in a chair and close your eyes or focus gently on something a short distance in front of you.
  2. Focus on your breathing.
  3. Feel your feet against the floor.
  4. If you get distracted, gently bring your focus back to your breath.

5. Exercise safely

Some exercises can be challenging, especially when you live with COPD. But movement is an important part of a healthy lifestyle and can be helpful for stress reduction and improved lung function, according to the American Lung Association.

It’s a good idea to discuss your exercise plans with your doctor and come up with a safe plan that fits your needs.

The American Lung Association suggests a moderate exercise plan of 20–30 minutes for 3 or 4 days a week.

Resistance training, pulmonary rehabilitation, aerobic exercise, and stretching are all options that may help reduce stress, improve energy, and help your body better use oxygen.

6. Join a support group

It’s important to have a strong support system around you. Joining a support group where you can meet others living with COPD can help decrease feelings of loneliness as well as assist in learning new coping skills from others in a similar situation.

The American Lung Association’s Better Breathers Club connects people living with lung disease. Bezzy COPD also has online forums that offer connection with others.

The takeaway

Stress can negatively affect people living with COPD. It’s a known trigger for worsening COPD symptoms. When you’re stressed, you may experience shortness of breath and it can increase your risk of COPD hospitalizations.

Stress reduction strategies may help. Breathing exercises, tai chi, yoga, mindfulness, and joining support groups are strategies that can improve mental and physical health.

Medically reviewed on February 27, 2024

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About the author

Elizabeth Pratt

Elizabeth Pratt is a medical journalist based in Australia. She has a master’s degree in health communication and has worked across all forms of media. Her work has appeared in a variety of outlets like the Australian Broadcasting Corporation, Huffington Post, Fox News, Salon, The Sydney Morning Herald, Escape, and Theravive. When she’s not writing stories, you’ll find her in her yellow armchair, planning her next trip. Connect with her on Twitter.

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