Life with chronic obstructive pulmonary disease (COPD), a persistent lung disorder that hampers normal breathing, can be exhausting. Routine activities like going to the market or putting dishes away can sometimes drain your energy, depriving you of time with friends and activities that you used to enjoy.
“COPD by itself can cause a lot of fatigue,” says Amy Attaway, MD, a pulmonologist at the Cleveland Clinic in Ohio. “It really comes down to the fact that your body has to work harder than for a person who doesn’t have the condition,” she says. “You lose a lot of energy because you’re expending a lot of your energy or calories on breathing with your respiratory muscles.”
But there are things to try and habits you can adopt to give yourself more get-up-and-go. Here are nine tips on how to manage fatigue through diet, exercise, lifestyle changes, and mental wellness.
1. Make Sure You’re Eating Enough
“People with advanced COPD can sometimes be underweight, and even eating can make them tired,” Dr. Attaway says. “I recommend that my patients see a nutritionist to optimize their diet.”
It’s a good idea to adopt a diet that includes healthy fats and proteins, Attaway notes. “Proteins help build back the muscle that you can lose when you have COPD,” she says.
2. Think Twice Before You Load Up on Carbs
According to Attaway, eating a lot of carbs at once can make you tired instead of giving you energy. “When you have COPD, blowing out the carbon dioxide can be harder. A meal that’s high in carbs actually makes more carbon dioxide,” she explains.
“I’ve had patients tell me their breathing gets worse after a high-carb meal, and research has also shown this,” says Attaway.
“It’s because of all that carbon dioxide that food produces in your body.”
3. Consider Pulmonary Rehabilitation
Pulmonary rehabilitation educates people about
COPD and exercise to give them extra tools for COPD management. The exercises involve cardiovascular training, strength training, and flexibility: all types of movement that can improve lung function, reduce symptom severity, and improve your quality of life.
Pulmonary rehabilitation can also provide patients with social support, according to Meredith McCormack, MD, an associate professor of medicine at Johns Hopkins Medicine in Baltimore. “People are in an environment where they’re trying to increase their physical activity with peers who are like them and facing similar issues,” Dr. McCormack says.
Pulmonary rehab programs can be very helpful in finding ways to conserve and boost energy with COPD.
“We teach and encourage exercise, but we also teach energy conservation techniques,” says Scott Marlow, the director of the pulmonary rehabilitation program at Cleveland Clinic in Ohio. “With more advanced COPD, people can have shortness of breath doing many everyday activities, such as combing their hair or brushing their teeth.”
Small changes, such as sitting down on a stool during a shower or stopping to rest a few times while preparing a meal, can make a big difference.
The main goal is to educate people about their condition, says Marlow. The information and strategies that pulmonary rehab teaches can reduce anxiety, which can also help prevent exacerbations. “The more you know, the more you are able to go out and do,” he says.
4. Stop Smoking
If you smoke and have COPD, quitting is probably the most important thing you can do, says McCormack. According to the Centers for Disease Control and Prevention (CDC), if a person is just beginning to experience
COPD symptoms such as mild shortness of breath with heavy work or exercise, stopping smoking may reduce further lung damage and
slow the progression of COPD.
The COPD Foundation suggests that this will help preserve the lung function you still have.
The more normal your lung function is, the less energy your body will have to expend on breathing. Many options can help you
kick the smoking habit, including:
- Gum
- Patches
- Smartphone apps
- Text and phone therapy
- Prescription medicine
5. Try to Lose Any Extra Pounds
There is increasing evidence that people with COPD who have overweight face worse outcomes, says McCormack.
A review linked an increase in fat mass to worse health outcomes, including a lower tolerance for exercise and an increased risk of early mortality.
The extra weight around the chest wall causes compression and reduces air capacity.
Even in the absence of COPD, research suggests that obesity is associated with greater fatigue.
Pulmonary rehab or a healthcare provider can provide nutritional counseling and a plan to increase activity, shed weight, and boost energy with COPD.
6. Get Enough Rest
Attaway says that establishing a routine and planning your day can help you make sure you get enough time to rest. “It’s important to allow for periods of rest in the middle of the day. A lot of my patients will plan for rest in the afternoon, maybe a brief nap,” she says.
She adds that sleeping for too long in the middle of the day can leave you groggy or make it more difficult to go to sleep at night. “A shorter nap is best, just enough to get your energy back.”
Sleep apnea or sleep-disordered breathing often occurs in people with COPD.
“Getting treatment for this condition that is separate from your
COPD treatment is an important part of your care,” says McCormack.
Low oxygen concentrations during sleep can affect your sleep quality, she says. Your doctor might prescribe supplemental oxygen, which could help you sleep better at night and lift your energy and mood during the day.
7. Get Screened for Depression
“It’s very common for people with COPD to have depression or to just feel down,” says Attaway. “When you have COPD, it’s harder for you to get around, and you may have to ask people for help,” she says. That can lead to feelings of guilt or helplessness. According to the COPD Foundation, other common emotions in people with COPD may include:
- Loss
- Denial
- Isolation
- Anger
- Guilt
- Regret
- Confusion
It’s important to be aware that depression and COPD often go together, says Attaway. “Be sure that you undergo screening for depression if you think you may be feeling down.” Depression can act as a drain on energy and motivation, so addressing it may improve energy levels.
She suggests setting a schedule and trying to keep in touch with friends and family. “Keep doing the activities that you enjoy and try not to spend too much time in your house,” says Attaway. Other ways to manage feelings of sadness and depression include:
- Avoid junk food and eat a balanced diet.
- Exercise where possible.
- Talk about your feelings with someone you trust.
- Speak to mental health professionals, including counselors or therapists.
8. Have a Doctor Check Your Vitamin D Levels
According to Attaway, many patients with COPD have low vitamin D, which can contribute to fatigue. “Many places don’t get much sun, especially in the winter, and our bodies can’t make the necessary amount without that exposure to sunlight,” says Attaway.
You can ask your doctor for a simple blood test to determine your vitamin D level. Depending on your age and level, your doctor might give you an additional supplement to raise your level to the normal range.
Research suggests that low vitamin D levels may have links to negative health outcomes in people with COPD.
Supplementing vitamin D to normal levels might reduce the risk of COPD flares, improve daily function, and enhance the quality of life for those with COPD, although no evidence supports the idea that vitamin D supplementation can slow lung function decline.
9. Try to Limit Your Stress
Chronic stress and anxiety can worsen COPD, says McCormack. “It’s not unusual for people with advanced lung disease to experience anxiety, which can interact with feelings of breathlessness,” says McCormack. Reducing your stress and anxiety can help you relax more fully and use your energy in more productive and healthy ways.
- Focus on relaxing music or nature sounds.
- Exercise and stretch, including with yoga and progressive muscle relaxation.
- Be open about your feelings with friends, family, professionals, or spiritual leaders.
- Attend personal therapy or support groups.
- Meditate.
“There are breathing techniques and visualization exercises that can help a person get through those times when they are feeling anxious or short of breath,” advises Marlow. Pulmonary rehab programs teach this kind of breathing, which is similar to methods taught in mindfulness workshops.
