June 17, 2019

COPD Fatigue Can Be Relentless, So Fight Back

How to get back your get-up-and-go

Elderly man tired from COPD

If every step you take with COPD is sluggish, put some pep in that step and fight fatigue. Pulmonologist Amy Attaway, MD, shares some tips.


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Why has COPD left me so tired?

Dr. Attaway explains: “Many people living with chronic obstructive pulmonary disease, or COPD, are in a hypermetabolic state. Your body feels like it’s spending all of its energy on breathing.”

It can feel like you’re using so much energy to breathe that you don’t have much left for physical activity.

But COPD may not be the cause of your fatigue

“There are times when someone has COPD, but something else is causing the fatigue,” says Dr. Attaway. “And those conditions are often treatable, through a daily medication or using a breathing mask at night.”

Non-COPD causes of fatigue may include:

  • Sleep apnea: Poor sleep at night can result in fatigue during the day.
  • Low oxygen levels: Oxygen levels may drop at night, causing you to wake up sluggish and sometimes with a headache.
  • Vitamin D: Low vitamin D is common in people with COPD.
  • Thyroid problems: People with COPD may have a higher risk of thyroid disorders.

COPD fatigue: Plan ahead

“A COPD diagnosis may make activities harder, so put a plan in place,” says Dr. Attaway. “Whether you’re heading off for a Disney vacation or just on a walk, set realistic expectations about what you can accomplish.”

Try these strategies:

  • Bring supplemental oxygen (if you use oxygen in the home).
  • Plan a rest period before and after each activity.
  • Identify transportation services at amusement parks or airports.
  • Build in extra time to get from point A to point B.

Nutrition is critical

To promote overall wellness, try eating:

  • Foods high in healthy proteins.
  • Healthy fats like those found in fish.
  • High-fiber foods that help move your bowels and decrease constipation.
  • Avoid large meals with simple carbs, when possible.

You may need extra support figuring out which foods will give you the most bang for your buck when it comes to energy. Ask your provider for a referral to a dietitian who can help you make a nutrition plan that works.

Exercise (whether you want to or not)

“COPD can promote a sedentary lifestyle, but that creates a bad cycle because the less active you are the more likely you can get muscle loss in the rest of your body,” says Dr. Attaway.

“Plus, lack of exercise may lead to weight gain. The additional weight can push on the diaphragm, making it harder to move air and contribute to shortness of breath.”

Dr. Attaway says it’s vital to start a home exercise program (after clearing it with your doctor). Set these goals:

  • Do the heart rate math: Aim for RHR+60 percent. If your RHR (resting heart rate) is 70, then shoot for 110 when you exercise.
  • Find a sweet spot: Exercise until “it’s somewhat hard or hard to breathe,” but don’t get to the “it’s very hard to breathe” stage.
  • Choose endurance exercise: Walking and biking are go-to forms of exercise that you can do 30 minutes a day, five days a week. Mix in some strength training when you can, but a cardio workout is a priority.

Take regular rest breaks

Regular breaks help conserve energy. If you have fatigue, take a nap for an hour or two in the afternoon.


“Just remember, a one-hour nap can easily turn into four,” says Dr. Attaway. “You want to stay active, so set a timer to keep yourself from snoozing the day away.”

Pulmonary rehabilitation to the rescue

You may need pulmonary rehab if you have:

  • More than one COPD flare-up per year.
  • Symptoms such as being out of breath walking at a regular pace with people your age.

Pulmonary rehabilitation has two phases:

  • Learning phase: During this six-week period, you learn the skills you need to live with COPD in addition to safe and healthy workouts to improve your breathing reserve.
  • Maintenance phase: You put all the skills you’ve learned into practice and maintain them.

“During pulmonary rehab, you learn how planning, nutrition, exercise and other strategies can help you beat COPD fatigue,” says Dr. Attaway. “Plus, you interact with others who have similar health issues. The social aspect is great as well.”

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