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Everything You Should Know About the Four Stages of COPD

Everything to Know About the Four Stages of COPD


COPD is a chronic lung disease that progressively restricts airflow in and out of the lungs. Learn about each stage and how to treat its many symptoms.


Chronic obstructive pulmonary disease (COPD) is a chronic lung disease that progressively restricts airflow in and out of the lungs. It usually includes the presence of other breathing conditions like chronic bronchitis and emphysema. Around 90 percent of COPD cases are caused by smoking cigarettes, but some other causes can be long-term exposure to air pollution or a rare genetic disorder involving a protein deficiency. The typical symptoms of constant coughing, wheezing, and shortness of breath can sometimes go unnoticed until the later stages of COPD, so early detection is vital in order to begin slowing its progression and managing the symptoms.

In order to determine what treatment to prescribe that will yield the most results, doctors use a system developed by the Global Initiative for Chronic Obstructive Lung Disease called the GOLD system. This system categorizes your symptoms based on their severity, your number of hospital stays, your exacerbation risk (flare-ups where your COPD worsens), your other current health problems, and your spirometry results. Your physician will obtain your spirometry results by testing your pulmonary function as you breathe into a machine that measures your forced expiratory volume in one second (FEV1).

After taking all these factors into consideration, your doctor will classify you under one of the four stages of COPD, which are mild, moderate, severe, and very severe. Your treatment will be based on which of these stages you are placed in. It is important to understand each stage, their overall symptoms, and explore your options for how to slow the progression of COPD and still live your life the way you want to. Let’s be honest, it is certainly a stressful and worrisome topic, but COPD does not define you.


Stage 1 of COPD


COPD is a chronic lung disease that progressively restricts airflow in and out of the lungs. Learn about each stage and how to treat its many symptoms.


During the first stage of COPD, you will probably not even notice the symptoms. You might attribute them to possibly catching a cold, having allergies, feeling fatigued due to aging, or just your normal cough triggered by smoking. In this stage, your lungs are functioning at or above 80 percent of normal lung capacity. You will likely develop a cough that produces an excessive amount of phlegm. These mild symptoms will creep up on you and you won’t even be aware that the health of your lungs is declining. Smokers especially should always consider the risk of developing COPD, and if these symptoms are increasing, should consult their doctor as soon as possible.

One of the most important things you can do for your COPD is to recognize the symptoms early so your physician can set you on a path towards effective treatment. The other critical thing to do is to stop smoking during this stage. In doing so, you are dramatically improving your overall health and your future. What’s worse, if you are diagnosed with COPD and choose to continue smoking, you are only speeding up the destructive nature of the disease.

How can this stage be treated? If you are able to catch COPD this early, your doctor might prescribe a short-acting bronchodilator (inhaler) to use as needed that lessens the symptoms you are feeling. To add to this treatment, there are some other preventative steps you can take toward living a healthier, better lifestyle:

  • Get your yearly flu and pneumonia shots. These vaccines will boost your immune system and protect your body against additional diseases and conditions.
  • Consider your environment. If you work somewhere with high amounts of pollution, it might be best to take a step back and reevaluate the risks. Avoiding triggers like dust, pollen, pollution, smoke, perfumes, and working or cleaning with strong chemicals will actively lessen the symptoms of early-stage COPD.
  • Make the switch to a healthier diet. Consuming mainly healthy foods and getting enough vitamins will keep your body feeling strong and resilient.
  • Up your exercise routine. Leading an active lifestyle gives your immune system that necessary support it needs to fight off COPD symptoms. It strengthens the muscles around your lungs for better breathing and improves how your body uses oxygen.


Stage 2


COPD is a chronic lung disease that progressively restricts airflow in and out of the lungs. Learn about each stage and how to treat its many symptoms.


Of all the stages of COPD, the second stage is when symptoms will become too persistent to ignore. The symptoms mentioned in stage one will continue and worsen. Though, your cough will become chronic, phlegm will be harder to expel, you might have trouble sleeping, and wheezing could become normal as the air you breathe tries to pass through airway obstructions. Airways could constrict and become inflamed as you experience shortness of breath on a more regular basis, especially when active. Even small activities can make it harder to breathe. Because your lungs are working harder than normal to keep your blood oxygen levels up, fatigue will set in and might hit you harder than normal.

In this stage, your lungs are functioning at 50-79 percent of their normal lung capacity. It is easy to see on a spirometry test that you have entered this stage of COPD. Instead of taking preventative measures like those prompted by stage one, this stage is more about managing ongoing symptoms. Your doctor will likely prescribe you a long-acting inhaler that you will use 1-2 times per day instead of simply whenever you need it. If you have a respiratory infection, you will be prescribed antibiotics to fight the infection so it doesn’t lead to a hospital visit from exacerbation.

The absolute best thing you can do for your COPD in this stage is to begin pulmonary rehabilitation. During this training program, you will be led by therapists as you exercise, learn about COPD, manage your symptoms, are counseled through the process of no longer smoking, and will be surrounded by others that share your experience. It provides you with a fantastic support unit that will help you achieve your goals and ultimately become a life-changing experience for you. If you decide to go at it alone, make sure you ask your doctor about the right types of exercises you can do that will help you cope with your symptoms, such as stretching, strength training, and aerobic exercise.


Stage 3


COPD is a chronic lung disease that progressively restricts airflow in and out of the lungs. Learn about each stage and how to treat its many symptoms.


During stage three of COPD, your lungs are now functioning at 30-49 percent of their normal lung capacity. All the symptoms that were previously experienced are further worsened, along with additional symptoms and frequent exacerbations. Respiratory infections could become a common thing due to the lungs not being able to rid themselves of viruses, bacteria, and irritants. Recurring episodes of bronchitis, colds, and pneumonia will drain you of most of your energy and any exercise you were previously doing will come to a slow halt. Other noticeable symptoms include:

  • morning headaches due to high levels of carbon monoxide in the body
  • edema (swelling of the feet or ankles) from high stress levels on the heart
  • inability to breathe deeply
  • lips or fingernails turning blue
  • rapid heartbeat or breathing
  • decreased mental alertness
  • mental confusion

Your quality of life may decrease considerably, and you will therefore want to discuss several options for treatment with your doctor. You might be prescribed a steroid inhaler, ongoing pulmonary rehabilitation, continuous flu vaccinations, or more frequent check-ups and pulmonary tests to track your progress. You will want to continue your efforts to exercise, eat healthy, and avoid lung irritants and pollutants as part of a strict treatment plan. Be sure to wash your hands frequently and avoid large crowds to lessen the chances of becoming sick.

Supplemental oxygen will likely be prescribed to you, either to use at night or all day. There are a variety of options you can choose from, and each are extremely beneficial to enhancing your quality of life! Oxygen therapy is not assigned to a specific stage of COPD, but you will notice that using it will greatly increase your ability to exercise, prevent morning headaches, sleep better, relieve shortness of breath, slow and prevent heart failure, and ultimately prolong your life.

Depending on your lifestyle, you can choose the oxygen system that works best for you. Portable oxygen tanks are common, but require a lot of upkeep as they need to be refilled when depleted of oxygen. Home oxygen concentrators do not need to refilled because they take in the air around you to provide you with oxygen. Portable oxygen concentrators are the easiest, most efficient way to get enough oxygen wherever you go. They are lightweight, can be carried, taken on planes, and give you ultimate freedom in your daily life.


Stage 4
Very Severe


COPD is a chronic lung disease that progressively restricts airflow in and out of the lungs. Learn about each stage and how to treat its many symptoms.


As your COPD continues to progress, stage four might become a reality. It involves all previous symptoms, but they are at their worst even when you are resting. This stage is often called “end-stage COPD”, but that title can be a bit dramatic. Many stage four COPD patients live years and years with their symptoms if they are closely following their treatment plan and implementing the proper lifestyle changes! Maintaining a positive attitude and undergoing oxygen therapy are the keys to battling the continuing symptoms of COPD and maintaining your quality of life. It’s important to have an action plan and to stick with it if you are to benefit from treatment.

This stage is characterized by sudden weight loss as your body uses more energy to get oxygen pumping through your blood. Exacerbations and hospital visits are more frequent, and many normal tasks become extremely difficult to do without help, such as eating and walking up stairs. Shortness of breath can sometimes be life-threatening and lead to other circulatory and heart complications due to lack of airflow. Patients are more prone to asthma, arthritis, diabetes, and strokes. Your symptoms may require emergency care because the lungs are now operating at 30 percent or less of their normal capacity.

In addition to previous symptoms, patients might also experience the following:

  • chronic respiratory failure
  • barrel chest (when the lungs are over-inflated)
  • crackling sounds upon inhaling
  • chest pain or tightness
  • drowsiness
  • depression

As far as treatment goes, all previous forms may be prescribed or enforced, almost always including supplemental oxygen. Oxygen therapy really makes all the difference between suffering through life with your COPD symptoms and leading a happy, independent life. As a last resort, some patients may opt to receive a lung transplant or undergo lung volume reduction surgery, in which 30 percent of diseased tissue is removed from the lungs. These procedures both require the patient to meet certain qualifications and each have their own risks post-surgery.


Be Kind to Your Lungs


COPD is a chronic lung disease that progressively restricts airflow in and out of the lungs. Learn about each stage and how to treat its many symptoms.


Knowing as much as you can about COPD can lead you to make crucial lifestyle changes that can alter the course of your life! Everyone is different and will not all experience the same symptoms and health issues. It is important to stay in close contact with your physician and care specialists to ensure that you are on the right track to slowing the progress of COPD.

There is no cure, but it can be effectively handled if you adhere to your treatment plan. That means you should stop smoking, avoid lung irritants, eat healthy, exercise regularly, and have the right attitude about managing your symptoms. In doing so, you have the potential to live for several more years to come! Do all you can to take action now towards making the necessary changes in your life that will improve your breathing and create a better future for you.

Have any questions for us? We’d love to help you find the right supplementary oxygen device for you, so you can live your very best life.

Liberty Medical’s support team is available 24/7 to answer all your questions! Call us today at 1-800-375-6060.






  1. Abdullah. Al Mamun on March 30, 2020 at 9:34 pm

    Thanks for the nice description of COPD at different stages. Hopefully, people will understand what is COPD, how to respond to that.

  2. Ashish Kumar Guha on March 30, 2020 at 11:48 pm

    I am a COPD patient and have learnt a lot from this informative guide. Thank you.

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