What Is COPD Fatigue?

African American man sleeping in bed

Jose Luis Pelaez Inc/Getty Images

In This Article
Table of Contents

Fatigue is one of the common effects of chronic obstructive pulmonary disease (COPD). Your lung disease affects the oxygen levels in your body and makes it hard for you to breathe, while overall weakness further contributes to a general feeling of exhaustion and low energy. This challenges your ability to maximize your capabilities, and it may become such a persistent part of your life that you might not realize that it's caused by your illness.

COPD Fatigue Symptoms

Severe fatigue affects approximately 50% of those who are living with COPD. Fatigue isn't the kind of tiredness that improves with sleep or a cup of coffee. It is persistent and profound, and occurs even when you haven't exerted yourself.

COPD-related fatigue can affect you both physically and mentally. The effects can be subtle and may gradually worsen as your lung function declines. You may also experience some variation in your level of fatigue or bouts of severe exhaustion at times.

Common symptoms of COPD-associated fatigue include:

  • Tiredness or exhaustion
  • Feeling worn out
  • Generalized physical weakness
  • Lack of motivation
  • Trouble concentrating
  • Sleepiness, even after a full night's sleep
  • Slow reaction time
  • Depression, irritability
  • Decreased appetite or a craving for sugary or fatty foods

You may notice worsening fatigue when you run out of your COPD medication or even when you start a new prescription. Increasing fatigue is often a sign that your COPD is not optimally controlled or that you have a complication, such as an infection.

Causes

There are a number of aspects of COPD that lead to fatigue. A progressive decline in lung function and decreased physical endurance, hallmarks of COPD, are large contributors. But it's also important to consider related conditions and complications that impact your energy levels, such as depression.

Oxygen Deprivation

Hypoxemia (inadequate oxygen in the blood) and hypoxia (inadequate oxygen in the organs and tissues of the body) can occur due to severe lung disease. COPD interferes with air exchange in your lungs and reduces your oxygen absorption as you breathe.

Your body needs oxygen for energy, and even a slight compromise in your oxygen levels can result in fatigue.

Strength and Endurance

Breathing is a struggle with COPD. You can consume a great deal of energy from this task alone. The disease is also commonly associated with malnutrition, decreased weight, and weak muscles, which make normal activities more taxing to carry out.

And staying inactive leads to muscle atrophy, which leads to a further decline in strength and energy.

Complications and Co-Morbidities

With COPD, you can develop a variety of health issues. Depression is very common in COPD, and it is one of the causes of generalized fatigue.

Heart failure, a complication of COPD, leads to oxygen deprivation due to reduced efficiency of blood flow. And frequent respiratory infections consume your body's energy, interfere with air exchange in the lungs, and reduce your oxygen levels.

Sleep problems, including sleep apnea, commonly co-exist with COPD. With COPD-associated sleep apnea, you might not feel rested in the morning after you sleep, even after sleeping for hours.

Diagnosis

If you feel low in energy, sleepy, or unmotivated, be sure to discuss your symptoms with your doctor. You may need to have a physical examination and/or diagnostic testing.

The results of your medical evaluation may guide an adjustment in your COPD treatment. They could identify another medical condition in addition to your COPD that could be increasing your exhaustion that, if treated, could lead to improvements in your fatigue.

Your doctor will begin by asking you questions about your daily activities, breathing, sleep, mood, and nutrition. They will also ask about other symptoms such as fever, pain, discomfort, respiratory symptoms, and digestive symptoms. If there is a concern, you may have screening for depression.

Your physical examination will include an assessment of your temperature, pulse (heart rate), respiratory rate, and blood pressure, These values can provide direction regarding the cause of your fatigue. Your oxygen level will be measured with a pulse oximeter, a non-invasive test that uses a probe placed on your finger.

Other tests you may need include:

  • Pulmonary function tests: Your doctor may have you take breathing tests, which measure your lung capacity and your ability to inspire (breath in) and expire (breath out). These tests are very important in the diagnosis of COPD, so comparing your current values to previous ones is helpful in monitoring your illness and potentially identifying how your COPD relates to your fatigue.
  • Blood tests: Fatigue can occur as a result of issues such as anemia (low red blood cell function), infection, and low oxygen. Depending on your history, your doctor may check your complete blood count (CBC) or arterial blood gas (ABG). CBC can show signs of anemia as well as infection (high white blood cells). An ABG will show signs of severe respiratory problems, such as low oxygen or altered carbon dioxide or bicarbonate.
  • Chest X-ray: A chest X-ray can show signs of progressive lung disease or heart disease, as well as signs of an infection in COPD.
  • Echocardiogram: Heart failure, which causes fatigue, is among the complications of COPD. And even when COPD is not contributing to it, heart disease often co-exists with COPD. An echocardiogram can help in the diagnosis of heart diseases such as heart failure and valve disease.
  • Sleep study: Sleep apnea is diagnosed with a sleep study that measures oxygen levels, breathing, and sleep stages during sleep.

Treatment

You can work with your medical team to begin using medical and lifestyle strategies to decrease your fatigue.

Maintaining healthy habits can help you avoid complications such as infections, and can also help you maximize your energy level. When you have COPD, taking your medication as prescribed is vital to this, as it helps reduce lung inflammation and prevent airway constriction.

If you are having a hard time remembering to take your medicine, talk to your doctor about whether other options—such as scheduled injections—may be possible for you.

Pulmonary Rehabilitation

Pulmonary rehabilitation involves breathing exercises and physical therapy routines that are specifically designed to help you function better with your lung disease. This type of supervised regimen improves fatigue in COPD, and it is also correlated with improved lung function and reduced dyspnea (shortness of breath), anxiety, and depression.

Breathing Techniques

When those with COPD are faced with strenuous activity, the natural tendency is to pant. This can wear you out faster by overworking your diaphragm. Work with your respiratory therapist to learn how to breathe in a healthier way.

The way that you control your breathing can help minimize your effort while maximizing the benefits of each breath. Breathing techniques like pursed-lip breathing and diaphragmatic breathing can help fight fatigue by regulating the air into and out of your lungs.

When performing any activity, exhale during the most difficult part through pursed lips and slowly inhale through your nose. Practice, repeat, practice, repeat.

Plan Your Activities

Consider conserving your energy by planning out your tasks so that you can get more done without being too exhausted to do things that are most enjoyable. Consider reorganizing your shelves at home so you won't have to exhaust yourself when finding items that you need. Sitting while you get ready in the morning can save up energy for the day ahead.

See if using a rolling cart at home or when you are out running errands helps keep you from wasting your energy on heavy lifting. And decide whether having your bedroom on the main floor of your house would be a more efficient way for you to take care of things like laundry.

Diet and Exercise

Exercise is associated with a longer life expectancy for people living with COPD. When it comes to exercise with COPD, doctors advise a combination of endurance exercises and flexibility exercises. Walking is considered a valuable activity for people who have COPD.

Eating a healthy diet is also important if you have COPD. Fresh foods rich in vitamins and minerals help fight infections, while protein and carbohydrates help maintain your energy levels. Be sure to stay hydrated with plenty of water too. Dehydration can be especially harmful to people with COPD, causing the thickening of mucus in the lungs and a progressive loss of lung capacity.

A Word From Verywell

Fatigue is affected by and affects all areas of life when you're living with COPD. It's important to talk to your doctor about your fatigue because it can be a sign of a serious health issue that requires treatment.

And even if you aren't experiencing an urgent medical problem, there are a number of effective approaches that you and your medical team can adopt so that you can increase your energy level—or at least prevent it from declining.

Was this page helpful?
Article Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Medina-mirapeix F, Bernabeu-mora R, Giménez-giménez LM, Montilla-herrador J, García-vidal JA, Benítez-martínez J. Patterns and predictors of exhaustion episodes in patients with stable COPD: A longitudinal study. Int J Clin Pract. 2018;72(5):e13068.doi:10.1111/ijcp.13068

  2. Goërtz YMJ, Spruit MA, Van 't hul AJ, et al. Fatigue is highly prevalent in patients with COPD and correlates poorly with the degree of airflow limitation. Ther Adv Respir Dis. 2019;13:1753466619878128.doi:10.1177/1753466619878128

  3. Spruit MA, Vercoulen JH, Sprangers MAG, Wouters EFM. Fatigue in COPD: an important yet ignored symptom. Lancet Respir Med. 2017;5(7):542-4. doi:10.1016/S2213-2600(17)30158-3

  4. Van herck M, Antons J, Vercoulen JH, et al. Pulmonary Rehabilitation Reduces Subjective Fatigue in COPD: A Responder Analysis. J Clin Med. 2019;8(8) August 20.doi:10.3390/jcm8081264

  5. Spruit MA, Burtin C, De Boever P, et al. COPD and exercise: does it make a difference?. Breathe (Sheff). 2016;12(2):e38-49. doi:10.1183/20734735.003916

  6. Li LSK, Butler S, Goldstein R, Brooks D. Comparing the impact of different exercise interventions on fatigue in individuals with COPD: A systematic review and meta-analysis. Chron Respir Dis.2019;16:1479973119894855.doi:10.1177/1479973119894855

  7. Ghosh A, Boucher RC, Tarran R. Airway hydration and COPD. Cell Mol Life Sci. 2015;72(19):3637-52. doi:10.1007/s00018-015-1946-7

Additional Reading