Breathlessness, cough, sputum – the most important COPD symptoms

Die Definition von COPD

COPD leads to narrowing of the airways in both chronic bronchitis and pulmonary emphysema. This constriction is usually accompanied by inflammation. Inflammation leads to accumulation of secretions and blockage of the respiratory tract: the typical COPD symptoms occur.

The most important of these are the following symptoms, but there are other effects depending on the patient:[1]

These are the typical symptoms of COPD

  • Dyspnea (shortness of breath)
  • Cough
  • Sputum
  • Chest tightness
  • Whistling respiration
  • Depression, anxiety, or other psychological problems
  • Tiredness
  • Cyanosis (blue skin due to a lack of oxygen)

This article will give you an overview of the symptoms of COPD, how they are expressed and what can provide relief.

Difficulty in breathing with COPD

Difficulty in breathing is the most common symptom of COPD patients. More than half of COPD patients suffer daily from breathlessness, which can occur regardless of severity and is often perceived as tormenting.

Difficulty in breathing or shortness of breath occurs at the beginning of the disease only under stress and is regarded by many patients as a normal sign of aging. However, as the disease progresses, many patients experience shortness of breath during everyday activities such as shopping, climbing stairs or while falling asleep. [2]

Breathlessness occurs in both chronic bronchitis and emphysema and is caused, among other things, by the fact that the air in the lungs can no longer be completely exhaled. The remaining air in the lungs then requires additional space, but no longer supplies the body with oxygen, as this has already been transferred into the bloodstream. Learn more about this phenomena here:

Bronchodilators are often used as medication in cases of breathlessness. These widen the airways and lead to relief from shortness of breath and whistling breathing. This also increases exercise capacity and quality of life. [3]

Often shortness of breath can be released with the right breathing exercises. These are special physical movements or postures that were developed specifically for this purpose. [4]

COPD Atemübungen können helfen
The right breathing exercises and positions can reduce shortness of breath with COPD.

Pursed lip breathing, breath stimulus position, diaphragmatic breathing, yoga or breath easing postures such as the forward leading position or the goalkeeper position are easy to perform and can be astonishingly effective. [5]

In Germany, these simple aids are usually learned in rehabilitation, respiratory physiotherapy or in special lung sports. [6] Our detailed article on this topic also gives you an overview:

The Kaia COPD App also provides you with good daily exercises to get a better grip on breathing difficulties in the long term.

Shortness of breath can therefore be relieved by breathing exercises, relaxation exercises, more movement and also by bronchodilating medication.

Dry or productive cough

According to the World Health Organization WHO, chronic bronchitis, i.e. chronic inflammation of the respiratory tract, is the occurrence of cough and sputum in a patient for at least three months in two consecutive years. It affects about 25-50% of all COPD patients.[7, 8]

In contrast to dry, unproductive chesty cough, cough with sputum is called productive cough. The secretion produced as a result of the inflammation must be removed – i.e. coughed up. To support this coughing up, cough expectorants are often prescribed for COPD. [9]

Husten ist ein Leitsymptom bei Bronchitis
Patients with chronic bronchitis often suffer from chronic cough with sputum.

Cough has a purifying function and transports air and mucus and sometimes food particels from the lungs to the outside. COPD is often accompanied by a morning cough with or without sputum.

Coughing can also be deliberately triggered as a reflex. This reflex can be triggered by irritation of receptors in the respiratory tract, but also in the lung, pericardium, diaphragm, esophagus and stomach. [10] So coughing is not just coughing and sputum is not just sputum either.

There are specific coughing techniques that enable COPD patients to cough secretion more effectively. Some of these work even better if accompanied by a warm drink. You can also find a good overview of these techniques in the Kaia COPD App.

The frequently used additional cough expectorants should not be used per se, but according to the subjectively assessed benefit. Hence the question: Do they make you feel better or not?

So relief from cough can be achieved by cough remover, specific coughing techniques or proven home remedies such as warm tea.


The sputum is also called phlegm and can look very different from patient to patient and from day to day. It contains water, cells, possible particles, microorganisms and can be whitish, yellowish, greenish, reddish, greyish or brownish.

Depending on the appearance, conclusions regarding the cause of the cough can sometimes be made. For example, whitish, clear sputum rather indicates a viral infection and greenish discoloration a bacterial infection. However, these simple rules of thumb do not always apply and a diagnosis should be left to the doctor. [11]

 It is helpful to remember the color and appearance of the sputum to be able to describe it when visiting the doctor. 

Sputum may also show changes in the course of COPD, which should be clarified. Initial studies also suggest that the bacteria in the sputum allow a prognosis for the course of the disease in COPD. [12]

Sputum can persist for longer times

; sometimes the right coughing technique or mucolytic drugs can help.

Cyanosis – blue lips

The narrowing and blockage of the individual small airways means that less gas can be exchanged between the air sacs and the blood. Less CO2 can be exhaled and less oxygen gets into the blood.

If the oxygen level in the blood is too low, this is called hypoxemia. This can often trigger agonizing shortness of breath and – depending on the severity – can also cause the lips and skin to turn blue.

If one is insufficiently supplied with oxygen over a longer period of time, other changes in the body develop, such as e.g. hippocratic nails and clubbing of fingers. [13]

Blue fingers can be a symptom of COPD.
Lack of oxygen can lead to parts of the body – such as the fingers – appearing blueish.

In order to increase quality of life, performance and life expectancy, lung doctors often prescribe long-term oxygen therapy. [14]

 COPD patients should also be vaccinated against pneumococcus and influenza every year. [15] 


Reduced lung function in COPD often leads to reduced physical performance – a phenomenon often accompanied by severe fatigue.

A study has found that fatigue in COPD is mainly favored by the following factors:

  • Depression
  • Muscular strength
  • Oxygen level in the blood[16]

To counteract these effects, doctors recommend that you drink enough, spend time outside if possible, and rest sufficiently.

The most important means against fatigue is physical activity supported by breathing exercises and breathing gymnastics. [17]

A structured and easy way to pulmonary rehabilitation is also offered by the Kaia COPD App. This app helps COPD patients to improve their quality of life and physical performance as well as to reduce breathing difficulties.

Sources and Scientific Literature

Important note: This article contains general information only and may not be used for self-diagnosis or self-treatment. It cannot replace a visit to the doctor.


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