The Stages of COPD

by Kathi MacNaughton Health Professional

Quite often on this site, I've gotten questions from people wanting to understand the stages of COPD. Perhaps they want to know how much time they, or their loved one, have left. Or maybe they want to know what to expect, how they're going to feel as things progress.

Although this information is covered in other posts, I thought it might be helpful to have a post dedicated only to that topic, so that it's easier to find when our readers search for information.

How COPD Stages Are Determined

Stages of COPDOnly your doctor can tell you what stage of COPD you are in. The way the doctor determines your COPD stage is by giving you a pulmonary function test called spirometry. Spirometry basically measures how forcefully you can exhale.

Knowing what stage your COPD is in helps your doctor plan the best treatment for you at any given point in the progression of your illness.

The image shown at the left (courtesy of the Global Initiative for Chronic Obstructive Lung Disease, or GOLD for short) gives a quick overview of the stages of COPD. But let's break down each stage into a bit more detail.

Stage 1: Mild COPD

During this stage, patients often are not even aware that they have COPD, because the symptoms are so mild they're not that noticeable. You might have a chronic cough or even some mucus discharge, but you may not be aware that airway function has started to deteriorate.

Stage 2: Moderate COPD

By the time you get to Stage 2, breathing problems have become more obvious. You might notice some shortness of breath during certain activities. Coughing may become more frequent or more productive of thick, yellowish mucus. People in this stage of COPD are likely to consult with a doctor to find out what's going on, and thus, get their COPD diagnosis.

Stage 3: Severe COPD

During this stage, breathing becomes much more challenging. You'll notice shortness of breath with almost anything you attempt to do. Carrying on your usual quality of life starts to be more difficult. Your doctor may prescribe supplemental oxygen at this stage, or if you were already using it on an as needed basis, the doctor may bump you up to continuous nasal oxygen, or increase your rate substantially.

During Stage 3, you are also at greater risk for complications such as lung infections and related conditions.

Stage 4: Very Severe, or End Stage, COPD

When you reach this point, you are in the end game. Your quality of life has greatly changed and every day may feel like a struggle just to get through. Your decreased ability to breathe properly is affecting everything you do, even eating, toileting or getting dressed.

You will certainly need to be on continuous oxygen at this point in time, and complications, such as infections or heart failure, can be life-threatening if you get them.

But, A Stage Is Just a Label

However, keep in mind that stages such as I've described above are only guidelines that help us understand a disease and to treat it effectively. Not every COPD sufferer will follow this exact progression. And there are things you can do that may slow or prevent the progression to some extent.

Certainly, stopping smoking, if you do smoke, is essential to your future level of health and quality of life!

But also, having healthy eating habits, learning how to balance exercise/activity with rest, and knowing the warning signs of COPD exacerbation and complications can also help to keep you as healthy as possible.

Kathi  MacNaughton
Meet Our Writer
Kathi MacNaughton

Kathi is an experienced consumer health education writer, with a prior career in nursing that spanned more than 30 years — much of it in the field of home health care. Over the past 15 years, she's been an avid contributor for a number of consumer health websites, specializing in asthma, allergy, and COPD. She writes not only as a healthcare professional, but also as a lifelong sufferer of severe allergies and mild asthma, and as a caregiver for her mother with COPD.