A pair of lungs stealing the battery out of a tired looking man's back

5 Tips for Re-Building Your Strength After COPD Zaps Your Energy

Some members of our community recently asked for more information on how to rebuild your strength when COPD has made you physically weak. So, using my base of knowledge as both a registered nurse and a fitness coach, this article will give you some practical tips on doing just that.

Balance your activity with rest and sleep

One reason people who have COPD may feel weak and tired is that they don't get enough replenishing rest. This can be due to their COPD symptoms, as well as the anxiety and stress that go along with them. When you have COPD, one of your most important tasks is learning just how to balance periods of activity with rest. These needs can change over time too, as your COPD progresses, though that may take many years.

You see, the sheer work of breathing when your airways are swollen and narrowed and your small lung cells don't pass on oxygen like they should can wear you out. In fact, fatigue is one of the most common symptoms of COPD, affecting as many as 7 out of every 10 COPD patients.1 Because of your lung damage, you have trouble getting oxygen in and letting carbon dioxide out. This can make you feel tired and lacking in energy.

When you feel tired, it's natural to want to do less. But that will only result in a loss of muscle tone and strength over time, making you even more fatigued, even with simple tasks. So the answer is not to do less. It's to find a way to replenish those energy stores.

Sleep is crucial

Sleep is an important part of the equation, but nighttime coughing or shortness of breath can interfere with restful sleep. Here are a few things that may help you sleep better:

  • Get a wedge pillow or elevate the head of your bed on blocks to make breathing easier.
  • Maintain a regular bedtime schedule.
  • Develop a relaxing bedtime ritual that will help you settle into sleep easier. Meditation, reading, listening to relaxing music, taking a warm bath are just a few suggestions.
  • Avoid drinking caffeine beverages for at least 2 hours before your bedtime.
  • Talk with your doctor about the possibility of taking a low-dose melatonin supplement. Melatonin is a natural sleep hormone.
  • Explore the need for nighttime supplemental oxygen with your doctor.

Rest periods also matter

Taking rest periods during the day is also important. Sometimes this is referred to as pacing yourself. Break any tasks you need to complete down into small steps and rest between each step. For example, getting ready for the day might look like this:

  1. Lay out your clothes for the day. REST
  2. Dress your upper body. REST
  3. Dress your lower body, including shoes or slippers. REST
  4. Wash up, brush your teeth and comb your hair. REST

Does that make sense? Your rest periods can be as long or short as you need them to be. When your breathing eases, you'll know it's time to continue.

Some people benefit from daytime naps, but nap with caution. While napping can restore some energy, long naps sometimes leave you feeling even more tired and may interfere with your ability to fall, and stay, asleep at night.

Eat a balanced, nutritious diet

Sometimes energy can be low because you're not fueling your body correctly. Eating the right foods in the right proportions can help you meet your increased energy needs and feel better overall. The American Lung Association offers these practical tips for improving your nutritional intake:2

  • Eat more complex carbohydrates, such as vegetables, fruits, and wholegrain products, rather than simple carbohydrates, such as sugar, candy, soda, and desserts.
  • Include foods rich in dietary fiber, such as fruits, vegetables, nuts, seeds, wholegrain bread, and wholegrain pasta.
  • Include servings of protein, such as lean meats, fish, poultry, eggs, and beans in most meals. Proteins are building blocks for muscle tone.
  • Avoid fried and highly processed foods, including fast foods. Whole foods are best.
  • Drink plenty of water, unless you are on a fluid restriction. Water can help thin your airway secretions and also avoid dehydration.

Stay active and exercise if you can

When you feel tired and weak, exercise may be the furthest thing from your mind. But muscles atrophy and weaken when they aren't used. So, sitting around all day is only going to make you even weaker. But even light activity will reap real benefits.

If you haven't been active recently, getting started can be hard. It's never too late to start being active, but start slow. The main idea is to move more and sit less throughout the day.3 Get up and walk around your house, if nothing else. Or do some leg raises while you're sitting. Or stand up and sit down from your chair a few times in a row.

Start slow

When you're ready, start to incorporate some light exercise. Experts recommend about 30 minutes a day, 5 days a week of moderate-level physical activity.3 Walking is one of the easiest, gentlest ways to get moving. Swimming and yoga can also be beneficial. There are even seated yoga classes available. I used to teach seated dance fitness classes that many of my participants loved--even those on oxygen!

When I say start slow, I mean to move at a slow pace, one that won't trigger severe shortness of breath. Also, if 30 minutes all at once is too much, then start with 5 minutes, a few times a day. Slowly build up your endurance. Adding in balance training or strength training with light weights will also help build your muscle tone and improve your energy over time.

NOTE: Before beginning any type of formal exercise program, be sure to get the green light from your health care team. One of the reasons people often fail to stay active after starting is because they try to do too much, too fast. Pulmonary rehabilitation is also a great way to learn what types and amounts of activity are best for you.

Get a handle on other chronic health challenges

It's not unusual for people with COPD to also have other chronic health conditions, such as heart disease and lung infections.4Depression and anxiety are also common. These accompanying conditions can also cause fatigue and deconditioning, or at the least, make it worse.

So, be sure to talk with your health care team about the best ways to manage them. It might mean changes in medication, or perhaps counseling. Your ongoing best health is worth the effort to deal with these other conditions in a proactive way, isn't it?

Learn how to breathe better

To a certain extent, you can retrain your breathing. There are specific breathing exercises that can help with this.5

With belly breathing, as you take your breath in, you let your stomach, or belly, expand. And then when breathing out, contract those same muscles. This helps you work the lower airway and get a deeper breath.

With pursed lip breathing, you can also use belly breathing. But when you exhale, do it through pursed lips, as though you were blowing out a candle or whistling.

With deep breathing, you inhale deeply then hold your breath for a count of five, if you can. Then breathe out (exhale) forcefully, until you have breathed out as much air as you can.

One final thing you can do to enhance your breathing is something called the "Huff Cough Technique."5 With this technique, you breathe in a little deeper than usual. Then, use your belly muscles to blow the air out in three even breaths. To do this, make the sound, “Ha, ha, ha” like you are trying to steam up a mirror. This can be helpful in enabling you to cough up the mucus in your lungs that makes you cough uncontrollably. Those coughing spells can be exhausting.

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