Reviewed by: HU Medical Review Board | Last reviewed: October 2021 | Last updated: August 2023

Chronic obstructive pulmonary disease (COPD) is one of the most common causes of wheezing in adults. Wheezing is a term used to describe a high-pitched whistling sound that can happen when someone breathes in or out. It is usually a sign of poorly functioning lungs.1

What is wheezing?

Wheezing is usually caused by the narrowing of the airways anywhere in the respiratory system. When air cannot move freely through the airways, it vibrates the walls of the airway. This is what makes the whistling noise we hear during wheezing.1,2

Wheezing more commonly happens when someone breathes out, or exhales. It also can happen when someone breathes in, or inhales. If wheezing happens during inhalation, it can be a sign of more serious lung problems.2

Why does COPD cause wheezing?

The cause of wheezing is some kind of blockage or narrowing of the airways of the lungs. People with COPD have airways that are blocked and inflamed. For this reason, COPD is a frequent cause of wheezing.1,3

People with COPD may have wheezing on some days but not others. They can also have wheezing that might come and go throughout the day. Wheezing often happens around the same time as the symptoms of chest tightness and shortness of breath.3

Wheezing can be caused by several different problems of COPD, including:1,4

  • Inflamed, narrow airways
  • Airways clogged with mucus
  • Spasms of the muscles surrounding the lungs (bronchospasms)
  • Frequent respiratory infections

COPD causes airways to be inflamed, which can make them narrower and disrupt the airflow. People with COPD also often have excessive mucus production. This mucus can fill airways and make it more difficult for air to travel through. This causes wheezing.1,4

People with COPD are also likely to experience bronchospasms. This happens when the muscles that surround the airways suddenly tighten up. This can narrow the airways and cause wheezing during the spasm.1,4

Because people with COPD have weaker lungs, they are more likely to catch respiratory infections like colds, the flu, or pneumonia. These infections can increase wheezing by further irritating the airways and producing mucus. After an infection is treated, the wheezing it caused should go away.1,4

Wheezing does not always mean a person has COPD. Wheezing is also a very common symptom of asthma. Also, not everyone with COPD will wheeze.1,3

How is wheezing treated in people with COPD?

Treatment plans designed for people with COPD are focused on improved lung function and keeping airways working efficiently.3

Some people may be prescribed drugs that more specifically address wheezing. These are called bronchodilators. Bronchodilators are typically inhaled and can be fast-acting or long-acting. Anticholinergics, a type of bronchodilator, are considered first-line treatment for COPD. They work by relaxing the muscles around your airways, which can cause air to flow through them better.1,5

Steroids, potent anti-inflammatory drugs, are also used to treat wheezing. These can be inhaled, injected, or ingested, depending on the severity of symptoms. Decreasing inflammation helps with airway swelling, improving wheezing.6

People with COPD should also try to identify and avoid triggers that may worsen their wheezing. Some triggers could be tobacco smoke or pollution. Staying up-to-date with flu and pneumonia vaccines can lower the chances of respiratory infections that can worsen or cause wheezing.1,4

Increased wheezing or wheezing that is worse than usual can be signs that a person with COPD is having an exacerbation or flare-up. People with COPD or their caregivers should contact a doctor for advice if they think the wheezing might be an early sign of a flare-up.3

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