Health Plus Medical Correspondent

“I felt like I couldn’t breathe!” the patient declared as they awoke in the night, gasping for breath. No this is not a COVID-19 patient, though it could be, but this is common to those with Chronic obstructive pulmonary disease (COPD).

One of the most basic elements our bodies need to survive is oxygen, which we obtain through breath. COPD impacts one’s ability to breathe deeply, and this alone can result in anxiety, not to mention the psychological stress that can arise from living with a chronic illness during a pandemic.

What is COPD?

Chronic obstructive pulmonary disease (COPD) is a progressive life-threatening lung disease that causes breathlessness (initially with exertion) and predisposes to exacerbations and serious illness.

COPD is a term used for lung disorders such as emphysema, chronic bronchitis, and in some cases chronic asthma. People with COPD may have difficulty breathing, chronic cough, fatigue, and chest tightening. COPD can also result in reduced blood oxygen levels, causing fatigue and leading to adverse health conditions.

How many are really affected by this condition?

The Global Burden of Disease Study reports a prevalence of 251 million cases of COPD globally in 2016. Globally, it is estimated that the disease caused 3.17 million deaths in 2015 (that is, 5% of all deaths globally in that year).

Why is anxiety especially common in COPD patients?

When our breath becomes shallow, our brains can sometimes perceive there to be a stressful situation at hand, even when there is not. This can cause a stress response in the body, often referred to as anxiety. It is important to understand that this is a normal function of the brain and finding ways to cope with anxiety due to shortness of breath can make your day-to-day activities easier. At home monitoring may be suggested by your health care professional to be clinically reassured of adequate oxygenation levels.

Sleep Apnea steals precious sleep, but it also steals something much more valuable: oxygen.

Sleep problems and sleepiness are common in COPD patients. Changes in breathing patterns that occur during normal sleep that do not affect healthy people may lead to more severe consequences in people with COPD, which may worsen and complicate COPD since they reduce blood oxygen. Even COPD patients without obstructive sleep apnea (OSA) may experience a drop in oxygen during sleep.

What are the symptoms of Low Oxygen at night?

According to the Journal of Respiratory Care, normal, oxygen levels while you are awake range between 95-100%. However, your levels do naturally drop while you are sleeping. Normal oxygen saturation levels while sleeping usually fall between 90-100%, and if levels fall below 88% during sleep, you may need supplemental oxygen for sleeping.

Just a few of the symptoms you may experience if your oxygen levels drop too much at night include:

– Rapid breathing

– Restlessness

– Waking up with a headache

– Fast heart rate

– Bluish tint to nail beds, earlobes, and/or lips

– Elevated blood pressure

– Shortness of breath

– Waking up gasping for air

– Snoring during sleep

– A decrease in daytime alertness

– Daytime drowsiness

– Waking up coughing or choking

– Poor memory

– Extreme fatigue, weakness, and lack of energy

Check your Oxygen levels

With the risks of Sleep Apnea, COPD and Hypoxemia heightened by fear of COVID-19 it is advisable to monitor your oxygen levels while you are asleep and periodically while you are awake, to ensure that your levels are where they are supposed to be.

You can do this with a simple finger pulse oximeter. A pulse oximeter is a small, lightweight device used to monitor the amount of oxygen carried in the body. This non-invasive tool attaches painlessly to your fingertip, sending two wavelengths of light through the finger to measure your pulse rate and how much oxygen is in your system.

Why is it important to recognise and address anxiety while living with COPD?

Facing the complex emotions that arise with a diagnosis of COPD can sometimes leave one feeling anxious. In addition to the anxiety of a pandemic, people living with COPD often experience shortness of breath. Whether we realise it or not, breathing not only brings oxygen into the lungs, but it also taps into something called the autonomic nervous system, which is what regulates many of the automatic processes that occur within the body. Intentionally trying to lengthen the breath can help your body feel safe and calm, thereby decreasing your symptoms of anxiety.

One way to do this is to pay attention to your natural breath and count the seconds it takes to breathe in and out at a normal pace. For you, it might be only one count on each side, and that is okay. Gradually try to increase the length of time you exhale first, then begin to increase your inhale, and try to deepen your breath by breathing deep into your belly. To start, focus on keeping your exhale either even with, or a little longer than your inhale to get the most calming benefit. This is called belly breathing and helps to relax the body and mind. Finding a way to manage your anxiety can help improve your quality of life.

Cure for COPD?

There is no cure for COPD, but there are treatments for its symptoms, including drug therapies, and behavioural remedies, with the last option being surgery.

In addition to behavioural remedies, one can try these tips for coping with COPD:

– Conserve energy by limiting activities and getting adequate sleep

– Develop an exercise plan in consultation with your physician

– Eat healthy high-protein foods

– Keep your home free of smoke and airborne irritants

– Take naps as needed, but not close to bedtime

– Join a respiration rehabilitation group and a smoking cessation support group.