Breaking the Dyspnea Cycle in COPD

Anxiety leads to breathlessness and then to more anxiety

A man is short of breath.
A man is short of breath.. Susan Chiang/Getty Images

Have you ever noticed that when you are having trouble breathing, you become increasingly anxious, which makes you start to panic, which in turn causes you to become even more short of breath? This sequence is known as the dyspnea cycle, which is incredibly common in COPD.

Dyspnea, more commonly known as shortness of breath, can be described as the sensation of having the urge to breathe which results from a lack of oxygen in the bloodstream.

It is one of the hallmark symptoms of COPD, and can also be the most frightening.

Patients with COPD often suffer from anxiety and panic attacks due to dyspnea, and these can start to dominate your life. In fact, for some people, certain emotional situations — for example, starting an argument with a family member, or being in a crowd — may spark or contribute to a cycle of breathlessness. The breathlessness then can lead to additional anxiety ... and a vicious cycle starts.

Understanding the Cycle

To learn how to break the dyspnea cycle, you must first understand how it occurs. When you start to feel short of breath, you worry you are not getting enough air, which causes anxiety. Anxiety makes you breathe harder and faster, which makes the dyspnea worse. This is when panic can set in, and some people with COPD have been diagnosed with panic disorder.

When people experience this sensation, it can be so distressing that they start to limit their activities in order to avoid anything that may cause them to feel shortness of breath.

Not only does this eventually end up taking all the joy out of life, but being sedentary can lead to many other problems, like obesity, which makes it even tougher to breathe.

How to Break the Dyspnea Cycle

Follow these steps to break the dyspnea cycle:

  • Pace yourself -- Pacing yourself helps to conserve energy which will allow you to do more before dyspnea gets out of hand.
  • Exercise -- Daily exercise will help you handle more activity with less shortness of breath.

The dyspnea cycle is not only frightening, but can lead to feelings of sadness and worry. If these feelings become overwhelming, they can start to interfere with daily life. Depression is also linked to COPD exacerbation. The good news is that anxiety and depression are treatable medical conditions. Talk with your doctor to see what treatment options are available to you. Once depression and anxiety are under control, your overall health will improve and you can start to enjoy life again.

Need help managing panic and panic disorder in COPD? Read 9 Ways to Manage Panic Attacks in COPD.


Bailey PH. The dyspnea-anxiety-dyspnea cycle--COPD patients' stories of breathlessness: "It's scary /when you can't breathe." Qualitative Health Research. 2004 Jul;14(6):760-78.

Living Well with Chronic Lung Disease. The StayWell Company. 2005.

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