It is important to determine how severe your symptoms are. Knowing if you have mild, moderate or severe symptoms helps to focus the intensity of your treatment. Severity is determined by how you feel every day, as well as how frequently you have flare-ups, or exacerbations, in which breathing becomes more difficult and/or mucus production increases. Flare-ups commonly occur during a cold or flu and can require an emergency visit to your health-care provider or treatment in a hospital.

Mild chronic obstructive pulmonary disease (COPD) is associated with occasional cough or shortness of breath, sometimes only with a cold or flu. Breathing difficulties do not limit daily activities.

People with milder disease may take medications only when they notice symptoms or only once or twice a day. They must watch for early signs of infection and remember to get a flu shot every year and keep up to date with other vaccinations, especially the pneumonia vaccine. In addition, they should stop smoking and avoid smoky areas.

Moderate COPD is associated with shortness of breath during exercise, frequent or daily cough with phlegm, or recurrent flare-ups requiring emergency visits to a health-care provider or the hospital.

More moderate symptoms require daily medication, usually inhalers. Flare-ups usually require corticosteroid pills and antibiotics, if there are any signs of infection.

Severe COPD is associated with breathlessness at rest that sometimes wakes you up. Flare-ups are frequent and often require hospitalization. Some people have signs of heart damage, such as leg swelling.

Severe disease often requires oxygen at home of blood oxygen levels fall below 89 percent. People with severe COPD need to immediately report any fever, increased coughing, shortness of breath or change in the color of phlegm. People with severe COPD are at the highest risk of dying of lung disease.