If you have COPD, the sounds made by your lungs can help your doctor evaluate the state of your airways and whether your treatment is working. Types of COPD lung sounds include wheezing, crackling, and ronchi.

COPD refers to a group of progressive lung diseases that make it harder for you to breathe.

Keep reading to understand more about what your healthcare team is listening for when it comes to lung sounds if you’re living with COPD.

Your lungs and lung cavity are covered by thin membranes called pleurae. Typically, they slide smoothly over each other to regulate your breathing.

A pleural friction rub is a quick, explosive sound. It can be heard when you breathe in or out. It’s a sign that something is interrupting the movement of the membranes.

In COPD, this sound is often due to inflammation.

Wheezing is a high pitched whistling sound. If a healthcare professional hears wheezes in only one area of your lungs, it may be due to a blockage.

In COPD, however, wheezes are more likely to be heard throughout both of your lungs and may be heard throughout the chest

The inflammation that comes with COPD can cause both your large and small airways to narrow. A wheezing sound is the vibration of air through these narrowed airways.

This wheezing sound can sometimes be heard when you breathe in. In most cases, though, it’s louder when you breathe out.

Crackles, previously called rales, refer to a noise that’s:

  • crackling
  • popping
  • clicking

A healthcare professional can listen to this sound using a stethoscope, and it’s most likely to be heard when you breathe in.

Crackling happens when small air bubbles pass through fluid, which is common in COPD. This can indicate a buildup of mucus or pus in your airways. Coughing temporarily dislodges the fluid, and the crackles go away.

Doctors categorize crackles into three different types:

  • Fine crackles: These are high pitched, quick sounds. They can indicate fluid in small airways. Fine crackles are often heard in people with pneumonia and congestive heart failure.
  • Coarse crackles: These are deeper, longer sounds than fine crackles. They occur when air bubbles pass through fluid in larger airways. Coarse crackles are more likely to occur in people with COPD.
  • Biphasic crackles: Biphasic crackles are a combination of both fine and coarse crackles.

Stridor is similar to wheezing, but the sound is typically louder than a wheeze. Doctors may hear it when you breathe in or out, and it can indicate upper airway blockages or narrowing.

If stridor is heard when you breathe in, it means there’s a narrowing or blockage above your voice box, called the larynx.

If the sound is heard when you breathe out, it means there’s a narrowing in your trachea or windpipe. The trachea is the tube that connects your throat to your lungs.

A rhonchus is a continuous sound that may be heard in the lungs. It’s a lower pitched sound than a wheeze. Through a stethoscope, it sounds similar to snoring.

This can indicate a buildup of fluid in the larger airways. In COPD, rhonchi can mean the airways are secreting an increased amount of fluids.

Hamman’s sign is a crackling or crunching sound that occurs at the same time as your heartbeat. It happens when air gets trapped in the space between your lungs, called the mediastinum.

Air doesn’t typically leak into this area. If your doctor detects Hamman’s sign, it means there’s been damage to your lungs or windpipe, which is causing air to escape.

A whooping sound can happen with coughing when a person is gasping for air. It’s the high pitched sound of air rushing into your airways.

This sound is often heard in pertussis, also known as whooping cough. Pertussis is caused by a bacteria.

People with COPD are at greater risk of contracting pertussis. Pertussis can cause COPD symptoms to flare.

Many people are successfully protected from pertussis with vaccination. Talk with your doctor to make sure your immunizations are up to date.

A healthcare professional can hear lung sounds with a stethoscope. Some can be detected even without a stethoscope.

To investigate further, your healthcare team might call for the following tests:

  • Spirometry: This test measures most of your lung volumes and the flow of air out of the lungs. You’ll breathe into a small device called a spirometer. It’s easy to do and can be performed in your doctor’s office or even at a person’s bedside in a hospital room
  • Laryngoscopy: This test uses a small scope to explore your throat and voice box (larynx).
  • Bronchoscopy: This test is similar to a laryngoscopy, but it explores deeper into your lungs. It can provide imagining or a sample so your doctor can find out more.
  • Chest X-ray: An X-ray uses a form of radiation to get a picture of your lungs. It can check for damage to the small air sacs in your lungs. This is a way of diagnosing emphysema, part of COPD.
  • CT scan: A CT scan is another way to get an image of your lungs and airways. It provides more details than an X-ray.

Treatments are available to manage the signs and symptoms of COPD. These include:

  • Cutting down or quitting smoking, if you smoke: This is the number one thing you can do to improve your lung health. It’s not an easy task, but medication and psychological support can help.
  • Inhalers: Doctors may prescribe medications in inhaler form to help open your airways and make breathing easier. These medications may be short- or long-acting, providing quick relief or helping prevent symptoms.
  • Nebulizers: For people who are unable to use an inhaler, a nebulizer turns medication into a fine mist. You then wear a mask or mouthpiece to breathe in the medication.
  • Corticosteroids: You can take these medications orally or through an inhaler. They may help manage a COPD flare.
  • Phosphodiesterase-4 inhibitors: These medications are taken orally. They can help bring down inflammation in the lungs and reduce COPD flares.
  • Mucolytics: COPD can cause excess mucus in your lungs. These medications can help thin out that mucus, making breathing easier.
  • Supplemental oxygen: It can be hard to get enough oxygen from the air if your lungs aren’t working optimally. Supplemental oxygen is delivered using nose prongs or a mask. It can increase the amount of oxygen available to your lungs and your body.

What are the symptoms of stage 1 COPD?

Typically, people with stage 1 COPD can have few symptoms, if any, while still displaying a forced expiratory volume (FEV1) between 80-100% of your predicted value. FEV1 is how much air you can expel from your lungs in 1 second.

Can lungs heal from COPD?

Once COPD damages your lungs, they cannot return to healthy function. That said, treatments can help your lungs function better and can help you manage your symptoms.

Can people with COPD have clear lung sounds?

When your COPD is well-managed or when your symptoms are mild-to-moderate, you’re less likely to have atypical lung sounds. In most cases, your lungs will sound clear. If you’re experiencing wheezing, it is usually caused by exacerbating factors that can be treated.

Listening to your lungs and airways can provide your doctor with a lot of information about what’s going on inside your body.

Certain sounds can indicate narrowing in your airways or fluid buildup. Your healthcare team may require further testing to find out more.