Why Do PF Patients Have Trouble Thinking Clearly?

Why Do PF Patients Have Trouble Thinking Clearly?

Just breathe, passionate help for the PF journey

Last week, I wrote about my brain-fog struggles. It’s common to wonder, “Why am I having so much trouble thinking clearly? Is it from pulmonary fibrosis?”

I was able to run this question by Noah Greenspan, a doctor of physical therapy who specializes in cardiovascular and pulmonary diseases. He said that many factors may contribute to a patient having trouble thinking clearly, and although it can be tempting to attribute all of our struggles to pulmonary fibrosis, the disease is not always the culprit. Following are possible explanations for why many of us have trouble thinking clearly. This isn’t meant to get you worried about something else, but to see how complicated the answer to this question is.

Possible thinking complications

Chronic hypoxia: Hypoxia is a fancy way of saying you aren’t getting enough oxygen to your brain and other organs. It is possible that chronically having less than 90 percent oxygen saturation could cause changes in your brain, which could cause you to think less clearly.

Decreased blood flow: This can be related to atherosclerosis (plaque in the arteries), particularly in the carotid arteries that supply blood to the brain. Or, it could be related to changes in the vessels of the brain itself. This is more common as we age and can cause subtle changes in your thinking and in your brain’s abilities.

Emotional stress: We may not realize the long-term emotional effects that dealing with a chronic illness can have on us. We are constantly forced to wrestle with our mortality and the grief that it entails. We also experience stress because of life change, the effect that our illness has on others, and the everyday stress of making sure you can breathe — not to mention the frequent clinic visits, medical exams, and procedures.

This takes its toll on us over time. It is common to experience anxiety, depression, and difficulty thinking clearly when dealing with so much physical and emotional stress.

Something else: Our bodies are incredibly amazing and incredibly complicated. There could be many other reasons.

Tips to help

There are lots of ways to care for your body and manage your stress.

Oxygen levels: It is important to keep your oxygen saturation at a safe level. Dr. Noah tells his patients to keep their oxygen saturation above 93 percent. Most oximeters that we use have an error rate of plus or minus 3 percent. This means if your oximeter shows your saturation is 93 percent, it could actually be between 90 to 96 percent, which is perfectly safe. Research has shown that oxygen levels between 90 and 100 percent are safe for patients. When oxygen saturation falls below 90 percent, damage can occur to the brain and body.

Blood pressure management: If your blood pressure is too high, your heart is working too hard to pump blood to the rest of your body. Taking care of the cardiovascular system is especially important to pulmonary fibrosis patients because our disease puts extra pressure on our hearts. Ask your primary care doctor or cardiologist for help to manage your blood pressure.

Practice relaxation techniques: Our bodies need a way to relax from the constant stress we are under. Stress relaxation techniques, as well as tai chi and qi gong, are very helpful. Here’s a program I use to help me de-stress. I don’t get any compensation for telling you about it. Dr. Noah also has some great ideas in his book, Ultimate Pulmonary Wellness,” and on his website.

Establish routines to help yourself: A lot of routines can help with thought organization.

  • Write down lists of things you need to remember and accomplish. I LOVE crossing items off my list!
  • Organize your home and your environment to find and remember things more easily. I keep a stack of bills on the table next to my easy chair so I don’t forget to pay them.
  • Create morning routines for yourself. I start my day thanking God for another day, take my morning medication, drink a protein shake, and do some simple exercises. I also have traditions for later in the day. Take a moment to write down the daily activities that will help you with your health and bring you joy.

My thanks to Dr. Noah Greenspan for his help with this topic.

I’d love to hear from you

Do you have trouble thinking clearly? What do you think might be contributing to your brain fog? Does it make sense that stress might be playing a part in your thinking clarity? 

Please leave a comment below.


Note: Pulmonary Fibrosis News is strictly a news and information website about the disease. It does not provide medical advice, diagnosis, or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website. The opinions expressed in this column are not those of Pulmonary Fibrosis News or its parent company, BioNews Services, and are intended to spark discussion about issues pertaining to pulmonary fibrosis.


  1. Wendy Ford says:

    Yes I mentioned this to my respiratory nurse a few years ago.
    I have IPF and am entering my 7th year.
    I’m on 15 litres when mobile but my sats still drop rapidly! Have at worst dropped into the 50s .
    Once it’s about 75 I wait it out till it’s recovered before moving on.
    I’ve noticed my short term memory is appalling.
    I can’t remember simple words even the name of my pets etc.

  2. Carol Malone says:

    I have Lupus with a host of problems associated with he use of steroids. Two years ago I was diagnosed with IPF but not told a thing about it. I am 67 years old and not in oxygen yet but I have seen that so tire more and have a lot of leg and ankle swelling now. It is frustrating because when I bring it up to my pulmonologist he says that I am doing ok for now. He has put me on Myfortic to help me. I get scared. My daughter doesn’t want to discuss it because that way she can pretend it isn’t happening. Thank you for being such honest.

    • Hi Kim

      I’m so glad you touched on this subject of poor memory was beginning to feel I was losing my mind. My son and husband also cause me to full on arguments as I am adamant I put things or done something then I have apologise when it’s discovered it’s not so. Sometimes I’m right but most of time I do slip up and forget to do things or where I put an item. Causes many sleeplessness and stress as its usually important stuff or papers!

      • Dulecia, I’m so glad this information was helpful, but so sorry this is happening to you too. Maybe you could print out this column to show them. It might help them understand that your memory changes are due to PF. This might help them (and you) be more compassionate with yourself. Many blessings

    • mary landry says:

      Please get on oxygen. I was diagnosed with ipf 6 months ago. My doctor had me start using oxygen, as needed.n it has really helped.

    • Dear Carol,
      Thanks so much for sharing. So sorry both your doctor and daughter aren’t facing what you are dealing with. It sounds like such a burden to handle the reality of disease without the support you need. I would consider getting a second opinion from another pulmonologist. So glad you shared with us. We understand what you are dealing with. Sending you a big hug.

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