When to Consider Oxygen Therapy for COPD

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Chronic obstructive pulmonary disease (COPD) is a chronic lung disease. When someone has COPD, breathing is difficult because the airways become inflamed and thickened. The tissue in the lungs that exchange oxygen becomes damaged, which makes it harder for air to flow in and out of the lungs.

Oxygen therapy for COPD is often an effective treatment because it can increase the oxygen that gets into the lungs and bloodstream. Research shows that people with COPD who undergo oxygen therapy have an increased life expectancy and a better quality of life.

Although oxygen therapy is more established in COPD treatment, other lung diseases may benefit from oxygen therapy as well.

An older man wearing supplemental oxygen.

Antonia Sanchez Albacete/EyeEm/Getty Images

Breathing Difficulties From COPD

When you breathe air into your lungs through your windpipe, the air enters into small air passages in the lungs (bronchi). The bronchi branch out into smaller air passages known as bronchioles. The air that passes through the bronchi and bronchioles eventually reaches small air sacs called alveoli that are equipped with small blood vessels (capillaries). When the air reaches the capillaries, it can then enter the bloodstream.

Through this process, carbon dioxide is getting released from the body by the same route—just in reverse. Carbon dioxide enters the capillaries, goes into the air sacs, and then passes out through the bronchioles, bronchi, and windpipe.

Healthy lungs have elasticized air sacs that deflate and inflate to make the process go smoothly. In a person with COPD, the airflow in and out of the lungs becomes strained and shallow. People with COPD have a harder time taking a full breath because of the way their lungs are functioning.

What Does Breathing With COPD Feel Like?

Breathing with COPD is more difficult because of the inflammation in the respiratory tract. Many people say having COPD feels like "breathing through a straw."

Can a Person With COPD Get Better?

COPD is an incurable disease that gets worse over time. The chronic nature of the disease, and the fact that it worsens over time, means that people with COPD often experience a lower quality of life and an increased mortality rate. COPD is the main cause of disability in the United States and the third leading cause of death.

The disease often has periods of getting worse (exacerbation events). There are two patterns in which these events will develop: sudden onset and gradual onset.

People with COPD require treatment to manage their condition and improve their quality of life. One form of effective treatment is oxygen therapy.

Oxygen Therapy Benefits 

Oxygen therapy is supplemental oxygen introduced into the body. There are many benefits of using oxygen therapy to help manage COPD symptoms. A person with COPD who uses oxygen therapy might be able to:

  • Perform daily tasks with less breathing difficulty
  • Participate in activities such as exercise without experiencing trouble breathing
  • Protect the organs in their body from further damage that can be caused by oxygen deprivation
  • Improve their sleep (which helps them feel more alert during the day)
  • Increase their life expectancy

Portable oxygen also gives people with COPD more freedom to travel without having to worry about experiencing symptoms.

Types of O2 Therapy for COPD 

There are many forms of oxygen therapy, all of which come with benefits and drawbacks.

Cylinders

Cylinders were the first option created for oxygen supply and can be taken with a person wherever they go. The tank is filled with oxygen in a gas form and is designed to offer a continuous flow of oxygen while a person uses it.

It can be easy to take on the go, but it only lasts for a short amount of time, which makes it the least popular option among people who require home oxygen therapy.

Liquid

Liquid oxygen tanks are easier to store and transport than gas oxygen tanks. They can also carry more oxygen (because 1 liter of liquid oxygen can be transformed into 860 liters of gas oxygen). That means that a small tank of liquid oxygen has a much longer shelf life.

Carrying around a liquid oxygen tank may seem like more of a burden than one filled with gas, but the liquid system can be used to refill portable oxygen-delivering devices, which would allow a person with COPD to still travel or go about their daily activities.

The liquid option is better for people who require more oxygen because they can sustain a higher flow of oxygen.

Concentrators

Home oxygen therapy is often performed using a concentrator. This type of system can provide different flows depending on the person’s needs. It works by pulling oxygen from the air.

The main drawback is that many oxygen concentrators are stationary, meaning that they can only be used at home. However, if a person does need to leave home, there are portable concentrators that provide the option of using a small cylinder that is filled with oxygen from the concentrator.

Some forms of concentrators are entirely portable and give people the ability to leave their home or even travel by air. However, these options do not provide a great amount of oxygen flow. Therefore, they may not be the best option for some people with COPD depending on their own oxygen supply needs.

These forms of oxygen therapy are administered to people with COPD using a tube-like device that is inserted into the nostrils (nasal cannula), a face mask, or a tube that is surgically placed directly into the windpipe.

What Is the Best Form of Oxygen Therapy?

The best form of oxygen therapy will depend on your needs and your lifestyle. For example, if you spend most of your time in your home, a concentrator might be a good choice. If you like to travel, having something that is portable will be an important consideration.

Talk to your doctor about how you see yourself living with oxygen therapy to determine the best equipment for you.

Getting Used to the Equipment 

According to the American Lung Association, there are a few facts that you should know about using your oxygen therapy equipment at home.

Check Your Oxygen Supply

Before you check your oxygen supply, wash your hands. You need to make sure that your hands are not contaminated with any germs that could lead to infection if they got into your oxygen therapy machine.

Next, pressurize the oxygen tank or turn on your concentrator (the instructions to follow at this point will be given by the medical supply company or your doctor).

Then, check the gauge on your device to determine how much oxygen you have left and when you will need to get more.

If you have a humidifier bottle, check the water levels. If it is below half full, refill it with distilled water. Ask your medical provider how to clean and refill the bottle to ensure that no germs get inside of it.

Attach the Tubing

If you are getting oxygen through a nasal cannula, attach it to the unit and make sure that the tub is not bent or blocked in any way. This will ensure that all the oxygen that you need gets through the tube and into your lungs.

Set the Flow Rate

The flow rate that you need will be highly personalized. Speak with your doctor about your needs before you set up your oxygen equipment.

When you're ready, you can set the rate on the machine. Usually, you will only have to set it once when you are setting up the equipment. The rate does not have to be adjusted unless your doctor tells you to.

Putting the Cannula in Your Nose

Wash your hands again before you put the cannula in your nose. Keeping your hands clean will help prevent any germs from getting into your nasal passages or the tubes.

Once you secure the cannula, you will be able to feel the oxygen as you breathe. If you are not able to feel it, put the cannula in a glass of water. If there are bubbles in the water, it means that the oxygen is flowing and the cannula is working as it should.

Cleaning your Equipment

Avoiding infection is important for people using oxygen therapy for COPD. Each piece of equipment that is part of your oxygen therapy needs to be cleaned regularly to keep it safe for you to use. Here is an overview of how often you need to clean each part.

  • Your cannula, air filter, and equipment need to be cleaned once a week.
  • The humidifier bottle should be washed with soap and warm water every time that you refill it.
  • Replace your cannula every two to four weeks.
  • The air filter should be replaced every month, and the tubing should be replaced every two months.
  • Your concentrator needs to be serviced by your oxygen supply company once a year.

If you are not sure how to clean the equipment, or you are using a tube that has been surgically placed into your windpipe, ask your doctor about how you can keep things clean.

Affordability and Insurance 

Medicare typically covers some of the costs of home oxygen if you have gone through the required tests and a doctor has written an order for oxygen.

To be qualified with Medicare you must be enrolled in Part B and have a doctor’s order for home oxygen. To qualify for coverage under Part B, you much pay a deductible of $203 before Medicare will begin to cover your oxygen therapy equipment. Once that is done, Medicare will cover 80% of the total cost.

Summary

COPD is a chronic disease that gets worse with time. Some people will need oxygen therapy at some point because as the disease progresses, breathing becomes more difficult. There are a few options for oxygen therapy, and the one that is best for you will depend on your needs and lifestyle.

A Word From Verywell 

Adapting to home oxygen therapy can be challenging, but once you get the hang of using and maintaining the equipment, it will improve your quality of life and even help you live longer with COPD.

Frequently Asked Questions

  • At what stage do COPD patients need oxygen therapy?

    People with COPD typically require the use of oxygen therapy when they reach a state known as hypoxia. Hypoxia is characterized as low levels of oxygen in the blood. When hypoxia occurs, it can affect the health of all other areas of the body including the heart.

  • How much supplemental oxygen do COPD patients use per day?

    Each person will COPD will need a different oxygen rate based on their medical needs. Research suggests that people with COPD should get oxygen delivery for at least 15–18 hours per day to help them manage the condition.

  • When does oxygen for COPD become dangerous?

    Although everybody needs oxygen to live, having too much can actually be dangerous. Oxygen levels should not go above 100 mmHg (millimeters of mercury)—if they do, oxygen toxicity occurs. The side effects of too much oxygen include:

    • Lung inflammation
    • Excess fluid in the lungs
    • A drop in heart rate
    • Reduced blood flow
    • Seizures
  • How do you know if you’re getting too much oxygen?

    The symptoms of getting too much oxygen can be mild at first and might include:

    • Coughing and throat irritation
    • Chest pain
    • Trouble breathing
    • Muscle twitching in the hands and face
    • Dizziness
    • Blurred vision
    • Nausea
    • A feeling of unease

    If you use supplemental oxygen and experience any of these symptoms, check the flow of your oxygen and call your doctor.

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11 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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