Oxygen Therapy, the Complete Guide

Supplemental oxygen therapy can be a lifesaver for someone dealing with a condition where lung function is impaired, such as chronic obstructive pulmonary disease (COPD). Oxygen therapy is a highly effective way to increase the amount of oxygen in the body to healthy, normal levels.

If you've been prescribed supplemental oxygen, you're probably wondering how to safely use it and more importantly, how it will benefit you. The following guide details everything you've ever wanted to know about oxygen.

Senior woman receiving oxygen therapy
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Oxygen therapy is a medical treatment that requires a prescription from a healthcare provider. Your healthcare provider may prescribe a range of oxygen flow rates for a range of different conditions, such as:

  • COPD
  • Pulmonary fibrosis
  • Severe asthma attack
  • Pneumonia
  • Pneumothorax (collapsed lung)
  • Sleep apnea

Your healthcare provider also may prescribe varying flow rates for different activities, such as during rest, sleep, or exercise.

Some people only require oxygen therapy while sleeping, while others may require it 24 hours a day. The amount and duration of oxygen therapy will depend on your condition. It is very important that you follow the settings exactly as prescribed, as using too much or too little oxygen can have serious consequences.


The air we breathe contains approximately 21% oxygen. For most people with healthy lungs, 21% oxygen is sufficient, but if you have chronic obstructive pulmonary disease (COPD) or a condition where your lung function is impaired, the amount of oxygen obtained through normal breathing is not enough. In this case, you'll need supplemental amounts of oxygen to maintain normal body function.

In addition to helping prevent heart failure in people with severe lung diseases, such as COPD, supplemental oxygen has many benefits. According to the American Lung Association, supplemental oxygen improves sleep, mood, mental alertness, and stamina, and allows individuals to carry out normal, everyday functions.

Increased Survival

By far, the most important benefit of long-term oxygen therapy (LTOT) is that it may prolong your life, especially if you have COPD with severe resting hypoxemia (low levels of oxygen in your blood) and/or you use oxygen continuously rather than just at night or sporadically.

Reduced COPD Symptoms

Supplemental oxygen can help relieve dyspnea, or shortness of breath, and other symptoms related to COPD and other chronic lung conditions, including fatigue, dizziness, and depression.

Fewer COPD Complications

COPD is associated with a number of complications, including pulmonary hypertension, secondary polycythemia, and cor pulmonale, a form of heart failure.

Supplemental oxygen helps reduce COPD complications by stabilizing pulmonary hypertension, reducing secondary polycythemia, and decreasing arrhythmias (irregular heart rhythms).

Moreover, oxygen has been shown to reduce the number of exacerbations (worsening of symptoms) and hospitalizations associated with COPD.

Increased Exercise Tolerance

Many patients with breathing difficulties have poor exercise tolerance that dramatically limits their ability to exercise. Studies suggest that using oxygen during exercise improves exercise endurance, heightens exercise performance, and ultimately decreases the sensation of breathlessness.

Improved Quality of Life

Not only does an adequate supply of oxygen improve your sleep and mood, but it also increases your mental alertness and stamina, allowing you to get more done during the day.

Using a portable oxygen concentrator can help you feel freer to engage in activities you enjoy, like going to a movie or out to dinner invitation. Maintaining independence and the freedom to be social can benefit your overall sense of wellness.

Research is not clear as to whether oxygen therapy can help sexual difficulties such as impotence, but if supplemental oxygen helps you during exercise, chances are good it'll help you breathe easier during sex too.

Additionally, using supplemental oxygen during sex can help you prolong intimacy, an added benefit for both partners. Talk to your healthcare provider about increasing your oxygen flow during sex.

Safer Air Travel

It's not uncommon for patients with COPD to experience severe hypoxemia when they travel by airplane. Supplemental oxygen during air travel helps you prevent severe hypoxemia and can benefit many COPD patients—even those who don't normally use oxygen.

Traveling with oxygen by airplane has never been easier, thanks to the United States Department of Transportation. It's true that now you can carry your own oxygen concentrator aboard all U.S. domestic flights and international flights beginning or ending in the United States, but your device must be approved by the Federal Aviation Administration.

Determining Need

If you need supplemental oxygen, it's unlikely that you'll notice your deficiency yourself. Instead, it will be something that becomes apparent to your healthcare provider after testing.

Your healthcare provider can measure the oxygen levels in your blood by obtaining an arterial blood gas (ABG) or by using a noninvasive device called a ​pulse oximeter.

Supplemental oxygen therapy is generally prescribed to people whose partial pressure of oxygen (PaO2) as measured by arterial blood gases (ABGs) is less than or equal to 55 mgHg and a documented oxygen saturation level of 88% or less while awake (or that drops to this level during sleep for at least five minutes).

Side Effects

While using oxygen longterm is generally safe, it does come with some side effects.

The most common side effect of using long-term supplemental oxygen is nasal dryness and skin irritation, primarily in the places where the cannula and tubing touches the face. Use a humidifier at home or saline solution to make nasal passages less dry, and be sure to take care of your skin by applying lotions as needed to prevent irritation.

Oxygen toxicity is also a side effect to consider, though this is less of an issue in those who take their oxygen as directed.

Never adjust your oxygen levels without supervision by a medical professional, and be sure to always ask if you're on the lowest effective dose for your condition.

Safety Considerations

Although oxygen is a safe, non-flammable gas, it does support combustion—in other words, some materials can readily catch fire and burn in the presence of oxygen. For that reason, just as with any medical treatment, it's important to follow certain precautions while using it.

If you or a loved one is prescribed supplemental oxygen therapy, stay safe by:

  • Storing oxygen properly: Oxygen canisters should be kept upright and in a place where they won't be able to fall over or roll; an oxygen storage cart or similar device is ideal. Store canisters well away from any type of heat source, gas stove, or lit candles. 
  • Posting "no smoking" signs around your home to remind visitors not to smoke near you or your oxygen.
  • Using caution around open flames like matches and candles, as well as gas heaters and stoves. If you are using supplemental oxygen, you should be at least five feet away from all heat sources.
  • Turning off oxygen supply valves when not in use.

Post the phone number of the company that makes your oxygen canisters and other supplies in a visible location in case you have any questions about the equipment.

And in the event of a fire, make sure you know how to properly use a fire extinguisher. Accidents can happen, but don't need to be tragic if you're prepared. 

Have Back-Up

In addition to doing what you can to prevent avoidable accidents, be prepared for emergencies that are out of your control, too.

While most people can manage during a power outage, people dependent upon electricity for supplemental oxygen have reason to take them a bit more seriously.

Create an emergency response plan in the event your power goes out. Make sure you have backup equipment, oxygen, and a generator in case of an emergency.

Therapy Options

The most common method of oxygen delivery is through a nasal cannula. This thin, plastic tube has two small prongs at one end that rest in the nostrils.

The nasal cannula can comfortably deliver oxygen to a person at one to six liters per minute (LPM), in concentrations ranging from 24% to 40%, depending upon how many LPM are being delivered. In comparison, room air contains about 21% oxygen, which is generally not enough for people with lung disease.

If you're a mouth-breather, however, administering oxygen through a nasal cannula may be slightly less effective. Talk to your healthcare provider and your dentist about ways to limit or avoid mouth breathing.

While useful, there are a number of barriers to using supplemental oxygen with a cannula for some patients. Whether it's issues with navigating life with the equipment or self-consciousness, reasons for non-adherence to oxygen therapy are many.

If you or a loved one are not using your supplemental oxygen as prescribed, recognizing the benefits of oxygen therapy—rather than focusing on the negative aspects—may help you overcome your obstacles for the betterment of your health.

There are two other delivery options that may help with compliance that can be considered as well:

Oxygen Therapy Glasses

Unlike a traditional nasal cannula, oxygen therapy glasses delivers oxygen effectively and discreetly by attaching the nasal cannula to the bridge of the glasses, eliminating the need for tubing across the face. This is an emerging method for delivering oxygen and is not widely-used at this time.

Transtracheal Oxygen Therapy

Transtracheal oxygen therapy (TTOT) is a method of administering oxygen directly into the trachea by way of a small, plastic catheter. TTOT is intended for delivery of oxygen of up to 6 liters per minute and is primarily used as an alternative treatment for only a select group of patients. Ask your healthcare provider if you're a candidate for TTOT.


Medicare will generally pay for most of your in-home supplemental oxygen supplies if you meet certain criteria. The primary requirement is that you have a breathing condition that will improve by using supplemental oxygen. You typically rent the machine from a supplier but may end up owning it outright after three years.

Medicare usually covers medical-grade oxygen, cannula, tubing, and supplies, concentrator tanks and storage containers, and a humidifier for your oxygen machine, among other items.

A Word From Verywell

Long-term oxygen therapy is an extremely helpful therapy for many people suffering from a variety of lung conditions, ranging from COPD to severe asthma. While there are some side effects and safety considerations to be aware of, it is generally a treatment with few risks. And because it's covered by Medicare, it's available to most people. Talk to your healthcare provider about whether oxygen therapy is the right fit for you and your condition.

8 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.
  1. Things to Know When Using Oxygen Therapy. American Lung Association.

  2. The Long-Term Oxygen Treatment Trial Research Group. A Randomized Trial of Long-Term Oxygen for COPD with Moderate Desaturation. The New England Journal of Medicine. 2016;375(17):1617-1627. doi:10.1056/NEJMoa1604344.

  3. American Lung Association. Supplemental Oxygen.

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  5. Turan O, Ure I, Turan PA. Erectile dysfunction in COPD patientsChron Respir Dis. 2016;13(1):5–12. doi:10.1177/1479972315619382

  6. Traveling with Oxygen. American Lung Association.

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  8. Abdo WF, Heunks LM. Oxygen-induced hypercapnia in COPD: myths and factsCrit Care. 2012;16(5):323. doi:10.1186/cc11475

Additional Reading
  • American Thoracic Society. Patient Education Information Series. Oxygen Therapy.

By Deborah Leader, RN
 Deborah Leader RN, PHN, is a registered nurse and medical writer who focuses on COPD.