Oxygen therapy can be a life changing treatment for individuals with advanced COPD or emphysema, but it is only necessary when the lungs are no longer able to maintain adequate oxygen levels in the blood. While many people believe oxygen will cure breathlessness, its primary purpose is to protect the heart and other vital organs from the damage caused by chronic low oxygen (hypoxia). In the UK, oxygen is strictly prescribed based on blood gas results rather than the sensation of breathlessness alone.
What We will cover in this Article
- The difference between breathlessness and low blood oxygen.
- How clinicians determine if you need Long Term Oxygen Therapy (LTOT).
- The role of Ambulatory Oxygen for activity and exercise.
- Common equipment used: Concentrators vs. portable cylinders.
- Important safety regulations for home oxygen use.
- Why ‘too much’ oxygen can be dangerous for some COPD patients.
When is Oxygen Therapy Required?
Oxygen therapy is not a treatment for breathlessness itself. Many people with COPD feel breathless even though their oxygen levels are perfectly normal. Instead, oxygen is prescribed when a patient’s blood oxygen levels fall below a specific clinical threshold (usually an SaO2 of less than 88% or a partial pressure of oxygen (PaO2) below a certain level).
A specialist will typically recommend oxygen if:
- Low Oxygen at Rest: Your oxygen levels are consistently low while you are sitting still.
- Low Oxygen during Activity: Your levels stay normal at rest but drop significantly when you walk or move.
- Right Sided Heart Strain: Low oxygen is causing the blood vessels in your lungs to narrow, putting dangerous pressure on the heart (Cor Pulmonale).
Types of Oxygen Delivery
In 2026, there are several ways oxygen is delivered to patients at home, depending on their lifestyle and clinical needs.
| Type of Therapy | Equipment Used | Usage Pattern |
| Long Term (LTOT) | Static Concentrator | Used for at least 15, 16 hours a day, including sleep. |
| Ambulatory | Portable cylinders or concentrators | Used only when walking or being active outside. |
| Short Burst | Cylinders with a mask | Occasionally used for recovery after a flare up (less common). |
The ‘Drive to Breathe’ and Safety
For a small group of people with COPD, the body adjusts to higher levels of carbon dioxide (SaO2). In these individuals, the brain switches its ‘drive to breathe’ from SaO2 levels to oxygen levels. If these patients are given too much supplemental oxygen, their brain may think they have enough and slow down their breathing rate, leading to a dangerous buildup of SaO2.
Because of this, oxygen must be tuned to a specific flow rate (e.g., 2 litres per minute) and should never be increased without medical supervision.
Critical Safety Rules for Home Oxygen
- No Smoking: Oxygen is highly flammable. Smoking while using oxygen, or even being near someone who is smoking, can cause catastrophic fires or explosions.
- Keep Away from Flames: Stay at least 3 metres away from gas cookers, candles, or open fires.
- No Oil Based Products: Do not use petroleum jelly (Vicks or Vaseline) on your nose or lips while using oxygen, as these can ignite in an oxygen rich environment. Use water based lubricants instead.
To Summarise
Oxygen therapy is a vital treatment for those with severely reduced lung function, used primarily to protect the heart and organs rather than to stop the feeling of breathlessness. It is prescribed following a formal assessment by a specialist respiratory team. While it can improve survival and quality of life, it must be used strictly as directed and with a total commitment to fire safety, particularly regarding smoking.
If you experience severe, sudden, or worsening symptoms, call 999 immediately.
Will I become addicted to oxygen?
No, oxygen is not addictive. However, if your body needs it to function, you may feel significantly worse if you stop using it, as your organs will be deprived of the oxygen they require.
Can I use oxygen only when I feel out of breath?
Generally, no. Long term oxygen is only effective if used for the prescribed number of hours (usually 15+ per day). Using it in ‘short bursts’ when breathless does not provide the long term protective benefits for the heart.
Can I travel with oxygen?
Yes. Portable oxygen concentrators are allowed on most flights and public transport, but you must coordinate with your oxygen provider and the travel company in advance.
Why does oxygen make my nose dry?
Constant airflow through the nasal cannula can dry out the lining of the nose. Using water based gels or a humidifier attached to your concentrator can help.
Authority Snapshot
This article provides a clinical overview of the use of supplemental oxygen in chronic respiratory disease management in the UK.
- Reviewer: Dr. Stefan Petrov. Dr. Petrov is a UK trained physician with an MBBS and postgraduate certifications in BLS and ACLS. He has hands on experience in general medicine, surgery, and emergency care. He has worked in hospital wards and intensive care units, performing diagnostic procedures and managing patients on long term oxygen therapy.
- Clinical Standards: This content is written to reflect the 2026 UK clinical guidelines for the prescription and safety of home oxygen therapy.
- Accuracy Note: This information is for general awareness and does not replace a professional clinical assessment or an oxygen prescription.
