For most passengers, even those with respiratory disease, air travel is safe and comfortable. Some patients with COPD may be at risk but, with screening, these patients can be identified and most can travel safely with supplemental oxygen.
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The air on a plane contains less oxygen than the air we normally breathe in.This leads to lower levels of oxygen in the blood. If you do not have a lung condition, the drop in oxygen is not enough that you would feel the difference.
The only oxygen equipment allowed on an airplane is the portable oxygen concentrator (POC). If you need oxygen in flight, you must take a portable oxygen concentrator with you, and , you must let your airline know ahead of time. They may require a doctor's letter to verify the need for the POC on the plane.
Most people with a lung condition can travel safely on planes, but you should talk to your doctor before you make any plans. You may need a fitness-to-fly (hypoxic challenge) test to confirm whether you need in-flight oxygen.
Values >95% on room air suggest that inflight hypoxemia is unlikely and that further evaluation is likely not necessary. Patients with saturations <92% on room air at rest should receive supplemental oxygen inflight, because they are at high risk of hypoxemia at altitude.
Low air pressure during air travel also decreases the amount of oxygen in the air. This effect is modest and generally not noticeable for healthy travelers. For patients with significant lung disease, a small decrease in available oxygen can cause significant symptoms, especially with exercise.
Airlines “pressurize” the air in the cabin, but not to sea-level pressures, so there's still less oxygen getting to your body when you fly, which can make you feel drained or even short of breath. The potential dehydration factor and sitting for long periods of time doesn't help.
Lower levels of oxygen in your blood may make you feel unwell or could even be harmful to you during or after your flight. This means that, even if you do not usually need oxygen, you may need it while flying. Additional oxygen keeps the oxygen levels in your blood at a comfortable level and keeps you safe.