How can I prevent hypoxia when flying?

For best protection, you are encouraged to use supplemental oxygen above 10,000 feet MSL. At night, because vision is particularly sensitive to diminished oxygen, a prudent rule is to use supplemental oxygen when flying above 6,000 feet MSL. So, when you fly at high altitudes, supplemental oxygen is the only solution.



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Others will allow you to bring your own Federal Aviation Administration (FAA) approved portable oxygen concentrator (POC) onto the flight, but will often specify the type of device you can use. You should speak to your airline as early as possible to make sure that they are able to accommodate your needs.

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The most common causes of hypoxia in aviation are: flying, non-pressurized aircraft above 10,000 ft without supplemental oxygen, rapid decompression during flight, pressurization system malfunction, or oxygen system malfunction.

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Hypoxia occurs within a few minutes if the cabin pressure altitude rises to between 5,000-6,000 m (about 16,000 - 20,000 ft). Acute hypoxia is characterised by impaired cognitive performance and sometimes a loss of consciousness.

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Some patients, however, are in need of more advanced pre-flight testing using a hypoxia-altitude simulation test (HAST), breathing a gas mixture with 15.1% oxygen, corresponding to an aircraft cabin altitude of 8000 feet (2438 m) [5–7].

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For a person who has been exposed to hypoxia for a long time, the situation can be very serious. Therefore, patients with heart, lung and respiratory diseases should consult their doctor before flying.

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A simple pulse oximeter reading while you are at high altitude, at rest and during activity, can determine if oxygen is needed at altitude. Alternatively, some pulmonary function labs can perform an altitude simulation test to determine your oxygen saturation at altitude.

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Oxygen production cannot be shut off once a mask is pulled, and oxygen production typically lasts at least 15 minutes, sufficient for the plane to descend to a safe altitude for breathing without supplemental oxygen.

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On most pressurized aircraft, if cabin pressurization is lost when the aircraft is flying at an altitude above 4,267 m (14,000 feet), compartments containing the oxygen masks will open automatically, either above or in front of the passenger and crew seats, and the oxygen masks will drop down in front of the passenger.

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