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Should I fly if I have breathing problems?

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.



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If you have a lung condition, your oxygen levels may already be low, or your lungs may not be able to work properly to keep the amount of oxygen in your blood at a safe level. Lower levels of oxygen in your blood may make you feel unwell or could even be harmful to you during or after your flight.

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The air is 'thinner' because the pressure is less and, as a result, there is less oxygen. In fact, the concentration of oxygen falls from 21% at sea level, to about 15%. Most people will tolerate this, but, if you already have problems breathing, this will become worse.

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Pleurisy is an inflammation of the thin layers of tissue that cover the lungs and ribcage. It causes severe chest pain and difficulty breathing. Flying commercially while suffering from pleurisy is strongly discouraged. Pulmonary embolism and respiratory distress are the two most feared complications.

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The most important preventive measure is to avoid flying when symptoms of upper respiratory tract infection are present. When this is not possible, passengers should yawn, swallow, or chew to relieve pressure in the middle ear. Use of the Valsalva maneuver and decongestants or antihistamines may be helpful.

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Traveling by airplane exposes people to decreased air pressure and lower than normal oxygen levels. For most people, these changes are not noticeable.

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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.

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Resting Pulse Oximetry
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.

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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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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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Answer: No. The cabin is pressurized between 6,000 and 8,000 feet on long flights. Adding supplemental oxygen is not necessary, because the percentage of oxygen is the same as being on the ground at those altitudes.

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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.

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The main risk of flying commercially while suffering from a chest infection is acute respiratory distress. The oxygen level and atmospheric pressure are respectively lower and higher than we are used to in a pressurized cabin. Passengers with a chest infection are especially vulnerable to these changes.

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