Managing COPD Flare-Ups: The Role of Oxygen Therapy

If you’re living with chronic obstructive pulmonary disease (COPD), you know how unpredictable it can be. Some days, your breathing feels manageable — and other days, even simple tasks like getting dressed or walking to the kitchen can leave you out of breath.

These sudden spikes in symptoms are called COPD flare-ups, and they’re more than just a rough patch. Flare-ups — often triggered by infections, cold air, smoke, or overexertion — can lead to a sharp increase in coughing, wheezing, and breathlessness, sometimes requiring hospitalisation if not managed early.

While prescribed medications, inhalers, and lifestyle changes are key parts of managing COPD, there’s another support option that some people aren’t as familiar with: oxygen therapy.

In this blog, we’ll walk you through:

• What oxygen therapy is and how it works
  
• Why it can be helpful during flare-ups
  
• The difference between medical and non-medical oxygen
  
• When to use oxygen — and when to seek medical help
  
• And additional strategies to help you feel more in control when symptoms worsen

What is oxygen therapy?

Oxygen therapy is a treatment that involves breathing in oxygen at higher concentrations than what’s found in normal air. For people with moderate to severe COPD, it’s often prescribed to help maintain healthy blood oxygen levels when the lungs can’t do so on their own.

Normally, the air we breathe contains about 21% oxygen, which is usually enough to keep the blood well oxygenated in healthy individuals — with normal blood oxygen saturation levels ranging from 95–100%.

But for someone with COPD, where the lungs are damaged and airflow is restricted, the body may struggle to absorb and circulate enough oxygen. As a result, blood oxygen levels can drop below 90%, especially during exertion or sleep — a condition known as hypoxaemia.

How does oxygen therapy works?

Oxygen therapy delivers concentrated oxygen directly into your nose (via a nasal cannula) or mouth (via a mask), helping:

• Raise blood oxygen levels
  
• Ease shortness of breath
  
• Reduce strain on the heart
  
• Improve energy levels and alertness
  
• Support better sleep and overall wellbeing

It’s typically prescribed after a blood oxygen test, such as a pulse oximetry reading or an arterial blood gas test, confirms that your oxygen levels are lower than normal — especially at rest or during exertion.

That’s where supplemental oxygen can help. By breathing in a more concentrated oxygen supply — often between 24% to 60% oxygen, depending on the device and flow rate — the lungs don’t have to work as hard to get the oxygen your body needs, helping to relieve breathlessness and improve energy.

What are the different types of oxygen delivery?

Oxygen therapy can be delivered in a few different ways, depending on your needs:

• Oxygen concentrators: Devices that filter and concentrate oxygen from room air. Often used at home for long-term therapy.
  
• Oxygen cylinders/tanks: Contain compressed medical oxygen and are typically used when higher flow rates are needed.
  
• Portable oxygen systems: Lightweight units or small canisters designed for short trips outside the home.

Your doctor or respiratory specialist will help determine the best format and dosage for your individual situation.

Why oxygen can be helpful during a COPD flare-up

A COPD flare-up can come on suddenly — leaving you more short of breath, more fatigued, and often feeling panicked. What’s happening during these episodes is that your already-compromised lungs become even less efficient at moving oxygen into your bloodstream. That drop in oxygen can affect your muscles, heart, brain, and energy levels, making you feel weak, disoriented, or breathless even at rest.

What oxygen does during a flare-up

During a flare-up, oxygen therapy can help by:

• Raising oxygen saturation levels back into a safer range
  
• Easing the sensation of air hunger, which helps reduce panic and anxiety
  
• Reducing the workload on your heart and lungs, giving your body a break
  
• Helping you recover faster and potentially avoid hospitalisation if used early (in accordance with your treatment plan)
  

If you’re already on long-term oxygen therapy (LTOT), your doctor may advise temporarily increasing your flow rate during a flare-up. If you’re not on LTOT, short-term or “spot use” of oxygen — particularly with guidance from a healthcare provider — may still help in certain situations.

What about portable or non-medical oxygen?

Some people find mild relief using recreational oxygen products — like small canisters of purified oxygen designed for occasional use. These are non-medical, over-the-counter products that can be used during travel, after exertion, or when experiencing light breathlessness — especially if medical oxygen isn't needed or available.

For example, Boost Oxygen is a portable, lightweight canister that delivers supplemental oxygen you can inhale through a mask or mouthpiece. While it’s not a replacement for prescribed therapy, it can offer short-term support and a feeling of relief in milder situations.

Medical vs. non-medical oxygen – What’s the difference?

With more people talking about oxygen therapy these days — especially in relation to COPD or recovery from illness — it’s easy to get confused between medical oxygen and non-medical (recreational) oxygen.

What is medical oxygen?

Medical oxygen is highly regulated and prescribed by a healthcare professional. It’s regulated as a medicine by the Therapeutic Goods Administration (TGA) under the Therapeutic Goods Act 1989 and requires appropriate prescribing, administration, monitoring, and documentation, similar to other high-risk medicines in Australia and is produced under strict safety and quality standards.

It’s typically prescribed when:

• Blood oxygen levels fall below 88–90%
  
• You’ve had a confirmed diagnosis of moderate to severe COPD
  
• You’ve undergone a blood oxygen test (pulse oximetry or arterial blood gas)

Medical oxygen is used for long-term oxygen therapy (LTOT), hospital stays, or acute flare-ups — and delivered through concentrators, cylinders, or oxygen systems based on your doctor’s plan.

What is non-medical oxygen?

Non-medical oxygen (also called recreational or supplemental oxygen) is available without a prescription. It’s not intended to treat medical conditions but can offer short bursts of oxygen for general use — like during exercise, travel, or in high-altitude environments.

Products like Boost Oxygen fall into this category. They contain around 95% oxygen in lightweight canisters, designed for quick, on-the-go use when you're feeling winded or run-down.

Shop Boost Oxygen Natural and SPORT at Aussie Pharma Direct

Important differences to know

 

Non-medical oxygen should never replace prescribed medical oxygen. But for some people — especially those with mild breathlessness or occasional symptoms — it may offer a complementary form of support, particularly during travel, activity, or recovery.

When to use oxygen and when to seek help

Knowing when to reach for oxygen — and when it’s time to seek medical attention — can make a big difference in how well you manage a COPD flare-up. Oxygen therapy can be a valuable tool, but it’s important to use it wisely and in line with your individual treatment plan.

Signs oxygen may help during a flare-up

You may benefit from using oxygen (as directed by your doctor or care plan) if you experience:

• Increased shortness of breath that doesn’t ease with rest
  
• Low oxygen readings on a pulse oximeter (typically below 90%)
  
• Dizziness, fatigue, or confusion — signs your brain and muscles aren’t getting enough oxygen
  
• Difficulty speaking in full sentences without gasping
  
• Needing to use your rescue inhaler more often than usual

If you already use long-term oxygen therapy, your doctor may advise temporarily increasing your flow rate during a flare-up. If you don’t usually use oxygen, speak with your doctor before trying it — even non-medical oxygen.

When to call a doctor or emergency services

You should seek urgent medical help if you experience:

• Severe breathlessness, even after using oxygen or medication
  
• Bluish lips or fingertips (cyanosis), which may signal dangerously low oxygen
  
• Confusion, agitation, or drowsiness — which could indicate reduced oxygen to the brain
  
• Fever, worsening cough, or chest tightness that could signal infection or pneumonia
  
• Signs of a panic attack that aren’t resolving with breathing techniques

Have a COPD action plan

Everyone with COPD — especially those at risk of flare-ups — should have a COPD action plan developed with their GP or respiratory specialist. This plan outlines:

• What to do at the first sign of a flare-up
  
• When and how to adjust oxygen flow rates (if prescribed)
  
• Which medications to use and when
  
• When it’s time to call for medical help

Having a plan (and sharing it with caregivers or family) means you’re not left guessing in the middle of a flare-up — and can take action early to feel more in control.

Other tips to manage a COPD flare-up

While oxygen therapy can play a crucial role during a flare-up, there are also other tools and habits that can help you manage symptoms, feel more in control, and support your recovery.

These small actions can make a noticeable difference in how quickly you bounce back — and may even help reduce the severity of future flare-ups.

1. Practice pursed-lip breathing

This simple breathing technique helps you slow down your breathing and release trapped air in your lungs. It can help reduce breathlessness and anxiety.

How to do it:

• Inhale slowly through your nose for about 2 seconds
  
• Exhale slowly through pursed lips (like you're blowing out a candle) for 4 seconds
  
• Repeat until your breathing feels more settled

To take your breathing exercises a step further, some people also use a lung-expansion device like AirPhysio. This Australian-made device is listed with the Australian Register of Therapeutic Goods (ARTG) ID 376021 and it uses gentle resistance and vibration to help mobilise mucus and improve airflow, making it a useful tool to complement breathing techniques — especially for those with chronic respiratory conditions like COPD.

 2. Stay hydrated

Fluids help thin mucus in your lungs, making it easier to cough up. Aim to drink water throughout the day, unless otherwise advised by your doctor.

3. Avoid triggers

Try to stay away from things that can worsen symptoms, such as:

• Smoke (including woodfire or tobacco)
  
• Cold or dry air
  
• Strong smells (cleaners, perfumes)
  
• Air pollution or dusty environments

If cold air is a trigger, try breathing through a scarf or face covering outdoors.

4. Sit upright

Posture matters. Sitting upright or leaning forward slightly (such as resting).

5. Use a humidifier (if needed)

If dry air worsens your cough or breathing, a cool mist humidifier can help maintain a comfortable moisture level in your home. Just be sure to clean it regularly to prevent bacteria or mould buildup.

6. Keep medications and inhalers within reach

Make sure you have your rescue inhaler or prescribed medications nearby at all times — especially if you're prone to flare-ups. Use them exactly as instructed by your doctor.

7. Use portable oxygen for on-the-go relief (if appropriate)

If you’re not on long-term oxygen therapy but sometimes experience mild breathlessness — particularly after exertion or during travel — portable, non-medical oxygen products may offer some short-term support.

Products like Boost Oxygen are lightweight canisters filled with purified oxygen, designed for occasional use when you need a quick boost — such as after climbing stairs, walking longer distances, or in higher altitudes. They’re not a replacement for prescribed oxygen therapy, but some people with mild COPD find them helpful for staying active and independent.

Always check with your healthcare provider before introducing new products into your COPD care routine — even over-the-counter options.

Conclusion

A COPD flare-up can feel overwhelming — but with the right tools, knowledge, and support in place, you can face those tough moments with greater confidence and control.

Oxygen therapy, whether prescribed or used in milder forms, can be a valuable part of your flare-up management strategy. When used appropriately, it can help restore oxygen levels, ease shortness of breath, and prevent complications. And when combined with breathing techniques, positioning, lifestyle adjustments, and support tools like AirPhysio or Boost Oxygen, many people find they can stay more active and recover faster.