Flying with Chronic Obstructive Pulmonary Disease (COPD) is possible for many individuals, but it requires careful preparation and medical consultation. COPD is a progressive lung disease characterized by obstructed airflow, making breathing difficult. The unique environment inside a commercial aircraft presents specific challenges that must be addressed to ensure a safe journey. Successful air travel depends on understanding the physiological effects of flight and meticulously planning for oxygen needs and logistical requirements.
How Cabin Pressure Affects COPD
The primary concern for individuals with compromised lung function is the simulated altitude maintained inside the airplane cabin. Commercial airplanes are pressurized to an altitude equivalent of 6,000 to 8,000 feet above sea level, even while cruising at much higher altitudes. This pressure change results in a lower partial pressure of oxygen in the inspired air compared to sea level conditions.
This reduction is unnoticeable for healthy passengers, but it can cause significant hypoxemia, or low blood oxygen, in those with COPD. Individuals who already have lower baseline oxygen saturation have less reserve to cope with this further decrease, which can exacerbate breathlessness and other respiratory symptoms.
Essential Pre-Flight Medical Clearance
The first action before planning air travel is to consult a pulmonologist or treating physician. This medical professional must assess the stability of the patient’s lung function and determine their fitness to fly, which is particularly important for those with severe COPD or a history of recent disease exacerbations.
To accurately predict a patient’s in-flight oxygen needs, physicians often recommend a Hypoxia Altitude Simulation Test (HAST). During a HAST, the patient breathes a gas mixture containing approximately 15% oxygen, mimicking the reduced concentration found in an airplane cabin at 8,000 feet. The patient’s blood oxygen saturation is monitored to see if it drops below a safe threshold, typically 90%.
If saturation falls too low, supplemental oxygen is introduced, and the exact flow rate needed to maintain a safe level is determined. Following the assessment, the physician must provide a signed letter confirming the patient is fit to fly and detailing the precise oxygen flow rate required during the journey, if applicable.
Navigating Airline Oxygen Requirements
Portable Oxygen Concentrators (POCs)
If supplemental oxygen is needed, most airlines do not permit passengers to use the aircraft’s onboard supply for non-emergency use. Instead, passengers must use a Federal Aviation Administration (FAA)-approved Portable Oxygen Concentrator (POC). This requires notifying the airline well in advance, typically at least 48 hours before departure.
Battery Requirements
Logistical planning for the POC centers on battery life, which is a stringent requirement imposed by airlines. Passengers must carry enough fully charged batteries to power the POC for 150% of the total expected travel time, including any layovers. For example, a six-hour flight requires at least nine hours of battery power. This rule accounts for unexpected delays, such as air traffic or weather issues.
The batteries themselves must also comply with strict regulations, especially regarding their watt-hour rating; some airlines prohibit batteries over 160 watt-hours. Spare lithium-ion batteries must be stored in carry-on baggage with terminals protected to prevent short circuits. Carrying the physician’s prescription and the manufacturer’s statement of the POC’s FAA approval is necessary to present to airline personnel and security staff.
Practical Tips for the Journey
Beyond the medical and oxygen logistics, several practical steps can make the travel day more comfortable and safer.
- Pack all essential medications, including inhalers and rescue antibiotics, in carry-on baggage for immediate access in case checked luggage is delayed or lost.
- Carry a hard copy of medical records and contact information for the care team.
- Maintain hydration by drinking plenty of water and avoiding alcohol and caffeine, as the low humidity in the cabin air can dry out airways.
- Move around the cabin periodically, if mobility allows, or perform simple leg exercises while seated to help prevent blood clots.
- Minimize the risk of respiratory infections by wearing a face mask and practicing frequent hand washing or sanitizing.