Oxygen & Pulmonary Hypertension

Understanding when oxygen is needed and how to use it safely

Some people living with pulmonary hypertension (PH) need supplemental oxygen to keep their oxygen levels healthy. Oxygen is a treatment — not a sign of failure — and it can make a meaningful difference in how you feel, how well your body works, and your overall quality of life.

This section explains when oxygen is needed, how oxygen is prescribed, and the different types of oxygen equipment you may use at home or on the go.

Why Oxygen Matters in PH

Oxygen gives your cells and organs the energy they need. When oxygen levels drop, the heart and lungs work harder — which can worsen PH symptoms and strain the heart.

Using oxygen (when prescribed) can help:

Improve breathlessness
Increase energy
Reduce strain on the heart
Improve sleep
Support safe movement and exercise

When Supplemental Oxygen May Be Necessary

Your PH team may recommend oxygen if:

Your oxygen level falls below the recommended range while resting
Your oxygen level drops during activity (like walking or climbing stairs)
Your oxygen level drops during sleep
You feel breathless, fatigued, or dizzy due to low oxygen
You have certain types of PH where oxygen is shown to improve outcomes

You may need oxygen all the time, only during activity, or only while sleeping — everyone is different.

How Oxygen Is Prescribed

(Walk Test + Face-to-Face Visit)
Oxygen cannot be ordered until specific steps are completed. These steps are required by Medicare and most insurance companies.

Walk Oxygen Test (6-Minute Walk or Similar Test)
Your care team checks your oxygen level while you walk. If your oxygen level drops below a certain point during the test, you may qualify for supplemental oxygen.
Face-to-Face Visit With Your Provider
You must see a PH clinician in person (or a qualifying telehealth visit, depending on rules) within 30 days of the walk test.

During this visit, your provider documents:

- Why you need oxygen
- When you should use it (activity, sleep, or 24/7)
- What flow rate you need (how many liters per minute)

The Oxygen Order Is Sent to a Durable Medical Equipment (DME) Company
The oxygen company contacts you to arrange:

- Delivery
- Equipment setup
- Teaching you how to use your device safely

Your PH team can help guide this process and answer questions along the way.

Types of Oxygen Equipment

There are several types of oxygen systems. Your provider and oxygen company will help you choose the safest option based on your lifestyle, activity level, and flow needs.

Oxygen Concentrators (Stationary/Home Units)

- Plug into an electrical outlet
- Pull in room air and concentrate the oxygen
- Provide continuous oxygen at home
- Not portable — used mostly while resting or sleeping

Portable Oxygen Concentrators (POCs)

- Battery-powered, lightweight devices designed for travel and daily activities
- Provide oxygen in pulsed doses when you inhale (some models provide continuous flow)
- Useful for people with mild-to-moderate oxygen needs
- Easier to carry on walks, errands, or during air travel

Oxygen Tanks / Cylinders (Compressed Gas Oxygen)

- Metal cylinders containing compressed oxygen gas
- Provide oxygen in either continuous flow or pulse flow
- Require refills via oxygen delivery service
- Good for people who need a steady flow or higher oxygen levels during activity

Liquid Oxygen Systems

- Store oxygen at extremely cold temperatures in a small portable unit
- Lighter than gas tanks
- Provide high flow rates, helpful for people with higher oxygen needs
- Not available everywhere, but very useful for active patients

When to Use Each Type of Oxygen

Your provider will help you match the equipment to your lifestyle. For example:

At home or sleeping → Stationary concentrator
Running errands or walking → Portable concentrator or small oxygen cylinder
High-flow needs → Liquid oxygen or larger cylinders
Travel → FAA-approved portable concentrator for airplanes

Questions to Ask Your PH Team

When do I need to use my oxygen — activity, rest, or sleep?
How many liters per minute should I use?
What type of oxygen system is best for my needs?
Can I use a portable oxygen concentrator safely?
How do I travel with oxygen (car, plane, altitude)?
What should I do if my oxygen levels drop suddenly?