Last Updated on July 23, 2025 by Analgesia team
LTOT in COPD
LTOT, which stands for Long-term oxygen therapy, is a treatment that increases the amount of oxygen in a patient’s blood by delivering oxygen through a mask or tube. It’s often prescribed for people with chronic lung disease and low blood oxygen levels, such as those with chronic obstructive pulmonary disease (COPD).
What Is COPD and Why Does Oxygen Matter
Chronic Obstructive Pulmonary Disease (COPD) is a progressive lung disease that limits airflow and reduces the lungs’ ability to exchange oxygen. It affects over 1.2 million people in the UK, with many more undiagnosed.
In advanced stages, COPD can lead to dangerously low blood oxygen levels (hypoxemia), requiring treatments like Long-Term Oxygen Therapy (LTOT) to support life and improve daily functioning.
Patients with IE-COPD (infrequent exacerbations) may not require LTOT unless blood oxygen levels are consistently low.
Long-term oxygen therapy can: Improve quality of life, increase life expectancy, improve sleep quality, and improve oxygen delivery to vital organs.
It is administered through a small machine that filters oxygen from the air and delivers it through a tube to the patient’s nostrils. The patient should use the oxygen for at least 15 hours per day, but a respiratory consultant or nurse may recommend using it for up to 24 hours.
Benefits of LTOT
- Improved Survival Rates
- Research has shown that LTOT can significantly increase survival rates in patients with severe hypoxemia (low blood oxygen levels).
- It reduces the risk of complications like pulmonary hypertension and right-sided heart failure.
- Enhanced Quality of Life
- By providing sufficient oxygen to the body, LTOT reduces symptoms such as breathlessness, fatigue, and confusion.
- Patients experience better energy levels, which enables greater participation in daily activities and social engagements.
- Relief from Hypoxemia Symptoms
- LTOT alleviates the effects of chronic oxygen deprivation, including headaches, irritability, and memory loss.
- Improved oxygenation can also reduce anxiety and depression associated with respiratory conditions.
- Improved Exercise Tolerance
- Oxygen therapy supports physical activity by reducing breathlessness during exercise.
- This enables patients to maintain mobility, participate in rehabilitation programs, and improve overall physical fitness.
- Reduced Hospital Admissions
- Regular use of LTOT has been linked to fewer exacerbations of respiratory disease, resulting in reduced hospitalizations.
- It provides a proactive approach to managing chronic conditions at home.
- Support for Cardiovascular Health
- LTOT helps reduce the strain on the heart caused by low oxygen levels.
- Improving oxygen delivery to tissues it lowers the risk of complications like pulmonary hypertension and heart failure.
- Enhanced Cognitive Function
- Adequate oxygen supply to the brain can improve cognitive function, concentration, and memory in individuals with chronic respiratory diseases.
- Better Sleep Quality
- Oxygen therapy can reduce nocturnal hypoxemia, which commonly disrupts sleep.
- Improved sleep contributes to better overall health and daytime alertness.
Limitations of Long-term oxygen therapy
- LTOT can be expensive and burdensome for patients and caregivers
- It can also be associated with psychological and social issues, as well as physical risks
- It can induce hypoventilation
Research on Long-term oxygen therapy
- Research has not provided definitive guidance regarding who should receive LTOT and how it should be delivered
- More research is needed to develop comprehensive guidelines to assist with oxygen self-management