Higher altitudes can worsen COPD symptoms. People with COPD may need supplemental oxygen when staying at higher altitudes or flying in a plane.

At higher elevations, your body needs to work harder to take in the same amount of oxygen as it does at elevations closer to sea level.

This can strain your lungs and make it harder to breathe. Breathing at higher altitudes may be especially difficult if you have COPD.

Depending on the severity of your COPD symptoms, you may need to supplement your breathing with oxygen at high elevations, particularly above 5,000 feet. This can help prevent oxygen deficiency.

The standard air pressure on commercial airline flights is equivalent to 5,000 to 8,000 feet (ft) above sea level. If you need to bring supplemental oxygen onboard, you’ll need to make arrangements with the airline before your flight.

Keep reading to learn more about how high altitudes affect COPD, including short stays and air travel, and when to talk with a doctor.

High altitude environments include those 4,921 ft (1,500 meters) or more above sea level. The higher the elevation, the more difficult breathing becomes.

Why is it harder to breathe at high altitudes?

The air at higher altitudes is colder, less dense, and contains fewer oxygen molecules.

At higher altitudes, you have less oxygen saturation. This means less oxygen travels through your bloodstream at high altitudes. You need to take in more oxygen by taking in more breaths to get the same amount of oxygen you would get at lower altitudes.

At what altitude is it hard to breathe?

Generally, people without COPD who experience altitude sickness most commonly experience it at or above 9,800 ft (3,000 m) above sea level. It’s less common to experience it at altitudes below 8,202 ft (2,500 m).

However, studies on the effects of high altitude on COPD defined high altitude as above 4,921 ft (1,500 m). People with COPD traveling at or above these levels may require supplemental oxygen or additional supplemental oxygen if they use oxygen therapy at their home altitude.

Acute mountain sickness, also known as altitude sickness, can develop during the adjustment to the changes in air quality at higher elevations.

Altitude sickness can affect people without COPD, but it may be more severe in people who have COPD or another lung or heart condition. People who are physically exerting themselves are also more likely to experience altitude sickness.

Altitude sickness can be mild to severe. Its early symptoms can include:

  • shortness of breath
  • dizziness
  • fatigue
  • lightheadedness
  • headache
  • nausea
  • vomiting
  • rapid pulse or heartbeat

When people with altitude sickness stay at higher elevations, the symptoms can become more severe and further affect the lungs, heart, and nervous system. When this happens, symptoms may include:

  • confusion
  • congestion
  • coughing
  • chest tightness
  • decreased consciousness
  • paleness or skin discoloration due to the lack of oxygen

Without supplemental oxygen, altitude sickness can lead to dangerous conditions, like:

  • high altitude cerebral edema (HACE), which develops due to fluid buildup or swelling in the brain
  • high altitude pulmonary edema (HAPE), which develops when too much fluid builds up in the lungs

People with COPD should always bring supplemental oxygen during long airplane flights and trips to the mountains. This can help prevent altitude sickness from developing and keep COPD symptoms from becoming more severe.

Many people with COPD can fly in airplanes.

Most aircraft maintain cabin altitudes of 6,000 to 7,000 ft (1,828 to 2,133 m), while some newer planes, including Boeing 787 and Airbus A350, can maintain cabin altitudes of around 5,000 to 6,000 ft (1,524 m to 1,828 m).

However, some people may get altitude sickness in airplanes, including those with COPD or other health conditions like heart disease.

If your flight is longer and depending on the severity of your COPD, you may need supplemental oxygen in order to fly.

If you have COPD, it’s best to talk with your doctor before air travel. They can recommend and prescribe supplemental oxygen if you need it.

Living in cities or towns closer to sea level may improve symptoms in people with COPD. The air becomes thinner at high altitudes, making it more difficult to breathe. This is especially true for people with COPD.

They need to try harder to get enough air into their lungs, which can strain the lungs and lead to other health conditions over time.

A 2020 meta-analysis suggests that people living at higher altitudes may be more likely to get COPD. However, high altitude on its own does not cause COPD.

Doctors often advise against relocating to high altitude areas. It often means a reduced quality of life for people with COPD. But, the effects of high altitude on COPD symptoms can vary from person to person.

Talk with your doctor if you’re considering permanently relocating to a city or town at a higher elevation. You can discuss the risks of the move and the impact it may have on your COPD symptoms.

Before you travel, it’s important to meet with your doctor to discuss how your trip may impact your COPD symptoms.

Your doctor can further explain altitude sickness, how high altitude might affect your breathing based on the severity of your COPD and other factors, and how you can prepare yourself for travel.

They may tell you to take additional medications or to bring supplemental oxygen with you during your travels.

If you’re concerned about how your COPD symptoms could become worse in high altitude conditions, you can ask your doctor to perform a high altitude hypoxia measurement. This test evaluates your breathing at oxygen levels simulated to resemble those at higher elevations.