Overview
Oxygen therapy is safe and well-tolerated for the vast majority of patients, but minor side effects are common — especially in the first few weeks of use. Most are mild and easily resolved with simple adjustments. This guide covers the side effects you may encounter with the SG and how to address each one.
Nasal Dryness
The most common side effect of cannula-delivered oxygen is dryness in the nasal passages. Oxygen from a concentrator is dry — there is no humidification by default — and constant airflow through the nostrils can dry the mucous membranes, leading to crusting, irritation, or a feeling of stuffiness.
Solutions: Use a saline nasal spray several times daily. Apply a water-based nasal moisturizer (avoid petroleum-based products like Vaseline, which are flammable around oxygen) around the nostrils. Add an optional humidifier bottle to the concentrator if your doctor approves it. Stay well hydrated by drinking plenty of water throughout the day.
Nosebleeds
Mild nosebleeds (epistaxis) sometimes accompany nasal dryness. Persistent dryness causes small blood vessels in the nasal lining to crack and bleed. Most nosebleeds from oxygen use are brief and self-limited.
Solutions: Address the underlying dryness using the methods in the previous section. If a nosebleed occurs, sit upright, lean slightly forward, and pinch the soft part of the nose for 10 minutes. If nosebleeds are frequent, recurrent, or heavy, consult your pulmonologist — sometimes a softer cannula or a different cannula size helps.
Skin Irritation
The cannula tubing rests on the cheeks, behind the ears, and across the upper lip. Continuous contact can cause redness, pressure marks, or mild skin breakdown over time, especially in patients using oxygen many hours per day.
Solutions: Reposition the tubing gently each day so pressure does not always fall on the same spot. Use soft cushion sleeves over the cannula behind the ears if available. Replace the cannula every 2 weeks to keep it soft and pliable. Clean the skin behind the ears and under the nose daily with mild soap to prevent buildup of sweat and oils. If irritation persists, ask the doctor about alternative cannula brands or padding products.
Headache
Some patients report headaches when starting oxygen therapy. In most cases these are mild and resolve within the first week as the body adjusts. Persistent or severe headaches, however, can signal either inadequate oxygen (the flow setting may be too low) or — in rare cases of COPD with CO₂ retention — too much oxygen leading to hypercapnia.
Solutions: Check your SpO₂ with a fingertip oximeter during use to confirm it is at or above 90%. If headaches are persistent, contact your pulmonologist for reassessment. Do not adjust the flow setting yourself.
Oxygen Toxicity
Oxygen toxicity is a rare but serious condition that occurs only with prolonged exposure to very high concentrations of oxygen (typically 60%+ FiO₂ for more than 24 hours). At the flow rates delivered by portable concentrators in home use, oxygen toxicity is essentially not a concern. The much more common risk is hypercapnia in COPD patients receiving too much oxygen — this is why precise prescription matters.
Solutions: Use only the prescribed flow setting. Never increase the setting on your own to feel better. If symptoms persist at the prescribed setting, see your doctor.
Fire Safety Precautions
Oxygen does not burn but it dramatically accelerates the burning of anything else. Cigarettes, gas stoves, candles, fireplaces, and even some hair products can become fire hazards near an oxygen source. Strict precautions are essential.
- No smoking within 3 meters of the device or the patient using it. This applies to all forms of smoking including vapes and shisha.
- No open flames in the same room: candles, gas stoves, fireplaces, lighters.
- No oil-based products around the nose: petroleum jelly, lip balm with oil, oil-based hair products.
- Keep electrical sources clean and in good condition — frayed wires can spark.
- Notify your fire department that home oxygen is in use so they have it on record for emergencies.
When to Call Your Doctor
Contact your pulmonologist if you experience any of: persistent shortness of breath even with oxygen running, SpO₂ readings consistently below 90% at the prescribed setting, persistent severe headache, confusion or drowsiness, blue or grayish skin color, or any sudden change in your breathing pattern. These can indicate that your prescription needs adjustment or another medical issue has developed.
For routine maintenance questions about the SG, see our maintenance guide.
