How to Exercise with Oxygen Therapy (EWOT)

How to Exercise with Oxygen Therapy (EWOT)

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Exercising with oxygen therapy (also known as EWOT) has many potential benefits and can be a great way to reduce the physical stress of exercise. This is especially true if you have the chronic obstructive pulmonary disease (COPD) or any other respiratory illness that affects your ability to receive oxygen.

In this blog post, we will discuss how oxygen therapy can reduce the physical stress of exercise. We will also give you some practical tips on how to maximize your oxygen intake during exercise.

First, let us talk about how your body reacts to exercise and what it does to compensate for low oxygen levels.

How Your Body Reacts to Low Oxygen Levels During Exercise

During exercise, your body uses a lot more oxygen and requires fast replenishment. In response, your heart rate and breathing rate increase to transport more oxygen to your muscles and surrounding tissues.

However, if you have a chronic respiratory illness like COPD, your body’s ability to absorb oxygen is impaired. With COPD, your lungs are unable to absorb oxygen sufficiently, so even the most basic activities like taking out the trash or washing the car can make you feel winded and fatigued.

Moreover, if you also have a concurrent heart condition such as congestive heart failure or atrial fibrillation, your heart has to pump even harder to get sufficient oxygen during exercise. And if you also have low oxygen levels in your blood, that puts additional stress on your heart.

So, while exercise is a good thing for general health, there is a dilemma: How do you get adequate exercise without exacerbating underlying cardiac or respiratory illnesses?

The answer is surprisingly simple—oxygen therapy.

How Oxygen Therapy Can Improve Your Exercise Regimen

Dr. Johnathan Edwards, a sports medicine physician and anesthesiologist in Las Vegas, demonstrated how surgery patients can retain 100% oxygen levels in their blood for up to 5 minutes with only a single breath. During his surgeries, Dr. Edwards routinely increases the blood oxygen concentration of his patients to 100% to maximize oxygen delivery and can do so at very low breathing rates.

How Oxygen Therapy Can Improve Your Exercise Regimen

What this means is that your body can hold on to oxygen for a lot longer than most people think. Once you get the oxygen into your bloodstream, it can stay present and available for up to 5 minutes. So, if you were to use oxygen therapy during exercise, theoretically, you could maximize your body’s oxygen levels for the duration of your training.

Here is why this is so important: If you have COPD, your blood oxygen level can become dangerously low during exercise. Thus, by providing supplemental oxygen, you could bring your oxygen levels back up to normal, or even better than normal, for the entire workout. You could potentially avoid the dangers of overexerting yourself and maintain a steady supply of oxygen to your muscles.

Oxygen Can Reduce the Inflammatory Response Associated with Exercise

When you exercise, your capillaries (small blood vessels) expand with inflammatory cells. This is a natural process that everyone experiences. However, this normal inflammation paired with persistent low oxygen levels is a dangerous combination.

The good news is that oxygen can constrict your blood vessels and counteract that inflammation the moment it begins. This is important because persistent inflammation has been linked to cancer, heart disease, and a host of other problems. So, whatever can be done to reduce the adverse side effects of inflammation is worth exploring.

5 Ways to Maximize Your Oxygen Levels During Exercise With Oxygen Therapy

Now that we have discussed how your body reacts to exercise and how oxygen therapy can help, here are 5 ways to increase your oxygen levels during exercise:

Maximize Your Oxygen Levels During Exercise With Oxygen Therapy - Focus on Your Breathing

    1. Focus on Your Breathing
      Supplemental oxygen is useless if your breathing technique is incorrect. That might sound harsh, but it is very much the truth. During exercise, it is too easy to shift your focus toward other things and lose sight of your breathing technique. Many people work out with music or TV in the background, and that is perfectly acceptable. However, you might want to try exercising without any distractions for the first week to get used to staying present and focused on your breathing. Concentrating on each breath during exercise alone can make a big difference in your oxygen levels.
    2. Breathe Through Your Nose
      Most people who use supplemental oxygen use a nasal cannula because it is more practical to wear than a face mask. However, during exercise, it is that much more important to focus on how you breathe. Inhaling through your nose does not come naturally, but it is more effective when using a nasal cannula because the oxygen is delivered through your nose first. Remember: Even though your concentrator or tank is releasing oxygen, that does not guarantee you will get everything that comes out of the concentrator. You still must use a proper technique (like focused nasal breathing) to maximize what you are getting.
    3. Avoid Pulse-Dose Settings During Exercise
      Many oxygen concentrators have a built-in setting called pulse-dose, which only delivers oxygen when you inhale. While this is a great way to preserve oxygen during regular use, it may not give you what you need during a workout. The reason is that your breathing pattern changes with increased exertion, as well as your body’s oxygen demand. These variables can affect oxygen delivery and the efficiency of pulse-dose settings during exercise. So to avoid insufficient oxygen levels, it is better to keep your unit on continuous flow during your workout to get a constant stream of oxygen. This will ensure that you get enough oxygen to keep up with your body’s increased demand. All home oxygen concentrations and some portable oxygen concentrators feature continuous-flow mode. (Please note: Always consult with your physician first to make sure this approach will fit with your medical needs.)
    4. Take Breaks
      Working out is hard for everyone, so it is perfectly acceptable to take breaks during your routine. The great thing about taking breaks while using supplemental oxygen is that you can replenish your blood oxygen levels at regular intervals—and be ready for the next round. Every break will give your body a chance to recharge. If using weights, the best approach is to take a break after every set. If you are doing aerobic exercises like jogging or cycling, start by taking more frequent breaks. You could always work your way up based on how you feel and your oxygen saturation percentage (using a pulse oximeter).
    5. Use Oxygen During Your Cool-Down
      After each workout, it is a good habit to decrease your heart rate gradually with a cool-down phase. This can be as simple as reducing your perceived effort by half every minute until your heart rate is closer to your baseline. Cool-downs can also help you relax and even prevent muscle soreness.
      Interestingly, oxygen can also do the same thing. When your body has enough oxygen, you will feel more relaxed, your heart rate will slow down, and your body will have enough oxygen to counteract the inflammation that leads to muscle soreness.
      So when you perform a cool-down, continue to use supplemental oxygen, so your body has enough to recover appropriately.

Final Thoughts

Incorporating oxygen therapy into your exercise regimen, commonly known as EWOT, offers a powerful way to boost blood oxygen levels while being active. This method not only counteracts the negative aspects of exercising but also keeps your spirits high and motivation strong. For those facing challenges in maintaining an active lifestyle due to COPD, oxygen therapy presents a valuable solution. It effectively manages symptoms, allowing you to concentrate on and enjoy your routine once again.

Information on this page is for reference and educational purposes only. For more information talk to your doctor or primary care provider.

Updated: January 5, 2024
Published: November 11, 2018

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Ryan Anthony, BS, RRT is a registered respiratory therapist and content writer and medical blogger currently located in Los Angeles, California. As a Respiratory Therapist, he performs a wide range of hospital duties including adult and neonatal intensive care, nitric oxide therapy, high-frequency oscillatory ventilation, conventional mechanical ventilation, noninvasive ventilation, BiPAP, CPAP, intubation assistance, bronchoscopy assistance, cardiopulmonary resuscitation, chest physiotherapy, and nebulizer therapy.

About Ryan Anthony:

Ryan Anthony, BS, RRT is a registered respiratory therapist and content writer and medical blogger currently located in Los Angeles, California. As a Respiratory Therapist, he performs a wide range of hospital duties including adult and neonatal intensive care, nitric oxide therapy, high-frequency oscillatory ventilation, conventional mechanical ventilation, noninvasive ventilation, BiPAP, CPAP, intubation assistance, bronchoscopy assistance, cardiopulmonary resuscitation, chest physiotherapy, and nebulizer therapy.

32 thoughts on “How to Exercise with Oxygen Therapy (EWOT)

    • Hi Dennis, We have a couple of options for you that provide constant flow. The SimplyGo and the Eclipse 5 are good options. I have passed along your information to one of our oxygen specialists who can best assist you by talking to you about your oxygen needs, your lifestyle and what you would like to spend. If you like you may also reach out to us at 888-360-9829 or if you prefer email sales@amsrco.com. We look forward to helping you with your oxygen needs.

      • Margaret

        I have the SimplyGo and even though you can get constant oxygen, two (2) CF isn’t enough for most folks and that is all you can get out of the SimplyGo concentrator. Also it only last about 55 minutes which is normally not long enough for some activities. I thought it would be great for taking into restaurants but if you are longer than 55 minutes you have a problem. It has a pulsating setting of 6, which is longer than my INOGEN but not sure it is actually any more air. Just a note as these portable concentrators are not cheap. Thanks for your info.
        Dick Wagner

        • Thank you for sharing your experience with the SimplyGo concentrator. Our Oxygen Specialists would be happy to understand your requirements and advise the way forward. Please give us a call at (877) 644-4581.

  1. The Inogen one has no continues flow. Beside using a small tank in a backpack what else would work. I have a floor model with tubes I can ride the bike on a wind trainer with continues flow. What for walking?

    • We offer several options that are a continuous flow and are on a wheeled cart that may work for you. Please give us a call, and one of our experienced oxygen specialists would love to talk with you about your needs and find a unit that would work for you. You can reach us at 888-360-9628 or if you prefer sales@amsrco.com

    • I have Inogen 4. ( not continuous flow) does that mean my portable oxygen use is a waste to use? Am I receiving any oxygen ?

      • Donna, pulse-dose units are smaller and lighter since they don’t have to provide continuous flow oxygen. It delivers oxygen just when the user inhales. They are great for running errands, walking, biking, playing golf, etc. Check your oxygen saturation from the pulse oximeter before and while you are using the oxygen concentrator. Any difference can be attributed to the concentrator.

  2. I’m not sure if my previous.comment went through or not…. if someone us already on oxygen vasialy 24/7, when preparing to exercise, should the 02 setting be increased?

    • Before starting any exercise program, you should consult with your doctor. You can also wear pulse oximeter to monitor your oxygen level while doing your exercises and adjust your oxygen accordingly.

      • I’m 49 and active, but I find in the gym I lose energy quickly. Hypertension, but otherwise healthy. Would oxygen therapy help me between sets or mid exercise?

  3. Question – I have heard that EWOT therapy wake up brain cells that is laying dormant after a stroke like hbot is that true?

  4. Hi

    I’m very keen on getting a continuous/ constant supply system for personal use

    Kindly advise with costing

    BW

    Dr Jain

    • Hello, The oxygen concentrators do require a prescription for oxygen therapy. The cost of the machines vary related to the output (continuous vs pulse) as well as a stationary or potable models. If you want to find out more about a specific machine our oxygen specialist are great at explaining and helping align a patient’s needs to the machine that will deliver the right level of oxygen and features. Give them a call at 888-743-0156.

        • My passion is snorkeling, I also have emphysema. Just yesterday I saw a picture of a woman snorkeling with her concentrator in a floating device behind her. I would be scared in case other people are splashing in the water and get the concentrator wet.

    • It’s a must to have a doctor’s prescription to purchase an oxygen concentrator. The doctor will tell how much the oxygen flow should be and how long it should be used.

        • Sure, Respironics makes an easy-to-use backpack for SimplyGo Mini. Our Oxygen Specialist would be happy to help you out with your requirements. Please give us a call at (877) 644-4581.

    • Watch on Craigslist for one. Must be careful of type, (pulse/cont.) You also want all paper work, (ALL PAPER WORK !!!–purchase date w/ serial #, all maintenance work done with SERIAL #, (WHAT WAS DONE AND THE DATE AND WHERE IT WAS DONE.) THEN CALL THEM UP W/ SERIAL #, they should be able to answer all your questions about a particular machine. BUT !!! a doctor should be consulted, because you need to know just what you need, a (cont. or pulse, or maybe one with both, which they do make.) Too many different units available and health conditions, to attempt to do it by yourself.

  5. Hi there
    I was wondering about your oxygen products. I have a severe case of COPD and I want to learn how to work out but I’m having a hard time breathing. I’m interested in one of your portable oxygen machines. Would one of these machines help me breathe better while I’m working out?

    Thank you

    • Our Oxygen Specialists would be happy to understand your requirements and advise the way forward. Please give us a call at (877) 644-4581.

  6. I have a ARYA portable oxygen concentrator that only has pulse 1-5 Settings, it pulse air when you breathe, my setting is 3, I just wonder how UT works with exercise, when it was checked at 97 idle and walk test it would dropped to 88 and they would set me down to cooperate back to 97, do you think I would. Need a constant flow concentrator

    • It depends on the FiO2 you need to maintain healthy oxygen levels. We cannot give any medical advice; please consult with your physician or healthcare provider. They are qualified experts to assess the condition and provide treatment.

  7. I have mother’s 10 liter concentrator, so all I need is a food grade plastic bag [size of grocery bag?] , a good mask and exercise..getting my heart beat up to 120, ?? Even at 80% efficiency, this would be great ! Is too much oxygen a bad thing? I went to chiropractor’s office , tried Liv O2 Ewot on bike, my blood pressure went up to 170\100…WHY?

    I would love to exercise at home, recover with EWOT….Please advise!

    Jay

    • Oxygen therapy should always be prescribed and monitored by a healthcare professional. Too much oxygen without proper medical supervision can have adverse effects on your health, including oxygen toxicity.

      EWOT involves using higher levels of oxygen during exercise to increase oxygen intake. This should only be done under the guidance of a healthcare professional who can monitor your oxygen levels and ensure your safety.

  8. I just started on O2. Went walking carrying a small tank. Breezy outside and I think the breeze was blowing the O2 out of my nose. At 2 cf my SpO2 was still below 88. Turned it up to 4 cf. SpO2 stayed at 90. Is there something to block the wind from my nose while walking? Or do I have another issue?

    • It’s possible that the breeze was affecting the delivery of oxygen to your nose while outside. To address this issue, you can consider tucking the tubing under your clothing to minimize the impact of the breeze. Additionally, you may want to try using a nasal cannula with a nasal cushion or an over-the-ear design, as these may provide a better seal and help prevent the oxygen from being blown away by the wind. Since you are on a continuous flow of oxygen, you may also try oxygen mask that fits perfectly on your face to minimize loss of oxygen.

      If you continue to experience low oxygen saturation levels despite these measures, it’s important to consult with your healthcare provider to rule out any other underlying issues and adjust your oxygen therapy as needed. They can provide personalized recommendations based on your specific situation and needs.

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