Oxygen instead of CPAP

[bearchaser303]

I had an in-home nighttime pulse oximetry test recently and the results showed multiple occasions of low oxygen levels while I slept. I had assumed the next step would be to send me for a full sleep study, however to my surprise the doctor instead ordered supplemental oxygen to be used at night. Has anyone used (with good results) supplemental oxygen in lieu of CPAP?

[palerider]

I had an in-home nighttime pulse oximetry test recently and the results showed multiple occasions of low oxygen levels while I slept. I had assumed the next step would be to send me for a full sleep study, however to my surprise the doctor instead ordered supplemental oxygen to be used at night. Has anyone used (with good results) supplemental oxygen in lieu of CPAP?

if you ain't breathin, you ain't getting any oxygen.

[LSAT]

I had an in-home nighttime pulse oximetry test recently and the results showed multiple occasions of low oxygen levels while I slept. I had assumed the next step would be to send me for a full sleep study, however to my surprise the doctor instead ordered supplemental oxygen to be used at night. Has anyone used (with good results) supplemental oxygen in lieu of CPAP?

if you ain't breathin, you ain't getting any oxygen.

With sleep apnea, you stop breathing several times each hour throughout the night. As Palerider said..."if you ain't breathin you ain't getting any oxygen".

[bearchaser303]

Yes that's what I thought, hence my surprise that he prescribed it. I'll look into it further. thank you.

[Chevie]

I had an in-home nighttime pulse oximetry test recently and the results showed multiple occasions of low oxygen levels while I slept. I had assumed the next step would be to send me for a full sleep study, however to my surprise the doctor instead ordered supplemental oxygen to be used at night. Has anyone used (with good results) supplemental oxygen in lieu of CPAP?

Is there any reason to suspect your lungs are dysfunctional?

If you have lung dysfunction, then supplemental oxygen might be appropriate.

If you have sleep apnea and healthy lungs, supplemental oxygen is rarely appropriate. CPAP instead.

[Goofproof]

Yes that's what I thought, hence my surprise that he prescribed it. I'll look into it further. thank you.

CLASSIC, Dr. treats the symptom not the cause, too bad he doesnt have a pill to throw at it. Jim

[Pneumophile]

OP: are you sure you're telling us everything we need to know about your clinical situation? Did you doc not say anything else that might explain this decision? Based on what you wrote it certainly is mistifying.

[WarmBodies]

mistifying

Gotcha.

[raisedfist]

why did you have an pulse oximetry test ordered? please provide more information so that we can better assist you.

[Okie bipap]

When I had knee replacement surgery two years ago, my doctor noted my blood oxygen level was dropping when I slept. He put me on supplemental oxygen at night until I could get tested for sleep apnea and get a machine. Once I got my machine, I called his office and had the oxygen concentrator returned. The xpap machine is much quieter than the concentrator was.

[Goofproof]

When I had knee replacement surgery two years ago, my doctor noted my blood oxygen level was dropping when I slept. He put me on supplemental oxygen at night until I could get tested for sleep apnea and get a machine. Once I got my machine, I called his office and had the oxygen concentrator returned. The xpap machine is much quieter than the concentrator was.

many pain meds depress the respiration drive. Had the same problem coming out from under spinal block, the nurses kept telling me to breath deeper. Jim

[D. H.]

There's enough oxygen in ordinary air; absent lung disease.

The problem is that you're not breathing correctly. Increasing the amount of oxygen will not break the apnea cycle. It might lengthen the time between arousals, but it doesn't address the real problem.

[Pneumophile]

An example of reduced lung function which can result in the need for oxygen in some people is after treatment with chemotherapeutic drugs. My own lung function was somewhat reduced after treatment with a cocktail of 7 different anticancer agents (they measure it before and after), some of which are pneumotoxic, but I don't have a need for supplemental oxygen myself. A large tumor full of inflammatory cells in the chest cavity probably didn't help any. Other diseases involving lung inflammation can also result in the need for supplemental oxygen.

Pneumophile

[bearchaser303]

OP: are you sure you're telling us everything we need to know about your clinical situation? Did you doc not say anything else that might explain this decision? Based on what you wrote it certainly is mistifying.

The doctor who ordered the in-home pulse oximeter test is my cardiologist treating me for recently diagnosed a-fib. Years ago (2008, I think) I had a sleep study and was diagnosed with sleep apnea and prescribed a CPAP. I was not consistently using it, sometimes might have it on for an hour, sometimes a few hours, only very rarely made it through the whole night and often didn't use it at all. By 2013 I was using it so infrequently I turned it back in. So fast forward to 2016 and I'm diagnosed with a-fib. I tell the cardiologist about the sleep apnea from before and he orders the in home test. Office nurse goes over the oximeter results with me and says she'll ask the doc for further instruction and get back to me. Next call I get is from a respiratory service saying the doctor ordered nighttime oxygen for me. So now I have this (noisy) machine and am confused how it will really help. Unfortunately this all happened so fast on Friday that I haven't been able to get back in touch with the doctors office - will do that on Tuesday. I wish now I hadn't accepted the oxygen machine until I spoke with the doctor office again. Perhaps it's a temporary measure as someone else mentioned. I did tell the doctor that if I need to resume sleep apnea treatment then my preference is to go for the dental appliance. Since the last sleep study was so long ago I assume I'll need to do another one now.

[rick blaine]

Hi bearchaser303,

I don't know if anybody's told you, but supplemental oxygen and CPAP aren't two versions of the same thing, and so can be used interchangeably.

As in: "Oh, you're not getting enough premium grade air into your lungs because there's narrowing in the 'fuel flow line'? [your throat and windpipe] We'll just up the percentage of O2 in the mix. Run that 'engine' rich for a while."

Breathing extra oxygen long term is harmful to the tissues. In effect, it causes them to wear out and age faster. And is to be avoided if possible.

You should really only be on supplemental oxygen if there's a direct necessity for it. And most of the time, O2 is only used short term.

Now, I don't know what your doctor is thinking and none of us here has seen those oximeter results. But (from what you say) you've made it pretty clear to your doc that CPAP is a categorical no-no.

So what is he or she to do?

If I wuz you, I'd tell your doctor you're willing to do what it takes to make CPAP work this time - so that, if that is the better way to go wrt treatment, he or she has that as an option.

Oh, and one more piece of information. The general view is that a dental appliance is only good for the lower end of the range of sleep apnea. Once the number of events (the AHI) gets above 20 an hour, it's generally not so effective.