Supplemental Oxygen

Have been on CPAP since January. My problem is not so much obstructive apnea, as it is hypopnea. I have COPD and Asthma. I exercise quite a bit, and learned diaphramatic breathing from Tai Chi and Aikido. So, during the day my SpO2 runs around 96-98%. When I sleep, however, my breathing get shallow, causing SpO2 to drop below 80%. The CPAP has helped a lot, but still quite a few hypopneas. I had a PFT, and the nurse asked how often I used supplemental oxygen. I told her "never, not even when hiking, doing Tai Chi or Aikido." Her mouth dropped, as she was surprised. This made me think I could improve my sleep with a little oxygen added to my CPAP. So, I got a concentrator, and the past 2 nights I have just used a little (1l/hr 90%). My AHI has dropped below 1, and my SpO2 averaged 93%, only dropping to 87% on a couple occasions. I may try upping it to 2l tonight. But I think I am on the right track.

If you are having hypopneas, have you tried raising your EPAP/CPAP to address those? It is a common misconception to treat hypopneas as being less serious than obstructive apneas.

Yes, my major problems are hypopneas, not OA. I increased the APAP to 8-18, which brought down the AHI <1, but my recording SpO2 monitor (CMS-50F) showed still O2 dropping below 80% occasionally, and average 90 or less. With the touch of oxygen the SpO2 average is now 93-94%, with only occasional drop to 87%. Feeling much better, too. Not waking up short of breath, which happened even sometimes with the CPAP.

jsielke wrote:with only occasional drop to 87%

Any time O2 goes below 90% is when docs panic.

jsielke wrote:When I sleep, however, my breathing get shallow, causing SpO2 to drop below 80%.

Not sure how you can breath shallow when on the cpap. I went thru the sore chest muscles when starting out on cpap, 80% O2 is a serious drop.

Are you sleeping at a lower level somewhere where the room O2 could be displaced by another gas?
Any headaches associated with this?
Finally, if you haven't done so, talk to a pulmonologist or sleep doc about this.

SAG wrote:

jsielke wrote:with only occasional drop to 87%

Any time O2 goes below 90% is when docs panic.

jsielke wrote:When I sleep, however, my breathing get shallow, causing SpO2 to drop below 80%.

Not sure how you can breath shallow when on the cpap. I went thru the sore chest muscles when starting out on cpap, 80% O2 is a serious drop.

Are you sleeping at a lower level somewhere where the room O2 could be displaced by another gas?

Nope, bedroom on second floor, usually have window open

Any headaches associated with this?

Before CPAP/Oxygen, you bet! Now, much better.

Finally, if you haven't done so, talk to a pulmonologist or sleep doc about this.

Did that. Amazed that I didn't need oxygen any time I exerted myself. I greatly benefited from what I learned in Pulmonary Rehab some 10 years ago.

you may need a bipap/bilevel, to ventilate properly. are you able to access a decent sleep doctor?

ajack wrote:you may need a bipap/bilevel, to ventilate properly. are you able to access a decent sleep doctor?

Sleep Doctor, no, but my Primary Care physician is also a pulmonologist, and he also thought the oxygen was a good idea. It's working, so "if it's not broke...."

It may well be the best option. My mother with asbestosis had O2 as a first treatment, followed by bilevel. If you use sleepyhead, it may give a guide to your minute vent and tidal volume.

jsielke wrote:

Finally, if you haven't done so, talk to a pulmonologist or sleep doc about this.

Did that. Amazed that I didn't need oxygen any time I exerted myself. I greatly benefited from what I learned in Pulmonary Rehab some 10 years ago.

jsielke wrote:

ajack wrote:you may need a bipap/bilevel, to ventilate properly. are you able to access a decent sleep doctor?

Sleep Doctor, no, but my Primary Care physician is also a pulmonologist, and he also thought the oxygen was a good idea. It's working, so "if it's not broke...."

I get the feeling there is a great deal of history and info missing here.
And I'm not sure there is a question or what the question is.

Not a question. I had hoped my experience might help others. Please forgive me for attempting to be helpful.

jsielke wrote:Not a question. I had hoped my experience might help others. Please forgive me for attempting to be helpful.

Thanks for sharing that, finally, that was helpful.