Bipap with supplemental oxygen

I am completely new to the bipap world. My daughter has a combo of central and obstructive sleep apnea. When we were first home with the bipap machine it took almost 2 weeks before we got the oxygen. During that two weeks, when we were just using the machine her SATs stayed at 97 and above. After we started using the oxygen at 3L, she slowly began getting strange symptoms and I called the doctors office and the doctor had me reduce the oxygen down to 1L. After a couple of days, all of the symptoms went away and she was taking off. We started physical therapy and exercising daily on the recombinant bike. Couple of the symptoms started coming back the last three or four days very very slowly and I'm just curious as to whether or not becoming more active and help her not need the oxygen anymore. During a nap today, we used the BiPAP machine and didn't use the oxygen and her SATs stayed at 97-99. The doctors office called and told me to turn it down from 1 L to 1/2L to begin with. Like I said, I'm just curious if becoming more active and getting in better shape can reduce the need for the supplemental oxygen.

There are apparently adverse effects of too much supplemental oxygen but what they are is completely outside of my experience. Others with respiratory therapy experience may be better able to comment.

I have noticed for myself and among others, setting a bi-level machine to higher than minimally necessary EPAP pressure can result in an increase in SpO2 values and perhaps that is what is happening. Since your doctor has sequentially directed you to reduce the supplementation, it may be that the therapy coupled with additional exercise has reduced and/or eliminated the need. If that's true, its a good thing.

Keep watching the SpO2 levels and keep communicating with your doctor. It sounds as if your doctor is being very careful.

Yes, exercise makes your muscles more efficient in utilizing oxygen and thus it is possible for you to to titrate your oxygen needs down if your oxygen saturation is improving. This is not always the case and it does not mean that if you train to run a marathon that you will for sure be able to discontinue the use of oxygen entirely. Some people will always need oxygen no matter what.

You will notice sometimes when exercising that your oxygen saturation will actually go up during the work out!

As long as your oxygen saturation does not go below 92 percent (any lower and the curve starts to descend steeply) then you do not need to increase your oxygen delivery. If she is consistently at 97 percent or higher with the Bi-PAP alone then IMO she does not need oxygen at all but of course that is up to the doctor.

Sounds like oxygen sensitivity to me. In a very select group of patients, too much oxygen suppresses the drive to breathe and CO2 builds up, resulting in drowsiness, lethargy, coma, etc.

What were the "strange symptoms"?