Adding Oxygen to CPAP

General Discussion on any topic relating to CPAP and/or Sleep Apnea.
drumma
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Adding Oxygen to CPAP

Post by drumma » Tue Apr 23, 2019 5:50 am

My doctor suggested I add 1 Litre of oxygen to my CPAP. Anyone else doing similar? What are you using for a concentrator? How's it working out for you?

I

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Julie
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Re: Adding Oxygen to CPAP

Post by Julie » Tue Apr 23, 2019 6:59 am

Why was the suggestion made to you? If Cpap is not working well, maybe we can help but would need info to go by - what machine (which model), pressure settings, what mask, history of problems, any meds? Etc. Some people use 02, but not many and only in specific circumstances. Too many MDs don't actually know much (if anything) about how Cpap works and tend to leave helping to DME's (or "let's try some 02 and see if it sticks")!

colomom
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Re: Adding Oxygen to CPAP

Post by colomom » Tue Apr 23, 2019 8:50 am

My son’s pulmonologist recently added O2 to his APAP. With the extra oxygen my son is sleeping better and his daytime fatigue and brain fog have lessened. We’ve already met our insurance deductible this year so renting a concentrator thru a DME does not cost us anything out of pocket for now. The concentrator they gave us is the Invacare Perfecto2, we’re happy with it. With our insurance the concentrator is a permanent rental, so when our insurance deductible resets next year I plan on purchasing a concentrator out of pocket. So far my research is pointing me toward the Everflow OPI, because i have been told that it is less noisy than other models.

Oxygen concentrators are a bit noisy so you may want to get a long enough hose to allow you to locate the concentrator outside of your bedroom, the respiratory therapist at the DME told me you can use up to 50 feet of hose.

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ChicagoGranny
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Re: Adding Oxygen to CPAP

Post by ChicagoGranny » Tue Apr 23, 2019 10:07 am

The OP mentioned COPD in an earlier thread.

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Goofproof
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Re: Adding Oxygen to CPAP

Post by Goofproof » Tue Apr 23, 2019 10:19 am

One LPM, isn't enough to help anything in XPAP, It would be vented out as fast as it went in, I use 3 LPM, that way I get some.

Downside, Cost, Heat in room with compressor, Noise (run in next room on 50 Ft MAX Green Tube) and last but not least cost for electric $10 to $20, a month. As far as COPD, not a clue, that's the one thing I don't have, YET! But 1 LPM, not helping... Jim
Use data to optimize your xPAP treatment!

"The art of medicine consists in amusing the patient while nature cures the disease." Voltaire

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Rexlan
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Re: Adding Oxygen to CPAP

Post by Rexlan » Tue Apr 23, 2019 10:59 am

I agree with Goofproof. 1L is a waste of time so I think you may want to look for a "new doctor" who knows what they are saying. I would also be sure you are working with a Pulmonologist and not just the primary care guy. More O2 than needed is not a good thing either.

I use O2 @ 2L but found that I had to increase to 3L with the APAP because of the natural venting it does. I have a Contec Pulse Ox and wore it a couple of nights and laid the graph in Sleepy Head. It showed a definite benefit at 3L and virtually none at 2L and I sleep better. So I would conclude that 1L is worthless.

I bought an Invacare Perfecto2 ($594) and am quite pleased with it. I put it in the master closet and put a 1/2" hole through the wall. Ran a 25' line on the floor along side the wall to the headboard of the bed. Zero noise and out of sight.

I also billed Blue Cross Blue Shield for it and they re-coded it as a rental and only paid 50% - out of network.. I made an appeal and told them they would need to pay me for the purchase (they said Medicare did not allow purchase). I said OK - then you treated it as a rental and I am happy to bill you monthly for the rental (from me) and you can pay $136/month for 36 months instead of giving me the 80% of $594 I asked for - works for me!! Still in the fight but I am reasonably confident I will prevail.

Dan_McD
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Re: Adding Oxygen to CPAP

Post by Dan_McD » Tue Apr 23, 2019 11:16 pm

I have OSA AND COPD. I add 1L to my Dreamstation thru a 25 ft hose. It has been helpful in keeping my o2 in the 88 to 92 saturation range consistently nocturnally. It has been proven thru studies that people with COPD for any length of time, their body will adjust to the 88-92 range and adding more oxygen can be detrimental. I started with an Invacare rental that had 14000 hours on it with dirty filters and a disappointing service agreement from the DME. It was noisy, noisy. I purchased an Everflo Q and it has been great. It is quiet except for the occasional compressor valve relief (soft thump). I use it in my bedroom. My dog got used to it, she sleeps at the end of my bed on the floor. My wife stopped complaining because the Invacare was waking her up. I'm not going to say that people that say 1L is worthless do not know what they are talking about, but I will say after 3 oximitry tests, the 1L makes about a 2% increase in my o2 level, particularly in REM. FWIW, my saturation pre-cpap was 74% during REM. I do not need or use oxygen during the day.

Edit: Changed mistake Evercare to correct name Everflo.

Dan_McD
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Re: Adding Oxygen to CPAP

Post by Dan_McD » Wed Apr 24, 2019 10:23 am

A quote from wiki..... "Prevention
In people with chronic obstructive pulmonary disease, carbon dioxide toxicity can be prevented by careful control of the supplemental oxygen. Just enough oxygen is given to maintain an oxygen saturation of 88 - 92%.[6]

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https://en.wikipedia.org/wiki/Effect_of ... ry_disease

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Rexlan
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Re: Adding Oxygen to CPAP

Post by Rexlan » Wed Apr 24, 2019 10:58 am

I guess one can find any data they want. However, if one does not need daytime O2 I do not think adding a 1L flow at night into the Dream Station is measurable. My data suggest that it is not with using the APAP with and without the O2 and by using just the O2 alone. In fact, My levels are better with the APAP alone as opposed to just the O2 alone. Other's mileage may vary and it may come down to how much of an increase is 1L really delivering when 50% of the air is vented initially unless you are introducing it directly at the mask.

Supplemental nocturnal oxygen does improve arterial oxygen saturation during sleep. However, it also appears to increase the severity of apnea-hypopnea events, which have been theorized to have distinct deleterious effects on the heart independent of hypoxemia. For this reason, supplemental oxygen therapy is not recommended as a primary therapy for obstructive sleep apnea in expert guidelines.

Conclusion:

This review shows that O2 therapy significantly improves oxygen saturation in patients with OSA. However, it may also increase the duration of apnea-hypopnea events.

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raisedfist
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Re: Adding Oxygen to CPAP

Post by raisedfist » Wed Apr 24, 2019 12:38 pm

This is best done by trial and error if indeed supplemental oxygen needs to be implemented into the PAP therapy. It's always best to start with 1L and go from there. The first step is to make sure the PAP therapy is optimized, as actual concrete sleep disordered breathing events that cause oxygen desaturation should be addressed by PAP therapy as best as possible before resorting to oxygen. Then, you add just enough O2 to reach your target goal. It's generally stated that 90% and above oxygen saturation while sleeping is sufficient. Occasional dips to 88% during REM sleep are fine as well.

Supplemental oxygen addresses hypoxemia but it doesn't address your apnea, or in the case of copd, any potential hypo/under ventilation - and can even make that worse.
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drumma
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Re: Adding Oxygen to CPAP

Post by drumma » Sun May 19, 2019 10:05 am

The 1 litre addition has been working well. i had issues with the "Iron Lung" rental because instructions state turn on CPAP before turning on concentrator. Impossible task if unit 25- 50 feet away. Machine too loud to keep in room. Switched to a Simply go and it is so quiet, can go to 2 litre continuous and beats the hell out of scuba tanks (joke) I used during the day. Easily can maintain mid 90's. My heated Air sense 10 is pre set and monitored by supplier with doctor report access. Presuure is 15 and I use mostly an Air fit FFM . sometimes an air touch,, and sometime a Simplus FFM

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ChicagoGranny
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Re: Adding Oxygen to CPAP

Post by ChicagoGranny » Sun May 19, 2019 2:03 pm

drumma wrote:
Sun May 19, 2019 10:05 am
the "Iron Lung" rental because instructions state turn on CPAP before turning on concentrator.
Wonder why that is :?: :?:

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palerider
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Re: Adding Oxygen to CPAP

Post by palerider » Sun May 19, 2019 2:09 pm

ChicagoGranny wrote:
Sun May 19, 2019 2:03 pm
drumma wrote:
Sun May 19, 2019 10:05 am
the "Iron Lung" rental because instructions state turn on CPAP before turning on concentrator.
Wonder why that is :?: :?:
So you don't fill the cpap with near pure oxygen, just in case there's any kind of ignition source.
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Accounts to put on the foe list: mper!?, DreamDiver, Geer1, almostadoctor, sleepgeek, ajack, stom, mogy, D.H., They're often post misleading, timewasting stuff.

Dan_McD
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Re: Adding Oxygen to CPAP

Post by Dan_McD » Sun May 19, 2019 2:53 pm

Rexlan wrote:
Wed Apr 24, 2019 10:58 am
I guess one can find any data they want. However, if one does not need daytime O2 I do not think adding a 1L flow at night into the Dream Station is measurable. My data suggest that it is not with using the APAP with and without the O2 and by using just the O2 alone. In fact, My levels are better with the APAP alone as opposed to just the O2 alone. Other's mileage may vary and it may come down to how much of an increase is 1L really delivering when 50% of the air is vented initially unless you are introducing it directly at the mask.

Supplemental nocturnal oxygen does improve arterial oxygen saturation during sleep. However, it also appears to increase the severity of apnea-hypopnea events, which have been theorized to have distinct deleterious effects on the heart independent of hypoxemia. For this reason, supplemental oxygen therapy is not recommended as a primary therapy for obstructive sleep apnea in expert guidelines.

Conclusion:

This review shows that O2 therapy significantly improves oxygen saturation in patients with OSA. However, it may also increase the duration of apnea-hypopnea events.
I hate it when people blow off what I said worked FOR ME. Your Quote:"Others mileage may vary".

Also you said "as opposed to using just the O2 alone". And then post data that says "For this reason, supplemental oxygen therapy is not recommended as a primary therapy for obstructive sleep apnea in expert guidelines"

Your posted data, if that is your defense, is in conflict with your "Opinion/Conclusion/Usage".

If your post is indicative that you have OSA and does not indicate you have COPD, then you should not voice your conclusion, battering those of us that actually have experience with both disorders.

Additionally, there has not been a recognized study since 1999, that can say for certain, yay or nay that supplemental nocturnal oxygen is or is not beneficial for patients that have both OSA and COPD. Only that caution should be given in the over kill of supplying oxygen to COPD patients and that was particularly directed to ER professionals.

The 1L of O2 added to my APAP tube works for me. It may or may not work for all.

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Rexlan
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Re: Adding Oxygen to CPAP

Post by Rexlan » Sun May 19, 2019 3:17 pm

Dan_McD wrote:
Sun May 19, 2019 2:53 pm
Rexlan wrote:
Wed Apr 24, 2019 10:58 am
I guess one can find any data they want. However, if one does not need daytime O2 I do not think adding a 1L flow at night into the Dream Station is measurable. My data suggest that it is not with using the APAP with and without the O2 and by using just the O2 alone. In fact, My levels are better with the APAP alone as opposed to just the O2 alone. Other's mileage may vary and it may come down to how much of an increase is 1L really delivering when 50% of the air is vented initially unless you are introducing it directly at the mask.

Supplemental nocturnal oxygen does improve arterial oxygen saturation during sleep. However, it also appears to increase the severity of apnea-hypopnea events, which have been theorized to have distinct deleterious effects on the heart independent of hypoxemia. For this reason, supplemental oxygen therapy is not recommended as a primary therapy for obstructive sleep apnea in expert guidelines.

Conclusion:

This review shows that O2 therapy significantly improves oxygen saturation in patients with OSA. However, it may also increase the duration of apnea-hypopnea events.
I hate it when people blow off what I said worked FOR ME. Your Quote:"Others mileage may vary".

Also you said "as opposed to using just the O2 alone". And then post data that says "For this reason, supplemental oxygen therapy is not recommended as a primary therapy for obstructive sleep apnea in expert guidelines"

Your posted data, if that is your defense, is in conflict with your "Opinion/Conclusion/Usage".

If your post is indicative that you have OSA and does not indicate you have COPD, then you should not voice your conclusion, battering those of us that actually have experience with both disorders.

Additionally, there has not been a recognized study since 1999, that can say for certain, yay or nay that supplemental nocturnal oxygen is or is not beneficial for patients that have both OSA and COPD. Only that caution should be given in the over kill of supplying oxygen to COPD patients and that was particularly directed to ER professionals.

The 1L of O2 added to my APAP tube works for me. It may or may not work for all.



:lol: :lol: You would know for sure if you were "battered" by me ... trust me on that ... :lol: :lol:

I hate it when people get their panties in a wad when they are wrong as can be and late to report it as well !!! ... :lol: :lol: :lol: :lol:

But hey ... As said - your mileage may vary. Mine, between the COPD and the OSA I am around 2 liters ... :lol: :lol:

I certainly hope you feel better and fully vindicated ... I know I do.

Chill out my friend ... it isn't a competition