More questions about O2?

[frh]

I posted in a couple of topics that they put me on O2 the night after turbinate reduction surgery. I felt great the next day so I used my wife's spare oxygen concentrator to bleed O2 into my mask. If O2 is not my silver bullet, it's darned close to it. I have been using it for two weeks and so far it seems to be the one thing that made the biggest difference in treating my OSA symptoms. (By the way, I forgot to turn on the O2 two nights in a row and my short term memory went down the tubes, I felt tired and cranky, etc.)

After telling the sleep doc about the O2 (after the second night on it), he scheduled a follow-up sleep study Sunday night, August 15th. He didn't act like the O2 was a big deal, he kind of brushed it off. Truth is, I think he was more annoyed that I have data and am trying to take charge of my own therapy than anything else.

I asked these questions in this topic viewtopic/t54377/AHI-and-blood-oxgen-saturation.html, but I think another forum member's issues got in the way. So I feel like my questions did not get answered. Are there any sleep tech's (or anyone else who is qualified) who can elaborate on these questions:

1. Why does there seem to be a reluctance to recommend supplemental O2 with CPAP? (I think this one was answered in the other topic, but wonder if there are insurance issues with CPAP and O2?)

2. Is there anything I can say to the sleep tech that might influence his recommendations for the doc to write a prescription for supplemental O2? (Or for that matter is there anything I can say to the doc?)

3. Is CPAP the right kind of machine for someone with OSA and shallow breathing? (I know my heartbeat slows way down at night, but I don't really know if my breathing is shallow.)

4. Should I leave the ambien at home the night of the sleep study? (knowing I will not really get to sleep, and my AHI will be through the roof?)

[frh]

Bump... My sleep study is tomorrow night and I would really appreciate if any of the experts who frequent the forum would try to answer my questions.

Thanks in advance, Rick

[Desperate_in_DM]

I'd love to see the answer for question #3 as well. I've had several physicians tell me that I have shallow breathing and have a tendancy to hold my breathe (unbeknownst to me) while I'm awake. Also have really low pulse. During my sleep study the tech came in twice to check the pulse-ox and commented that my pulse was registering between 38-42BPM. I am in no way an athlete.

[Jayjonbeach]

I am new to therapy and don't have any answers but still wanted to pipe in.

I was VERY disappointed when I learnt that CPAP therapy was NOT going to be with Oxygen. I thought it was and I was quite sure that getting some REAL Oxygen (I live in Toronto and air quality is not the best here for sure) would be a HUGE help.

Hopefully someone will come by and answer a few questions for you/us, I'd like to know if hooking up oxygen to a S9 machine is possible and would a doctor ever recommend it if they thought it was going to help.....

[Mr Capers]

Hi frh,

I'm on supplemental O2 at night only. My prescription came about because I asked the RTs for the loan of a recording pulse oximeter so I could check my oxygen desaturation after several months on my BiPAP Auto servo ventilator. I desaturated on the report pretty severely, thus I was put on O2 supplemental. My sleep doc is a jerk as a person and appears to be borderline competent. I saw the oximetry report and the chief RT had written O2 @ 3L on it and added her name. Maybe she actually generated the prescription. I'm in an HMO and they showed no reluctance to add O2 to my prescription.

Bottom line, get your doc's office to let you do pulse oximetry at home where you sleep better using their machine. They will be quicker to believe their own machine than yours. But, a pulse oximeter is a good purchase for all of us. Reports from your CPAP may look fine, but you can still desaturate.

You gotta be your own advocate,
Mr Capers

[brazospearl]

What you could say to influence any of these medical people depends on them and your relationship to them, as well as the data from your study tomorrow night. I wonder if the doctor who did your surgery would be willing to write you a script for O2? Or is that the same one as your sleep doctor? I know any doctor can write a cpcp script, is that true for oxygen also?

[Julie]

Of course - any MD can write a script for just about anything medically called for, but whether in fact it is called for is another story. Cpap is supposed to do nothing more than help open your airway a bit to allow 'regular' air in. All of us will feel good on extra 02, but that doesn't mean we need it or should have it. There are problems that can go along with it as well and unless your MD (never mind the techs, they're not qualified) thinks you need it, you should stick with Cpap until a legitimate need is documented.

[Goofproof]

Maybe they don't want everyone on added O2, is they are afraid the body will adapt the new O2 levels as normal, then we'll have to ship people to a planet that has a higher O2 level than Earth. HMO's won't like that!

Too much O2 is dangerious, it can be a fire hazzard, a health hazzard, can cause organs to fail. Even worse is Human Combustion, and ending up a case on the X-Files. Jim

Added O2 probably would make most patients feel better, but with that feeling better, would we be better, or would the added O2 just mask underlying problems?

[Joel RRT]

When you evaluate a patients desaturation or any presentation of impired oxygenation you always follow a specific track. Its A B C. They stand for Airway, does the person have an un-impaired passageway to the lungs/alveoli? Breathing, if the airway is intact, are they breathing adequately? Circulation, If they have an open patent airway and they are breathing adequately, is there and impairment of the blood? Heart pumping well? Enough hemoglobin, enough circulation to the lungs? Is that hemoglobin functioning like it should? My point is, by self administering Oxygen to yourself you are bypassing many important questions that your MD should know about and possibly investigate. If your AHI is normal on the CPAP yet you are still tired, other things need to be investigated. As for the dangers of supplemental oxygen, there are risks in using it. Small, but they are still there. Thats why you still need a script in order to get it. Its a drug. In some cases it can cause changes/damage to your lung tissue. In patients with COPD it can cause CO2 retention. Bottom line, you need to talk to your MD about this.


Please note: I am not a physician, I am a respiratory therapist, and this is a very cursory answer to your questions about Oxygen and CPAP use.

[Jayjonbeach]

Some very good info in this thread already, hopefully it will keep going and thanks to those who posted.

I am very interested in the positive effects that Oxygen could have being added to therapy but the post right above me outlines some reasons why people should not being jumping right into it, and it was explained in another why doctors just don't jump to recommend it.

Having said that, I want my saturation level monitored and I want a copy of my orginal sleep study. Sadly here in Canada they changed the rules and now people are only allowed ONE sleep study per LIFETIME. Of course that is utterly ridiculous and hopefully that could be revised but for now I will have to be my own doctor in this regard.

I will give normal CPAP therapy a few months to see what happens, I am just starting and would like a picture of my SAT level now and each month down the road to see if things improve.

To the OP thanks for posting these questions and good luck in your upcoming study.

[BlackSpinner]

Sadly here in Canada they changed the rules and now people are only allowed ONE sleep study per LIFETIME. Of course that is utterly ridiculous and hopefully that could be revised but for now I will have to be my own doctor in this regard.

No, your province dictates the coverage, I know people who have had more then one study done here in Quebec. Besides you can have as many studies as you want if you or your personal insurance pays for it.

[Goofproof]

Some very good info in this thread already, hopefully it will keep going and thanks to those who posted.

I am very interested in the positive effects that Oxygen could have being added to therapy but the post right above me outlines some reasons why people should not being jumping right into it, and it was explained in another why doctors just don't jump to recommend it.

Having said that, I want my saturation level monitored and I want a copy of my orginal sleep study. Sadly here in Canada they changed the rules and now people are only allowed ONE sleep study per LIFETIME. Of course that is utterly ridiculous and hopefully that could be revised but for now I will have to be my own doctor in this regard.

I will give normal CPAP therapy a few months to see what happens, I am just starting and would like a picture of my SAT level now and each month down the road to see if things improve.

To the OP thanks for posting these questions and good luck in your upcoming study.

Before I'd go with another sleep study, I'd have a machine and software and reader to track my own progress. Now I have even gotten a CMS 50E Pulse Ox, to add another level of tools to monitor my health. I also have a blood pressure monitor and Glucose meter, my Defibulator is built in. My bedroom looks like a ER. Jim

[Slinky]

Yes, 02 is easily bled into S9 CPAP therapy. Its a simple matter of an addition of an adapter between the humidifier output and the mask hose.

See one here https://www.cpap.com/productpage/O2-Enr ... apter.html

[Goofproof]

Yes, 02 is easily bled into S9 CPAP therapy. Its a simple matter of an addition of an adapter between the humidifier output and the mask hose.

See one here https://www.cpap.com/productpage/O2-Enr ... apter.html

WARNING: Before you buy, make sure it has a flow check valve built into it and a vent to dump the O2 so it can't ever get into the HH and XPAP. Cheaper ones are on the market that just provide a port to hook the line to, those are not safe as the O2 flow can back up into the XPAP & HH, causing a fire hazzard, when and if the XPAP shuts off. Jim

[Slinky]

Or so I thought too, GoofProof, but two DME provider RRTs have told me that that is not the case. Both were willing to order in the more expensive adapters but said there really was no need. Even my local Resmed Rep and my local Respironics Rep have said the same thing; that cheap, basic adapter is sufficient and safe. Resmed even makes or provides one of the "cheaper" type as I remember it.