Oxygen

Use of supplemental oxygen in patients with OSA results in substantial improvements in nocturnal desaturation and cardiac bradyarrhythmias; however, because the underlying pathophysiology is not changed, only modest reductions in the AHI are seen (69). Variable effects on hypersomnolence are seen with oxygen therapy with some studies showing improvement (70) and others showing no change (71,72). Hence, oxygen cannot be considered a first-line treatment for OSA, but may be considered as a temporizing measure if significant hypoxemia is present and CPAP or other therapies cannot be tolerated (73). Furthermore, oxygen should be considered in patients with substantial desaturation despite adequate CPAP therapy. These patients often have concomitant pulmonary pathology (e.g., emphysema).

Transtracheal delivery of oxygen is another mode of oxygen delivery that has showed promise. Delivery of oxygen below the level of obstruction appears to be a more effective strategy for stabilizing respiration. Two studies have shown improvement in AHI and subjective symptoms in patients treated with transtracheal oxygen (74,75). Data are quite limited; however, the relative invasiveness of this procedure limits its use to patients with severe desaturation in whom alternative measures have been unsuccessful.

Sleep Apnea

Sleep Apnea

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