There was an increase in PaC02 from 40 to 43 mm Hg after oxygen administration. However, daytime sleepiness was not improved by oxygen administration. Alford and colleagues demonstrated that nasal oxygen at 4 L/min increased the length of sleep disordered breathing events, as well as arterial Pco2, resulting in a lower pH at the end of apneic events. However, nasal oxygen improved oxygen saturations throughout sleep and obliterated atrioventricular block in two subjects in their study, which included patients with COPD. Thus, our finding that oxygen administration improves oxygenation in patients with sleep-disordered breathing agrees with previous work.
This study demonstrates that oxygen is not beneficial in improving daytime somnolence in patients who have mild obstructive sleep apnea, while confirming the usefulness of nasal CPAP for this purpose. It also demonstrates that oxygen and nasal CPAP have comparable efficacy in improving neuropsychologic function, particularly in terms of improved visual attention. buy ortho tri-cyclen
We conclude that oxygen is not beneficial in improving daytime hypersomnolence compared with CPAP, nor does it improve the level of sleep-disordered breathing as effectively. On the other hand, oxygen might be beneficial for that subset of patients with sleep apnea for whom hypoxemia, hypertension, and cardiac arrhythmias are the primary sequelae, rather than daytime hypersomnolence. A controlled trial of o2 vs CPAP in more impaired OSA patients may also be warranted, particularly in patients who are CPAP intolerant.
Category: Obstructive Sleep Apnea
Tags: cardiac arrhythmias, diastolic blood pressure, hypopnea, obstructive sleep apnea