tag:blogger.com,1999:blog-12660458.post114367000383691450..comments2023-09-01T10:33:09.297-04:00Comments on Pulmonary Roundtable: Quick sleep questionUnknownnoreply@blogger.comBlogger3125tag:blogger.com,1999:blog-12660458.post-1146031745577564192006-04-26T02:09:00.000-04:002006-04-26T02:09:00.000-04:00Oxygen can actually stabilize sleep stage and prev...Oxygen can actually stabilize sleep stage and prevent central sleep apnea. Furthermore, oxygen can actually improve OSA thru central mechanisms (loop gain etc). I have read at least two studies in past week where our tech started patient on O2 when they refused CPAP during split night PSG. In both, there was a significant decrease in AHI. However, if OSA is severe, I would continue to push patient for CPAP therapy.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-12660458.post-1143755746359146842006-03-30T16:55:00.000-05:002006-03-30T16:55:00.000-05:00The only thing that would worry me is that nocturn...The only thing that would worry me is that nocturnal oxygen can worsen central apneas. <BR/><BR/>Has your patient tried the nasal pillows; it is not much different than nasal prongs.<BR/><BR/>Nonetheless, I have prescribed nasal oxygen with <BR/>the hope of preventing the cardiovascular side effects (see JCH references) and attempting to "play-up" the EDS side effects in the patients so they ultimately decide to use CPAP.<BR/><BR/>Another thing that you could try is a dental appliance. There are plenty of sites on the web that advertise. I am sure that some dentists in rural Tennessee who make them...<BR/>http://www.medicalnewstoday.com/medicalnews.php?newsid=13666Mike Lhttps://www.blogger.com/profile/12177750268091750583noreply@blogger.comtag:blogger.com,1999:blog-12660458.post-1143752135899835452006-03-30T15:55:00.000-05:002006-03-30T15:55:00.000-05:00I think that is a great question. I do not know t...I think that is a great question. I do not know the sleep literature at all, but with a quick lit search I found the following:<BR/><BR/>1) Treatment with 1-2L oxygen (but not compressed air), increased NO levels in patients with OSA, suggesting a "vasodilatory effect." This could impact pulmonary hypertension in these patients.<BR/>*Teramoto, Sleep Med. 2003 Sep;4(5):403-7<BR/><BR/>2)Oxygen treatment (with a non-rebreather) can decrease sympathetic nerve activity in patients with OSA, and thereby attenuate hypoxia-related vasoconstriction and hypertension associated with apneic episodes <BR/>*Imadojemu VA, Am J Respir Crit Care Med. 2002 Jan 1;165(1):61-6. <BR/><BR/>3) "Oxygen administration for the correction of OSA-related nocturnal hypoxemia was both safe and effective in alleviation of OSA-related symptoms. It also appeared to have a beneficial effect on minimum oxygen saturation levels. Thus, oxygen therapy may be considered a treatment option in patients who fail to comply with CPAP and are not candidates for a surgical procedure."<BR/>*Landsberg R, Am J Rhinol. 2001 Sep-Oct;15(5):311-3<BR/><BR/>4) However, nocturnal oxygen administration does not improve intelligence in men who snore. <BR/>*Block AJ, Chest. 1989 Feb;95(2):274-8.<BR/><BR/>5) Low flow oxygen improved sleep architecture and patients felt better, but did not perform better on a multiple-sleep-latency test<BR/>*Smith PL,Am Rev Respir Dis. 1984 Dec;130(6):958-63<BR/><BR/>So, looks like a reasonable intervention to me. And, that will be the extent of my reading regarding the sleep disordered breathing for the rest of the year.Jeff Hhttps://www.blogger.com/profile/01209432708535732499noreply@blogger.com