Sleep apnea, a common disorder that affects millions of people worldwide, is characterized by repeated pauses in breathing during sleep, which can lead to low oxygen levels in the blood and tissues, as well as disrupted sleep quality and daytime functioning. In this article, we will look at the benefits and drawbacks of using medical oxygen for sleep apnea as a treatment.

One of the main treatments for sleep apnea is continuous positive airway pressure (CPAP) therapy, which involves wearing a mask that delivers pressurized air to keep the airway open during sleep. However, some people may not tolerate or adhere to CPAP therapy due to various reasons, thus medical oxygen may be used as an alternative or adjunctive treatment.

Medical oxygen delivers pure oxygen to the lungs through a nasal cannula or a mask and can increase the oxygen level in the blood and tissues and prevent or treat hypoxemia, which is a condition that occurs when the oxygen level is below normal. Medical oxygen may also have some beneficial effects on the heart and brain function in people with sleep apnea.

Medical oxygen may also have some limitations and risks, therefore, medical oxygen should be used with caution and under medical supervision in people with sleep apnea.

Benefits of Medical Oxygen for Sleep Apnea

Medical oxygen can have some benefits for people with sleep apnea, especially those who have severe or refractory hypoxemia, which means that their oxygen level remains low despite using CPAP therapy or other treatments. Medical oxygen can:

• Increase the amount of oxygen in the blood and tissues and prevent or treat hypoxemia, which can cause various symptoms and complications, such as fatigue, headache, impaired cognition, heart failure, pulmonary hypertension, or death.

• Improve the oxygen saturation, which is the percentage of haemoglobin bound to oxygen in the blood.
• Reduce the cardiovascular risk in people with sleep apnea by lowering the blood pressure, heart rate, and cardiac output that can increase due to hypoxemia and sympathetic activation during sleep.
• Prevent or treat the cardiac arrhythmias, such as atrial fibrillation or ventricular tachycardia, that can occur due to hypoxemia and oxidative stress during sleep.
• Protect the endothelial function and reduce the inflammation and thrombosis that can contribute to atherosclerosis and vascular disease in people with sleep apnea.

Drawbacks of Medical Oxygen for Sleep Apnea

Medical oxygen can also have some drawbacks for people with sleep apnea, especially those who have mild or moderate hypoxemia, which means that their oxygen level is only slightly below normal or within normal range. Some of these drawbacks are that medical oxygen:

• Does not address the underlying cause of sleep apnea, which is the obstruction of the airway.
• May not be able to prevent or treat the other consequences of sleep apnea, such as metabolic syndrome, insulin resistance, or neurocognitive impairment.
• May not be able to improve the subjective symptoms of sleep apnea, such as snoring, gasping, or choking.
• Can cause carbon dioxide retention in some people with sleep apnea, especially those who have chronic obstructive pulmonary disease (COPD) or obesity hypoventilation syndrome (OHS). Carbon dioxide retention occurs when the high level of oxygen suppresses the breathing drive and reduces the ventilation of carbon dioxide from the lungs.
• Can cause oxygen toxicity in some people with sleep apnea, especially those who use high concentrations or flows of oxygen for a long time. Oxygen toxicity occurs when the excess level of oxygen causes damage to the cells and tissues by generating reactive oxygen species (ROS) and oxidative stress.
• Ccan cause a fire hazard in some people with sleep apnea, especially those who smoke or use open flames near their oxygen device.

Indications and Contraindications

Medical oxygen is not suitable for everyone with sleep apnea, and it should be used only under certain conditions and with medical supervision:

Medical oxygen may be indicated for people with sleep apnea who:

• Have severe or refractory hypoxemia, which means that their oxygen level remains low despite using CPAP therapy or other treatments.
• Have comorbid conditions that require oxygen therapy, such as COPD, heart failure, or pulmonary fibrosis.
• Cannot tolerate or adhere to CPAP therapy due to various reasons, such as discomfort, inconvenience, cost, or side effects.

Medical oxygen may be contraindicated for people with sleep apnea who:

• Have mild or moderate hypoxemia, which means that their oxygen level is only slightly below normal or within normal range.
• Have a high risk of carbon dioxide retention, such as those with COPD or OHS.
• Have a history of smoking or fire accidents.

Recommendations and Precautions of Medical Oxygen for Sleep Apnea

Medical oxygen should be used with caution and under medical supervision in people with sleep apnea. You should:

• Consult your doctor and get a prescription that specifies your oxygen needs, such as the type, amount, duration, and frequency of oxygen therapy.
• Follow your doctor’s instructions on how to use and adjust your oxygen device and monitor your oxygen level and carbon dioxide level regularly.
• Choose the right device that meets your oxygen needs and preferences.
• Use your device safely and avoid any potential hazards or complications.
• Avoid smoking and open flames near your device and keep it away from heat sources and flammable materials.

Avoid using too much or too little oxygen and adjust it according to your doctor’s prescription.