Table of ContentsView AllTable of ContentsOxygen in Sleep ApneaWhy Oxygen May Not Be EnoughBoth Oxygen and CPAP
Table of ContentsView All
View All
Table of Contents
Oxygen in Sleep Apnea
Why Oxygen May Not Be Enough
Both Oxygen and CPAP
Oxygen therapy for obstructive sleep apnea (OSA) treatment is not a first-line treatment. It might help, though oxygen typically may not be considered unlesscontinuous positive airway pressure (CPAP), surgery, and other treatments have not met with success.Some studies suggest oxygen can help certain people due to what’s called “loop gain,” a measure of stability in the mechanics of breathing that tends to be high in people diagnosed with OSA. Low arousal threshold is another metric for the drive to breathe. Oxygen therapy may help when these factors are at work, though more research is needed.Astronaut Images / Getty ImagesOxygen in Sleep ApneaOxygen can be given through a mask or with prongs (called nasal cannula) that sit in the nostrils.It may prove an option in treating OSA.As the understanding of obstructive sleep apnea (OSA) advances, researchers increasingly note that treatment success varies with the individual. Not everyone will respond to standard treatments, nor are they all compliant with their CPAP therapy or other measures.As personalized approaches become more common, they’re based on specific features of OSA including:Structural airway collapse in thepharynx(the airway doesn’t stay open)Changes in how muscles in the pharynx compensate during breathingElevated loop gain, an exaggeration in the respiratory driveA lower threshold of respiratory arousal (it takes less stimuli to interrupt sleep)Typically, these factors are assessed under lab conditions but new approaches may allow them to be identified during routine sleep studies. Sleep studies are completed when a healthcare provider wants to confirm an OSA diagnosis or the response to treatments for it.Whether someone can benefit from oxygen therapy for OSA can depend on understanding how these factors are at work and the individual’s response to supplemental oxygen. There’s evidence to suggest that oxygen can help people with high loop gain but less intense pharyngeal features, but not necessarily in all types and cases.Obstructive sleep apnea can cause oxygen levels to drop while you sleep.Overnight oximetryis used to monitor the oxygen levels and pulse rate during sleep studies or, sometimes, at home. You havehypoxemiaif oxygen levels in your blood dip below 88% for more than five minutes.Why Oxygen May Not Be EnoughThere’s still controversy over whether supplemental oxygen can benefit people with OSA but otherwise normal respiratory function. For one thing, the structural features of OSA (like airway collapse) don’t change with oxygen therapy. More oxygen can’t help if it doesn’t reach the lungs.For oxygen, research yields mixed results. Some studies find that oxygen’s effect on theapnea-hypopnea index (AHI), a key measure of sleep apnea, is minimal. Other studies find a modest benefit that increases dramatically in people with specific OSA factors.A 2023 review of 27 oxygen therapy studies found that supplemental oxygen improved AHI and oxygen saturation in the blood, but CPAP was considerably more effective at lowering AHI.Oxygen doesn’t improve the levels of excessive carbon dioxide that may accumulate during sleep, which can be dangerous.It also may not improve excessive daytime sleepiness.The use of supplemental oxygen may mislead people who think their OSA is adequately treated without CPAP or other treatment. This can leave them at greater risk for cardiovascular conditions like stroke or a heart attack. Some studies find that CPAP lowers the risk of complications like high blood pressure but oxygen alone does not.Both Oxygen and CPAPBecause OSA is associated with high blood pressure, researchers have looked into the role of supplemental oxygen in addition to CPAP.A 2019 study found the oxygen virtually eliminated a rise in morning blood pressure common with OSA but didn’t address other symptoms.This led to a conclusion that the blood pressure rise is due to the hypoxia and not sleep interruption, which is at odds with older research findings.More research is needed to see if both used together is an effective approach.Oxygen for Sleep Apnea With COPDOxygen can be used to treat people withchronic obstructive pulmonary disease (COPD), such as emphysema. But the use of oxygen to treat OSA without CPAP orbilevel therapycan actually cause breathing to worsen in someone who also has COPD.SummaryOxygen therapy remains controversial in the treatment of obstructive sleep apnea, with mixed research evidence for its benefits with or instead of CPAP. As the science advances, a better understanding of specific factors at work in OSA may lead to more personalized approaches in which oxygen therapy may improve symptoms.If you’re concerned about your breathing during sleep, speak with a board-certified sleep specialist and get the treatment you need. A formal sleep study may be the first step toward optimizing your health and well-being.
Oxygen therapy for obstructive sleep apnea (OSA) treatment is not a first-line treatment. It might help, though oxygen typically may not be considered unlesscontinuous positive airway pressure (CPAP), surgery, and other treatments have not met with success.
Some studies suggest oxygen can help certain people due to what’s called “loop gain,” a measure of stability in the mechanics of breathing that tends to be high in people diagnosed with OSA. Low arousal threshold is another metric for the drive to breathe. Oxygen therapy may help when these factors are at work, though more research is needed.
Astronaut Images / Getty Images
Oxygen can be given through a mask or with prongs (called nasal cannula) that sit in the nostrils.It may prove an option in treating OSA.
As the understanding of obstructive sleep apnea (OSA) advances, researchers increasingly note that treatment success varies with the individual. Not everyone will respond to standard treatments, nor are they all compliant with their CPAP therapy or other measures.
As personalized approaches become more common, they’re based on specific features of OSA including:
Typically, these factors are assessed under lab conditions but new approaches may allow them to be identified during routine sleep studies. Sleep studies are completed when a healthcare provider wants to confirm an OSA diagnosis or the response to treatments for it.
Whether someone can benefit from oxygen therapy for OSA can depend on understanding how these factors are at work and the individual’s response to supplemental oxygen. There’s evidence to suggest that oxygen can help people with high loop gain but less intense pharyngeal features, but not necessarily in all types and cases.
Obstructive sleep apnea can cause oxygen levels to drop while you sleep.Overnight oximetryis used to monitor the oxygen levels and pulse rate during sleep studies or, sometimes, at home. You havehypoxemiaif oxygen levels in your blood dip below 88% for more than five minutes.
There’s still controversy over whether supplemental oxygen can benefit people with OSA but otherwise normal respiratory function. For one thing, the structural features of OSA (like airway collapse) don’t change with oxygen therapy. More oxygen can’t help if it doesn’t reach the lungs.
For oxygen, research yields mixed results. Some studies find that oxygen’s effect on theapnea-hypopnea index (AHI), a key measure of sleep apnea, is minimal. Other studies find a modest benefit that increases dramatically in people with specific OSA factors.
A 2023 review of 27 oxygen therapy studies found that supplemental oxygen improved AHI and oxygen saturation in the blood, but CPAP was considerably more effective at lowering AHI.
Oxygen doesn’t improve the levels of excessive carbon dioxide that may accumulate during sleep, which can be dangerous.It also may not improve excessive daytime sleepiness.
The use of supplemental oxygen may mislead people who think their OSA is adequately treated without CPAP or other treatment. This can leave them at greater risk for cardiovascular conditions like stroke or a heart attack. Some studies find that CPAP lowers the risk of complications like high blood pressure but oxygen alone does not.
Because OSA is associated with high blood pressure, researchers have looked into the role of supplemental oxygen in addition to CPAP.
A 2019 study found the oxygen virtually eliminated a rise in morning blood pressure common with OSA but didn’t address other symptoms.This led to a conclusion that the blood pressure rise is due to the hypoxia and not sleep interruption, which is at odds with older research findings.
More research is needed to see if both used together is an effective approach.
Oxygen for Sleep Apnea With COPDOxygen can be used to treat people withchronic obstructive pulmonary disease (COPD), such as emphysema. But the use of oxygen to treat OSA without CPAP orbilevel therapycan actually cause breathing to worsen in someone who also has COPD.
Oxygen for Sleep Apnea With COPD
Oxygen can be used to treat people withchronic obstructive pulmonary disease (COPD), such as emphysema. But the use of oxygen to treat OSA without CPAP orbilevel therapycan actually cause breathing to worsen in someone who also has COPD.
Summary
Oxygen therapy remains controversial in the treatment of obstructive sleep apnea, with mixed research evidence for its benefits with or instead of CPAP. As the science advances, a better understanding of specific factors at work in OSA may lead to more personalized approaches in which oxygen therapy may improve symptoms.
If you’re concerned about your breathing during sleep, speak with a board-certified sleep specialist and get the treatment you need. A formal sleep study may be the first step toward optimizing your health and well-being.
12 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Lv R, Liu X, Zhang Y, Dong N, Wang X, He Y,et al.Pathophysiological mechanisms and therapeutic approaches in obstructive sleep apnea syndrome.Signal Transduct Target Ther. 2023 May 25;8(1):218. doi:10.1038/s41392-023-01496-3Joosten SA, Tan M, Wong AM, Landry SA, Leong P, Sands SA,et al.A randomized controlled trial of oxygen therapy for patients who do not respond to upper airway surgery for obstructive sleep apnea.J Clin Sleep Med. 2021 Mar 1;17(3):445-452. doi:10.5664/jcsm.8920Ruan B, Nagappa M, Rashid-Kolvear M, Zhang K, Waseem R, Englesakis M,et al.The effectiveness of supplemental oxygen and high-flow nasal cannula therapy in patients with obstructive sleep apnea in different clinical settings: A systematic review and meta-analysis.J Clin Anesth. 2023 Sep;88:111144. doi:10.1016/j.jclinane.2023.111144Koka V, De Vito A, Roisman G, Petitjean M, Filograna Pignatelli GR, Padovani D,et al.Orofacial Myofunctional Therapy in Obstructive Sleep Apnea Syndrome: A Pathophysiological Perspective.Medicina (Kaunas). 2021 Apr 1;57(4):323. doi:10.3390/medicina57040323Sands SA, Edwards BA, Terrill PI, Butler JP, Owens RL, Taranto-Montemurro L,et al.Identifying obstructive sleep apnoea patients responsive to supplemental oxygen therapy.Eur Respir J. 2018 Sep 27;52(3):1800674. doi:10.1183/13993003.00674-2018Semelka M, Wilson J, Floyd R.Diagnosis and treatment of obstructive sleep apnea in adults.Am Fam Physician. 2016;94(5):355-60.Xie J, Sert kuniyoshi FH, Covassin N, et al.Nocturnal hypoxemia due to obstructive sleep apnea Is an independent predictor of poor prognosis after myocardial infarction.J Am Heart Assoc. 2016;5(8). doi:10.1161/JAHA.115.003162.Ruan B, Nagappa M, Rashid-Kolvear M, Zhang K, Waseem R, Englesakis M,et al.The effectiveness of supplemental oxygen and high-flow nasal cannula therapy in patients with obstructive sleep apnea in different clinical settings: A systematic review and meta-analysis.J Clin Anesth. 2023 Sep;88:111144. doi:10.1016/j.jclinane.2023.111144Gottlieb DJ.Supplemental oxygen for obstructive sleep apnea: is there a role after all?.Am J Respir Crit Care Med. 2019;199(2):140-141. doi:10.1164/rccm.201807-1216ED .Aboussouan LS, Bhat A, Coy T, Kominsky A.Treatments for obstructive sleep apnea: CPAP and beyond.Cleve Clin J Med. 2023 Dec 1;90(12):755-765. doi:10.3949/ccjm.90a.23032Turnbull CD, Sen D, Kohler M, Petousi N, Stradling JR.Effect of supplemental oxygen on blood pressure in obstructive sleep apnea (SOX). A randomized continuous positive airway pressure withdrawal trial.Am J Respir Crit Care Med. 2019;199(2):211-219. doi:10.1164/rccm.201802-0240OC.van Zeller M, McNicholas WT.Sleep disordered breathing: OSA-COPD overlap.Expert Rev Respir Med. 2024 Jun;18(6):369-379. doi:10.1080/17476348.2024.2373790
12 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Lv R, Liu X, Zhang Y, Dong N, Wang X, He Y,et al.Pathophysiological mechanisms and therapeutic approaches in obstructive sleep apnea syndrome.Signal Transduct Target Ther. 2023 May 25;8(1):218. doi:10.1038/s41392-023-01496-3Joosten SA, Tan M, Wong AM, Landry SA, Leong P, Sands SA,et al.A randomized controlled trial of oxygen therapy for patients who do not respond to upper airway surgery for obstructive sleep apnea.J Clin Sleep Med. 2021 Mar 1;17(3):445-452. doi:10.5664/jcsm.8920Ruan B, Nagappa M, Rashid-Kolvear M, Zhang K, Waseem R, Englesakis M,et al.The effectiveness of supplemental oxygen and high-flow nasal cannula therapy in patients with obstructive sleep apnea in different clinical settings: A systematic review and meta-analysis.J Clin Anesth. 2023 Sep;88:111144. doi:10.1016/j.jclinane.2023.111144Koka V, De Vito A, Roisman G, Petitjean M, Filograna Pignatelli GR, Padovani D,et al.Orofacial Myofunctional Therapy in Obstructive Sleep Apnea Syndrome: A Pathophysiological Perspective.Medicina (Kaunas). 2021 Apr 1;57(4):323. doi:10.3390/medicina57040323Sands SA, Edwards BA, Terrill PI, Butler JP, Owens RL, Taranto-Montemurro L,et al.Identifying obstructive sleep apnoea patients responsive to supplemental oxygen therapy.Eur Respir J. 2018 Sep 27;52(3):1800674. doi:10.1183/13993003.00674-2018Semelka M, Wilson J, Floyd R.Diagnosis and treatment of obstructive sleep apnea in adults.Am Fam Physician. 2016;94(5):355-60.Xie J, Sert kuniyoshi FH, Covassin N, et al.Nocturnal hypoxemia due to obstructive sleep apnea Is an independent predictor of poor prognosis after myocardial infarction.J Am Heart Assoc. 2016;5(8). doi:10.1161/JAHA.115.003162.Ruan B, Nagappa M, Rashid-Kolvear M, Zhang K, Waseem R, Englesakis M,et al.The effectiveness of supplemental oxygen and high-flow nasal cannula therapy in patients with obstructive sleep apnea in different clinical settings: A systematic review and meta-analysis.J Clin Anesth. 2023 Sep;88:111144. doi:10.1016/j.jclinane.2023.111144Gottlieb DJ.Supplemental oxygen for obstructive sleep apnea: is there a role after all?.Am J Respir Crit Care Med. 2019;199(2):140-141. doi:10.1164/rccm.201807-1216ED .Aboussouan LS, Bhat A, Coy T, Kominsky A.Treatments for obstructive sleep apnea: CPAP and beyond.Cleve Clin J Med. 2023 Dec 1;90(12):755-765. doi:10.3949/ccjm.90a.23032Turnbull CD, Sen D, Kohler M, Petousi N, Stradling JR.Effect of supplemental oxygen on blood pressure in obstructive sleep apnea (SOX). A randomized continuous positive airway pressure withdrawal trial.Am J Respir Crit Care Med. 2019;199(2):211-219. doi:10.1164/rccm.201802-0240OC.van Zeller M, McNicholas WT.Sleep disordered breathing: OSA-COPD overlap.Expert Rev Respir Med. 2024 Jun;18(6):369-379. doi:10.1080/17476348.2024.2373790
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Lv R, Liu X, Zhang Y, Dong N, Wang X, He Y,et al.Pathophysiological mechanisms and therapeutic approaches in obstructive sleep apnea syndrome.Signal Transduct Target Ther. 2023 May 25;8(1):218. doi:10.1038/s41392-023-01496-3Joosten SA, Tan M, Wong AM, Landry SA, Leong P, Sands SA,et al.A randomized controlled trial of oxygen therapy for patients who do not respond to upper airway surgery for obstructive sleep apnea.J Clin Sleep Med. 2021 Mar 1;17(3):445-452. doi:10.5664/jcsm.8920Ruan B, Nagappa M, Rashid-Kolvear M, Zhang K, Waseem R, Englesakis M,et al.The effectiveness of supplemental oxygen and high-flow nasal cannula therapy in patients with obstructive sleep apnea in different clinical settings: A systematic review and meta-analysis.J Clin Anesth. 2023 Sep;88:111144. doi:10.1016/j.jclinane.2023.111144Koka V, De Vito A, Roisman G, Petitjean M, Filograna Pignatelli GR, Padovani D,et al.Orofacial Myofunctional Therapy in Obstructive Sleep Apnea Syndrome: A Pathophysiological Perspective.Medicina (Kaunas). 2021 Apr 1;57(4):323. doi:10.3390/medicina57040323Sands SA, Edwards BA, Terrill PI, Butler JP, Owens RL, Taranto-Montemurro L,et al.Identifying obstructive sleep apnoea patients responsive to supplemental oxygen therapy.Eur Respir J. 2018 Sep 27;52(3):1800674. doi:10.1183/13993003.00674-2018Semelka M, Wilson J, Floyd R.Diagnosis and treatment of obstructive sleep apnea in adults.Am Fam Physician. 2016;94(5):355-60.Xie J, Sert kuniyoshi FH, Covassin N, et al.Nocturnal hypoxemia due to obstructive sleep apnea Is an independent predictor of poor prognosis after myocardial infarction.J Am Heart Assoc. 2016;5(8). doi:10.1161/JAHA.115.003162.Ruan B, Nagappa M, Rashid-Kolvear M, Zhang K, Waseem R, Englesakis M,et al.The effectiveness of supplemental oxygen and high-flow nasal cannula therapy in patients with obstructive sleep apnea in different clinical settings: A systematic review and meta-analysis.J Clin Anesth. 2023 Sep;88:111144. doi:10.1016/j.jclinane.2023.111144Gottlieb DJ.Supplemental oxygen for obstructive sleep apnea: is there a role after all?.Am J Respir Crit Care Med. 2019;199(2):140-141. doi:10.1164/rccm.201807-1216ED .Aboussouan LS, Bhat A, Coy T, Kominsky A.Treatments for obstructive sleep apnea: CPAP and beyond.Cleve Clin J Med. 2023 Dec 1;90(12):755-765. doi:10.3949/ccjm.90a.23032Turnbull CD, Sen D, Kohler M, Petousi N, Stradling JR.Effect of supplemental oxygen on blood pressure in obstructive sleep apnea (SOX). A randomized continuous positive airway pressure withdrawal trial.Am J Respir Crit Care Med. 2019;199(2):211-219. doi:10.1164/rccm.201802-0240OC.van Zeller M, McNicholas WT.Sleep disordered breathing: OSA-COPD overlap.Expert Rev Respir Med. 2024 Jun;18(6):369-379. doi:10.1080/17476348.2024.2373790
Lv R, Liu X, Zhang Y, Dong N, Wang X, He Y,et al.Pathophysiological mechanisms and therapeutic approaches in obstructive sleep apnea syndrome.Signal Transduct Target Ther. 2023 May 25;8(1):218. doi:10.1038/s41392-023-01496-3
Joosten SA, Tan M, Wong AM, Landry SA, Leong P, Sands SA,et al.A randomized controlled trial of oxygen therapy for patients who do not respond to upper airway surgery for obstructive sleep apnea.J Clin Sleep Med. 2021 Mar 1;17(3):445-452. doi:10.5664/jcsm.8920
Ruan B, Nagappa M, Rashid-Kolvear M, Zhang K, Waseem R, Englesakis M,et al.The effectiveness of supplemental oxygen and high-flow nasal cannula therapy in patients with obstructive sleep apnea in different clinical settings: A systematic review and meta-analysis.J Clin Anesth. 2023 Sep;88:111144. doi:10.1016/j.jclinane.2023.111144
Koka V, De Vito A, Roisman G, Petitjean M, Filograna Pignatelli GR, Padovani D,et al.Orofacial Myofunctional Therapy in Obstructive Sleep Apnea Syndrome: A Pathophysiological Perspective.Medicina (Kaunas). 2021 Apr 1;57(4):323. doi:10.3390/medicina57040323
Sands SA, Edwards BA, Terrill PI, Butler JP, Owens RL, Taranto-Montemurro L,et al.Identifying obstructive sleep apnoea patients responsive to supplemental oxygen therapy.Eur Respir J. 2018 Sep 27;52(3):1800674. doi:10.1183/13993003.00674-2018
Semelka M, Wilson J, Floyd R.Diagnosis and treatment of obstructive sleep apnea in adults.Am Fam Physician. 2016;94(5):355-60.
Xie J, Sert kuniyoshi FH, Covassin N, et al.Nocturnal hypoxemia due to obstructive sleep apnea Is an independent predictor of poor prognosis after myocardial infarction.J Am Heart Assoc. 2016;5(8). doi:10.1161/JAHA.115.003162.
Gottlieb DJ.Supplemental oxygen for obstructive sleep apnea: is there a role after all?.Am J Respir Crit Care Med. 2019;199(2):140-141. doi:10.1164/rccm.201807-1216ED .
Aboussouan LS, Bhat A, Coy T, Kominsky A.Treatments for obstructive sleep apnea: CPAP and beyond.Cleve Clin J Med. 2023 Dec 1;90(12):755-765. doi:10.3949/ccjm.90a.23032
Turnbull CD, Sen D, Kohler M, Petousi N, Stradling JR.Effect of supplemental oxygen on blood pressure in obstructive sleep apnea (SOX). A randomized continuous positive airway pressure withdrawal trial.Am J Respir Crit Care Med. 2019;199(2):211-219. doi:10.1164/rccm.201802-0240OC.
van Zeller M, McNicholas WT.Sleep disordered breathing: OSA-COPD overlap.Expert Rev Respir Med. 2024 Jun;18(6):369-379. doi:10.1080/17476348.2024.2373790
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