Nocturnal Oxygen: Is it Still Necessary?
I am writing to ask you if I should continue nocturnal oxygen during sleep. A few months ago I had a flare-up of COPD and was in the hospital for 3 nights. I am feeling better and have resumed all of my previous activities. The hospital doctor said to use oxygen at a setting of 2 with activities and during sleep. However, my breathing is fine when I go shopping and do laundry, and I have not been using the portable oxygen system for the past 2 weeks. However, I am afraid to stop the oxygen during sleep at night even though I don’t think that I really need it. What should I do?
Janet from Silver Springs, MD
Your situation is quite common. Someone with COPD can get a respiratory infection, and then need to use oxygen when discharged from the hospital. Oxygen is prescribed when the oxygen saturation level is 88% or below at rest, with walking, and’or when sleeping. Many doctors recommend use of oxygen during sleep if it is also needed with walking activities.
I assume that the oxygen supply company provided both a portable system (for activities) and a concentrator (for sleep).
At your next appointment, I suggest that you ask your health care provider to measure your saturation level at rest and while walking in the hallway for at least 2 minutes. This will determine whether you will need to use oxygen at rest and during activities.
To check whether you require oxygen during sleep, your health care provider can order a test called nocturnal oximetry. This system (shown above) measures your oxygen saturation while you sleep breathing room air (not using oxygen that evening) and records the results on a computer chip. You return the device the next day and the results can be viewed on a computer screen and/or printed on paper. Generally, if your oxygen saturation is consistently above 88% during sleep, then you should be able to stop nocturnal oxygen.
I hope this information is helpful.
Donald A. Mahler, M.D.