Preliminary Findings in the Treatment of Obstructive Sleep Apnea with Transtracheal Oxygen
Abstract
The effects of continuous low flow oxygen via transtracheal oxygen delivery (TTOD) were assessed in four patients with obstructive sleep apnea (OSA) and daytime hypersomnolence who were unable to tolerate continuous positive nasal airway pressure (CPAP). The overall quality of sleep, sleep fragmentation, pattern of respiration, and nocturnal oxygen saturations were evaluated with the patients receiving 2 to 3 L/min of oxygen by TTOD, and the results were compared to polysomnograms with and without nasal cannula oxygen. The mean respiratory disturbance index (apneas plus hypopneas/hour of sleep) was improved by TTOD compared to no therapy or nasal cannula oxygen, and improvement in sleep disturbance was associated with improvement in overall nocturnal oxygen saturation. The mean apnea duration was not increased by TTOD and the duration of the longest apneic spells was decreased by 33 to 85% with this therapy. These improvements in respiratory status were accompanied by symptomatic improvement in daytime sleepiness, and there were no significant side effects. These findings suggest that TTOD may be a safe and effective alternative treatment of OSA for some patients who are unable to tolerate nasal CPAP therapy.
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One transtracheal supplemental oxygen trial found a significant reduction in AHI from 65 to 26 (p<0.05), and the other transtracheal trial with just 4 subjects trended towards a reduction.
“Two of the supplemental oxygen trials examined the effectiveness of transtracheal supplemental oxygen, 76,77 and one found a significant reduction in the AHI from 65 to 26, p<0.05 72 and trended towards a reduction in the other study with just 4 subjects.77”
A consistent finding across the four supplemental oxygen trials is a reduction in the severity of hypoxemia.
“Although sample sizes in all four studies are small, a consistent finding is a reduction in the severity of hypoxemia.”
There have been four randomized controlled trials of supplemental oxygen therapy for OSA.
“There have been four randomized controlled trials of supplemental oxygen therapy for OSA.[76][77][78][79]”
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Practice Parameters for the Medical Therapy of Obstructive Sleep Apnea
Standards of Practice Committee of the American Academy of Sleep Medicine, Morgenthaler, T. I., Kapen, S., Lee-Chiong, T., Alessi, C., Boehlecke, B., Brown, T., Coleman, J., Friedman, L., Kapur, V., et al. (2006) · Sleep · doi:10.1093/sleep/29.8.1031 · Cited by 299 · see citing works
Veasey, S. C., Guilleminault, C., Strohl, K. P., Sanders, M. H., Ballard, R. D., & Magalang, U. J. (2006) · SLEEP · doi:10.1093/sleep/29.8.1036 · Cited by 217 · see citing works
Transtracheal Oxygen, Nasal CPAP and Nasal Oxygen in Five Patients with Obstructive Sleep Apnea
Farney, R. J., Walker, J. M., Elmer, J. C., Viscomi, V. A., & Ord, R. J. (1992) · Chest · doi:10.1378/chest.101.5.1228 · Cited by 41 · see citing works
- Authors
- Chauncey, J. B., & Aldrich, M. S.
- Affiliations
- University of Michigan (US)
- Corresponding author
- James B. Chauncey
- Venue
- Sleep
- Publisher
- Oxford University Press (OUP)
- Published
- 1990-03-01
- Volume
- 13
- Issue
- 2
- Pages
- 167-74
- ISSN
- 0161-8105 (ISSN-L)
- 1550-9109
- OpenAlex
- W2398107159
- Cited by
- 34
- References
- 0
- Citations by year
- 2017: 1 · 2016: 4 · 2014: 1 · 2013: 3 · 2012: 2
- FWCI
- 0.78
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- SLEEP (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Physiology › Obstructive Sleep Apnea Research
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Respiratory Support and Mechanisms
- Keywords
- obstructive sleep apnea, low-flow oxygen therapy, CPAP intolerance, excessive daytime sleepiness, respiratory disturbance index, nocturnal oxygen saturation, apnea duration, sleep fragmentation, alternative sleep apnea treatment
- MeSH terms
- Adult, Aged, Female, Humans, Male, Middle Aged, Monitoring, Physiologic, Obesity, Morbid, Oxygen, Positive-Pressure Respiration, Sleep, Sleep Apnea Syndromes, Sleep Stages, Trachea
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