The Complete Guide to Using CPAP with Oxygen

Millions of men and women suffer from Sleep Apnea, and that means they may be at greater risk for serious medical issues, like heart attacks, strokes, obesity, depression and even accidents caused by too little sleep. CPAP machines can offer an excellent solution for many of these problems, providing a steady stream of air that helps keep airways open and unobstructed during sleep. But sometimes, CPAP alone may not be enough to treat an underlying medical condition or to prevent an existing condition from becoming worse. Often, these patients benefit from the addition of supplemental oxygen that’s delivered through their CPAP machine. Interestingly, many Sleep Apnea patients - even those who have been using CPAP - are surprised to learn that CPAP is not the same as oxygen therapy. Since both CPAP therapy and supplemental oxygen deliver therapy air through masks, it’s easy to see how that confusion happens. But if your doctor has suggested using CPAP with oxygen, if you have an underlying medical condition like heart or lung disease, or if you think oxygen might benefit your CPAP results, it’s important to know what makes CPAP machines different than oxygen, so you can make sure you’re getting the best therapy for your needs.

No. CPAP machines use a continual stream of air - the same mixture of oxygen, nitrogen and other elements in the air we normally breathe - to keep your airways open while you sleep. During CPAP therapy, a special mask delivers the stream of air directly to your airway to help prevent the soft tissues at the back of your throat from collapsing. It’s these intermittent periods of collapse that interfere with normal breathing, producing the interruptions in breathing that are the hallmark of Sleep Apnea. While CPAP delivers “normal” air, oxygen therapy focuses only on the delivery of pure oxygen. Patients with certain types of health problems, including Sleep Apnea, other breathing disorders, and heart disease, often benefit from added oxygen to provide cells and organs with the enriched air they need to improve the way they function. Like CPAP, oxygen is delivered through a mask. Oxygen can be stored in a pressurized tank or, more frequently, it can be taken directly from the surrounding air using a concentrator. The concentrator uses filters to remove other elements and impurities from the air, so only pure oxygen is delivered.

In addition to the “type” of air each therapy delivers, CPAP and oxygen therapy can be used to treat different types of disorders and diseases.

CPAP, or continuous positive airway pressure, is a therapy that was developed specifically to treat Sleep Apnea (sometimes called Obstructive Sleep Apnea or OSA). CPAP works by providing a gentle and continuous stream or “force” or air to your airway while you sleep. As this gently pressurized air passes through your airway, it helps to keep the airway open - particularly the airway at the back of your throat. In people with Sleep Apnea, these soft tissues “over-relax” during sleep, dropping down into the airway and temporarily blocking normal breathing. The flow of air provides just enough pressure to help keep the soft tissues “in place,” so the airway remains open, and you can breathe normally.

Oxygen therapy delivers only pure oxygen, and it’s typically used to treat patients who have specific medical conditions that result in low oxygen levels in the blood, including people with:

• congestive heart failure
• emphysema
• lung cancer or other lung diseases
• chronic obstructive pulmonary disease (COPD)
• other conditions (like Sleep Apnea) that cause low levels of circulating oxygen during sleep

Your cells and organs depend on a certain level of oxygen to function. Supplemental oxygen can provide additional oxygen when your breathing is hampered by a disease or medical condition like Sleep Apnea.

Yes. Many patients benefit from adding oxygen to CPAP. Your doctor will be able to determine if CPAP with oxygen could be beneficial for you based on your medical history and other factors.

If you use a CPAP device, adding oxygen to CPAP therapy is a relatively simple process. Both the CPAP airstream and the oxygen come in through the same mask. Depending on the oxygen delivery system you have, you may need to use an adapter (with or without an additional one-way valve) to connect the oxygen supply line with the tubing used by your CPAP device, or your mask may have a special adapter built into its design. Be sure to read and follow the directions provided with your oxygen supply unit, or call CPAP.com at 1-800-356-5221 and ask a member of our team for assistance. There are other precautions you need to follow when using oxygen with CPAP. For instance, you should not smoke around an oxygen supply device, and you should also keep your device away from heat. Most units also instruct you not to turn the CPAP device off while oxygen is in use. In most cases:

• you should not turn the oxygen unit on until the CPAP unit is already running; and,
• you should turn the oxygen unit off before you turn off the CPAP machine.

Your oxygen system will provide you with specific instructions for your unit.

Yes, CPAP units that have humidifiers built in to moisturize the air can still use supplemental oxygen. The oxygen unit will be connected in the same manner, using the guidelines provided by your oxygen device manufacturer.

Yes, you can use a BiPAP machine with oxygen. As when using oxygen with CPAP, the oxygen will come in through the same mask you use for your BiPAP therapy. You may need a separate adapter to connect the tubing of both devices, or your mask may have a built-in adapter. Your oxygen unit will provide you with complete instructions for hooking the oxygen up to your BiPAP device.

Some studies have shown that oxygen alone can be beneficial for patients with Sleep Apnea, while other patients may not need additional oxygen to gain the benefits from CPAP. As a standalone treatment, oxygen delivery typically is not enough to keep the airway at the back of the throat open. This means that even though oxygen is flowing through a mask or cannula, you’ll still experience breathing interruptions - and much of the oxygen will wind up not being inhaled. CPAP uses a more forceful (but still gentle) stream of air that “triggers” the muscles at the back of the throat to remain more “taut,” preventing the soft tissue from dropping into the throat and “cutting off” air.

When the airway “collapses” during a Sleep Apnea event, you aren’t able to breathe in air as you usually do while awake. That means your organs - particularly your heart and brain - and other tissues aren’t receiving the average levels of oxygen they need to stay healthy and work the way they should. Over time, the breathing interruptions and lower levels of oxygen associated with Sleep Apnea can contribute to serious medical problems, including heart disease and cardiovascular events like heart attacks. When you use CPAP with oxygen, you reap two main benefits:

• The CPAP device and delivery system help keep your airway open for normal breathing while you sleep, and they also allow you to breathe in more of the supplemental oxygen.
• The supplemental oxygen provides your body with the extra oxygen it needs to function normally.

Not everyone who has Sleep Apnea will need supplemental oxygen. Your doctor will be able to determine if adding oxygen to CPAP makes sense for you and your medical needs.

If you’d like to find out more about combining CPAP with oxygen therapy, or if you’d like more information about CPAP units, masks or supplies, if you have insurance questions, or if you just want to learn more about CPAP and its benefits, we can help. Check out our blog and sign up for our newsletter for up-to-date information about CPAP and Sleep Apnea, and to receive special offers and discounts on equipment and supplies.