Getting a patient to use his oxygen correctly can be one of the more challenging things we as pulmonary physicians have to do. Many patients, despite our explanations, do not understand the need to keep a satisfactory oxygen level through the day and that failing to do so presents a significant risk for major complications. Many patients feel that they need their oxygen therapy only when they feel short of breath or just “when they think they need it.”
The need for effective oxygen therapy was pointed out in a recent study of patients with a scarring disease of the lungs called pulmonary fibrosis. I have written about scarring diseases before and described how many of these patients will eventually require oxygen as their disease worsens. This particular study looked at the nighttime oxygen levels of patients with pulmonary fibrosis and sleep apnea.
The observations in this study point out clearly that it is the reduction in oxygen level at night and not any associated sleep apnea that is associated with poor outcomes and worsening disease-related quality of life and increased mortality.
I get it. Using supplemental oxygen 18-24 hours a day is inconvenient but so are hospitalizations for heart failure, heart attacks, strokes, etc. If you require oxygen therapy (and this should be tested accurately) then do it right. You must maintain an adequate oxygen level for 18 to 24 hours a day to get survival benefit. You will live longer and better.
