Sleep apnea is a common sleep disorder characterized by repeated interruptions in breathing while a person sleeps. Many individuals wonder if an oxygen concentrator can provide the necessary treatment. For the most common forms of sleep apnea, an oxygen concentrator is not the primary treatment because it fails to address the underlying physical cause of the problem.
The Mechanism of Sleep Apnea
Sleep apnea is categorized into two main types based on the cause of the breathing interruptions. Obstructive Sleep Apnea (OSA) is the more prevalent form, involving a mechanical issue where soft tissues in the throat collapse. This physical blockage prevents air from moving into the lungs, even though the body attempts to breathe.
Central Sleep Apnea (CSA) occurs when the brain temporarily fails to send signals to the muscles that control breathing. This communication problem means there is no effort to breathe, unlike the physical obstruction seen in OSA. In both types, the result is a drop in blood oxygen saturation. The core problem of OSA is the cessation of airflow due to a blocked airway, not a lack of oxygen in the surrounding air.
The Function of Oxygen Concentrators
An oxygen concentrator is a medical device designed to increase the concentration of oxygen delivered to a user. The machine draws in ambient air, which is naturally about 21% oxygen. A compressor pressurizes this air, pushing it through specialized filters called molecular sieve beds containing zeolite material.
This material selectively traps and removes nitrogen and other gases. The resulting gas stream is highly purified, typically consisting of up to 95% oxygen, which is delivered to the patient through a nasal cannula or mask. The sole function of the concentrator is to enrich the inhaled air with oxygen; it does not generate air pressure or assist with the physical movement of air past an obstruction.
Why Supplemental Oxygen Does Not Treat Obstruction
Providing supplemental oxygen alone fails to treat the root cause of Obstructive Sleep Apnea. Since the airway is physically blocked, adding more oxygen does not remove the obstruction. The breathing stoppage event, known as an apnea, still occurs.
While extra oxygen may reduce the severity of the drop in blood oxygen levels, it does not reduce the number or duration of the breathing interruptions. Continued episodes of airway closure lead to fragmented sleep and daytime symptoms like fatigue. Furthermore, elevating the oxygen concentration can suppress the body’s natural drive to breathe, which is often triggered by low oxygen levels. This suppression can potentially lengthen apneic events, leading to a build-up of carbon dioxide.
Primary Therapies for Sleep Apnea
The standard treatments for Obstructive Sleep Apnea directly address the mechanical cause of the disorder. The most common therapy is Positive Airway Pressure (PAP), which uses a machine to deliver a continuous stream of pressurized air through a mask. This pressurized air acts as a “pneumatic splint,” physically holding the upper airway open and preventing soft tissues from collapsing during sleep.
Continuous Positive Airway Pressure (CPAP) delivers air at a single, fixed pressure throughout the night. Auto-adjusting PAP (APAP) machines monitor breathing patterns and automatically adjust the pressure level as needed, providing greater pressure only during times of increased obstruction. Bi-level PAP (BiPAP) is a variation that delivers two distinct pressures: a higher one during inhalation and a lower one during exhalation. This is often used for patients who struggle to exhale against the fixed pressure of a CPAP device. Other treatments include oral appliances that reposition the jaw and tongue, and lifestyle changes like weight loss or positional therapy.
Situations Requiring Supplemental Oxygen
While not a primary treatment for OSA, supplemental oxygen has a role in specific circumstances, often used with a PAP device. It is sometimes prescribed for individuals with Central Sleep Apnea (CSA) to manage low oxygen levels caused by the brain’s failure to signal breathing. Oxygen may also be used when sleep apnea co-exists with other chronic lung conditions, such as Chronic Obstructive Pulmonary Disease (COPD) or pulmonary fibrosis.
These co-existing conditions can cause chronic low blood oxygen levels (hypoxemia) even during normal breathing. In these situations, concentrated oxygen provides necessary secondary support to the lungs, working alongside the PAP device. Any use of supplemental oxygen must be prescribed and carefully monitored by a physician to ensure the benefits outweigh the potential adverse effects.