Supplemental oxygen needs during sleep. Who benefits?

The physiologic changes that occur in ventilation during sleep contribute to nocturnal oxygen desaturation in those with lung disease. Nocturnal supplemental oxygen is often used as therapy, although convincing data exist only for those who are hypoxemic both during sleep and wake. Ongoing trials may help address whether oxygen should be used in those with only desaturation during sleep. If used, oxygen should be dosed as needed, and patients should be monitored for hypercapnia. Because of its prevalence, obstructive sleep apnea may commonly overlap with lung disease in many patients and have important consequences. Patients with overlap syndromes may be good candidates for noninvasive ventilation during sleep.