Preliminary findings in the treatment of obstructive sleep apnea with transtracheal oxygen

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.