Information for Doctors

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Thoracic Medicine

Think you might have a breathing disorder or just looking for more information?

Sleep Medicine

Latest News

New research confirms that sleep disturbances are linked to pain and depression, but not disability, among patients with osteoarthritis (OA).  Results from a new study found that poor sleep increases depression and disability, but does not worsen pain over time.

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Older women with disordered breathing during sleep were found to be at greater risk of decline in the ability to perform daily activities, such as grocery shopping and meal preparation, according to a new study led by researchers at the Johns Hopkins Bloomberg School of Public Health and the University of California, San Francisco.

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People with moderate to severe obstructive sleep apnoea may have an intrinsic inability to burn high amounts of oxygen during strenuous aerobic exercise, according to a new study led by researchers at University of California, San Diego School of Medicine.

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This webinar will be a clinical presentation in assessing a child who presents with snoring. Snoring is a very common presentation in childhood with some studies suggesting that up to 30% of children will snore at some point in their life. Within those that snore, there will be some who have obstructive sleep apnoea.

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Sleep apnoea may make it hard for you to remember simple things, such as where you parked your car or left your house keys, a small study suggests.

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Researchers believe that disrupted circadian clocks are the reason that shift workers experience higher incidences of type 2 diabetes, obesity and cancer. The body's primary circadian clock, which regulates sleep and eating, is in the brain. But other body tissues also have circadian clocks, including the liver, which regulates blood glucose levels.

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Home Oxygen Therapy

What is the aim of oxygen therapy?

The aim of home oxygen therapy is to increase the levels of oxygen in the blood, relax the blood vessels in the lungs and to avoid the long term conditions that chronic low oxygen levels can cause.  Home oxygen therapy has been proven to improve quality of life, general well-being and the longevity of people with Chronic Obstructive Pulmonary Disease (COPD).


Why do I need Home Oxygen?

Oxygen is essential for life.  Sometimes in lung disease, the body has trouble delivering enough oxygen into the blood where it is carried to our organs and tissues.  In these cases, home oxygen can increase the level of oxygen in the blood, improving function of the whole body.


Who uses home oxygen?

In Australia to be eligible for home oxygen therapy funded through the Medical Aid Subsidy Scheme (MASS) you require a thoracic physician review. As part of this assessment you will require an arterial blood gas (ABG) measurement on room air.
Home oxygen therapy is for people who have low levels of oxygen in their blood, due to a lung or heart disease. People who may need oxygen at home include those with chronic obstructive pulmonary disease (COPD), alpha 1 antitrypsin deficiency, pulmonary hypertension, heart failure, severe angina, cystic fibrosis and lung cancer.


How is oxygen provided?

An oxygen concentrator (see image below) is the most common method of providing oxygen.  The air that we breathe is made up of oxygen and nitrogen.  A concentrator is an electronic pump that filters out the nitrogen and supplies oxygen through tubing.  Often electricity costs for running the concentrator can be subsidized.
Oxygen can also be provided via pre-filled cylinders - these are more expensive and need to continually be replaced.  
Supplementary (portable or ambulatory) oxygen therapy (in addition to fixed or domiciliary oxygen therapy) is a necessity for active patients who leave their homes and for daily activities. Although ambulatory oxygen therapy is prescribed for such patients little is known about the effectiveness of long term ambulatory oxygen therapy in such situations.

 

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Will I have to use the oxygen all the time?

border.eclipse_portable_oxygen_concentratorEveryone is different and your doctor will give you a prescription outlining exactly how long and how often you need to use the oxygen.  You will be given a flow-rate that your oxygen will be set to (usually between 1 and 4 Litres per minute) and a recommended number of hours per day during which the oxygen should be used.  It is important that you follow your prescription to get the maximum benefit from having home oxygen.  From time to time, your doctor will assess your oxygen prescription and may change it depending on how you are going.

 Oxygen and Sleep

Some patients with COPD who desaturate and drop their oxygen levels at night may also have associated obstructive sleep apnoea syndrome (OSAS). Risk factors include obesity, thyroid disease, cardiac disease, and diabetes mellitus. OSAS may also have carbon dioxide (CO2) retention which will influence the safe amount of oxygen that will be prescribed.
If suspected of OSAS a diagnostic sleep study is recommended as often oxygen alone is not indicated. Treatment may require continuous positive airway pressure (CPAP) with or without supplemental oxygen.


How do I qualify for the Medical Aid Subsidy Scheme?

When the arterial oxygen tension (PaO2) is 55mmHg or less (or 59mmHg or less when conditions such as cor pulmonale, pulmonary hypertension or polycythaemia are present).

 

  • In remote areas, when arterial blood gas estimations are unavailable, hypoxaemia must be demonstrated by oximetry indicating an oxygen saturation of 85% or less (or 90% or less when conditions such as cor pulmonale, pulmonary hypertension or polycythaemia are present).
  • In all cases, applicants should be on maximum medical treatment. Arterial blood gas estimations (or oximetry measurements in remote areas only), should be obtained after the condition is considered to be stable.
  • The above measurements are required for both the initial application and the first (four month) reapplication. Clinical assessment only (without measurements) is required for subsequent annual reapplications.


For more information on Home Oxygen Therapy see these links:

Australian Prescriber Magazine
Australian Lung Foundation

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