A recent study from Lund University in Sweden has found no significant differences in quality of life, symptoms, hospital stays, or mortality rates between patients with lung diseases and low blood oxygen levels who received home oxygen therapy continuously for 24 hours versus those who received it for 15 hours daily.
According to Magnus Ekström, the lead researcher, “This finding is significant for patients with chronic obstructive pulmonary disease and other lung conditions who rely on long-term oxygen therapy at home.” The study has been published in the New England Journal of Medicine.
In the United States, around 1 million individuals experience severely low oxygen levels each year and begin oxygen therapy at home. Patients typically use a nasal oxygen mask 24/7, which many find restrictive and uncomfortable. Additionally, the cold and dry oxygen can cause issues such as dryness, sore spots, and airway inflammation. Furthermore, using such equipment may lead to feelings of stigma among patients.
The primary goal of oxygen therapy is to extend life, but there is variability in its application, and research supporting its effectiveness has been limited.
In this large-scale, randomized controlled trial, the researchers looked into how different durations of oxygen therapy impacted crucial health outcomes. A total of 241 patients suffering from chronic and severely low blood oxygen levels were divided into two groups: one receiving oxygen therapy for 24 hours a day (117 participants) and the other for 15 hours a day (124 participants). The follow-up period lasted one year, with all participants completing the study and a high adherence to the prescribed oxygen therapy schedule.
Ekström stated, “We observed no significant differences between the two groups in terms of hospital admissions or mortality risk. Additionally, when comparing self-reported quality of life, physical activity, symptoms, and fatigue, there were no noticeable differences or benefits associated with using oxygen for more than 15 hours a day.”
These findings contrast with older research from the 1970s, which implied that continuous 24-hour therapy might enhance survival rates.
Josefin Sundh, co-leader of the study and a pulmonologist at Örebro University and University Hospital, explained, “The previous studies were smaller and primarily focused on patients with chronic obstructive pulmonary disease, making it challenging to recruit seriously ill individuals for randomized research. Moreover, the patients in those studies differ from the current population starting home oxygen therapy. Our study’s strength lies in its larger sample size and its representation of modern patients, who tend to be older and often have additional cardiovascular conditions, including many women.”
The group that received oxygen for 15 hours a day typically used it at night when oxygenation levels tend to drop. “The results suggest that it is safe for these patients to be without oxygen for a substantial portion of the day. This could help minimize side effects associated with the therapy and allow for a better integration of treatment into their daily routines,” Ekström added.
This study utilized data from Swedevox, the Swedish National Registry for Respiratory Failure.
The research team is now investigating if using high-flow, warmed, and humidified oxygen at night can enhance patient outcomes and overall well-being.
