How to Use a CPAP Machine With Oxygen

Key Takeaways

• CPAP therapy and supplemental oxygen can be used together: CPAP keeps the airway open, while oxygen therapy increases the amount of oxygen a person breathes in.
• You can connect your oxygen tubing to your CPAP machine through a bleed-in adapter that adds an oxygen port to your CPAP hose or through a port that’s already part of your heated hose or mask.
• Oxygen therapy alone isn’t typically recommended for treating obstructive sleep apnea, and the combination should be supervised by a clinician because incorrect oxygen levels can be harmful.

How CPAP and Oxygen Work Together

When used together, CPAP therapy and oxygen therapy support both airflow and oxygenation for people with complex breathing disorders. The CPAP machine keeps the airway open, while supplemental oxygen ensures that the air reaching the lungs contains a higher concentration of oxygen.

CPAP machines send pressurized air through a hose and a mask, which helps prevent tissues in the upper airway from narrowing or obstructing airflow to the lungs. An oxygen tank or concentrator delivers oxygen-enriched air through tubing, which is inhaled through a nasal cannula, face mask, or other connected device.

Doctors may prescribe this dual therapy for individuals with coexisting respiratory or cardiovascular conditions, such as COPD, obesity hypoventilation syndrome (OHS), or severe sleep apnea with nocturnal hypoxemia.

Don’t Just Test Your Sleep. Understand It.

Measure key sleep metrics and review your results with a licensed sleep-care provider. Discuss sleep issues and options to make restless nights a thing of the past.

Results and data from the comfort of your own bed

Virtual consultation with a licensed sleep-care provider

Diagnosis, prescription, and personalized care plan

4.8

35,000+ tests sold

Get Started

How to Connect Oxygen to a CPAP

If your doctor has prescribed both CPAP therapy and supplemental oxygen, the two can be used together in a few different ways. Oxygen is typically added to the CPAP system so it blends with the pressurized air before you inhale, ensuring you receive both airway support and adequate oxygen throughout the night.

Because setup can vary based on your equipment and prescription, it’s important to follow your provider’s instructions and use compatible connectors or ports designed for safe oxygen delivery.

Oxygen Source

There are three types of prescription oxygen systems that can be used with a CPAP machine: oxygen concentrators, liquid oxygen tanks, and compressed oxygen tanks. All three systems are available in stationary and portable models, and each has unique benefits and drawbacks.

• Oxygen concentrators: An oxygen concentrator is a device that draws in the surrounding air and separates oxygen from other gasses. Oxygen concentrators don’t require refills, but they must be plugged into a power outlet or portable battery.
• Oxygen tanks: Oxygen tanks store oxygen for use. Depending on the type of system, oxygen is either stored as a gas or liquid. Oxygen tanks don’t need electricity, but they do require regular refills.

Connecting Oxygen to a CPAP Machine

There are a few ways an oxygen system can be connected to a CPAP machine. 

• Bleed-in connector: A small adapter that connects an oxygen supply line to CPAP tubing, allowing supplemental oxygen to mix with pressurized air before it reaches the mask
• Oxygen connector on CPAP tubing: Lets supplemental oxygen be added directly into the airflow without the need for an external adapter
• Built-in oxygen port on CPAP mask: Delivers supplemental oxygen directly at the mask, where it blends with CPAP airflow before inhalation

Using CPAP and Oxygen at Night

Connecting your oxygen source to your CPAP machine at night is a relatively simple process, though the exact steps will depend on your specific setup. The first two steps only need to be completed when you first set up your machine and if your hose or mask doesn’t already have an oxygen port.

Be sure to check your specific CPAP machine and oxygen supply unit instructions before setup.

1. Add a bleed-in adapter: The adapter is a small, plastic piece with a slot for your CPAP hose and a port for your oxygen tube. Add it to the end of your CPAP hose that connects directly to the CPAP machine by sliding the house into the adapter.
2. Connect the adapter to your CPAP machine: Once the adapter is connected to your CPAP hose, you can connect the other end of the adapter to your CPAP machine where you would normally connect the hose.
3. Connect your oxygen tube: Slide your oxygen tube into the oxygen port on your adapter, hose, or mask. If you require a constant supply of oxygen at all times, you may need a flow splitter on your oxygen supply unit so you can connect one tube to your CPAP machine for nighttime use and keep one available for daytime. That way, you won’t experience a gap in your oxygen supply as you set up your CPAP machine and put on your mask.
4. Turn on your CPAP: To prevent oxygen from building up in your CPAP, turn on your CPAP machine before turning on your oxygen supply unit.
5. Turn on your oxygen supply and put on your mask: Once both the CPAP machine and oxygen supply unit are on, oxygen should flow along with pressurized air through your CPAP mask.

Medical Conditions Treated Using CPAP With Oxygen

There are several medical conditions that may be treated using a combination of CPAP and oxygen therapy. 

• Chronic obstructive pulmonary disease (COPD): COPD, which includes emphysema and chronic bronchitis, is a term for a group of lung conditions that interfere with breathing. Although not everyone with COPD requires both CPAP and oxygen therapy, this combination may be recommended for those with high levels of carbon dioxide in their blood.
• Overlap syndrome: Some people are diagnosed with both COPD and obstructive sleep apnea (OSA), a condition called overlap syndrome. Because people with overlap syndrome may need pressurized air to keep the upper airway open in addition to receiving supplemental oxygen, doctors often recommend combining CPAP and oxygen therapy.
• Central sleep apnea (CSA): Central sleep apnea is an uncommon form of sleep apnea in which a person experiences shallow breathing or brief pauses in breathing during sleep due to problems in the part of the brain that controls respiration. Doctors may combine PAP therapy and supplemental oxygen when a person diagnosed with certain types of CSA also has low blood oxygen levels during sleep.
• Heart failure: Heart failure happens when the heart has trouble pumping blood through the body. Heart failure can cause a person to develop a type of CSA called Cheyne-Stokes breathing, which involves alternating periods of hyperventilation and shallow or halted breathing. Nighttime use of both CPAP and oxygen therapy may be recommended for people with Cheyne-Stokes respirations who have low blood oxygen.

Experts do not recommend oxygen therapy on its own for people with OSA, the most common form of sleep apnea. While oxygen therapy has been studied as an alternative to CPAP, it’s not clear if this approach is effective. If CPAP isn’t working or isn’t tolerated, treatment options for people with OSA include oral appliances and sleep apnea surgeries.

Safety Tips When Using CPAP With Oxygen

Oxygen is a relatively safe gas, but there are a few safety guidelines you should follow if you’re using CPAP with oxygen.

• Keep oxygen away from flame or heat: Fires spread more easily in oxygen-rich environments, so be sure to keep your oxygen source at least five feet away from heat or flames. Don’t smoke, and avoid using oxygen near combustible electronics like space heaters and hair dryers. Have a fire extinguisher in your home.
• Ensure your CPAP is in good working order: While rare, CPAP machines can sometimes overheat, smoke, or catch fire due to an electrical or mechanical malfunction. This could be extra dangerous if you also use oxygen, so be sure to check your CPAP for any signs of overheating.
• Store your oxygen properly: Oxygen units should always be upright and in an open, ventilated space. Never plug your concentrator into an extension cord.
• Avoid aerosols and oils: Aerosols like air fresheners are very flammable so never use them around your oxygen source. Oil-based creams — like vapor rub petroleum jelly — are also flammable so opt for water-based lotions instead.

Frequently Asked Questions