Grant: Randomized Controlled Trials

Long-term oxygen therapy (LTOT) is the only component of the management of chronic obstructive pulmonary disease (COPD) that improves survival in patients with severe daytime hypoxemia. In Canada, LTOT is usually provided by a stationary oxygen concentrator and is recommended to be used for at least 15-18 hours a day. Sleep-related oxygen desaturation often occurs in patients with COPD who do not qualify for LTOT. The suggestion has been made that the natural progression of COPD to its end stages is dependent upon the severity of nocturnal desaturation. A number of patients are currently treated with nocturnal oxygen although the beneficial effects of this therapy have not been confirmed. Our primary objective is to determine, in patients with COPD not qualifying for LTOT but who present significant nocturnal oxygen desaturation, whether nocturnal oxygen therapy provided for a period of 3 years decreases mortality or delays the prescription of LTOT. We propose a multi-center, experimental study comparing the effect of nocturnal oxygen therapy added to usual care vs. usual care alone in patients presenting sleep-related oxygen desaturation who do not qualify for LTOT. We hope to reduce mortality from all cause and requirement for LTOT over the study period.