Has this worked for anyone?
 

Forgive me if this has been discussed a lot before, but I was wondering if anyone has had great sucess with hyperbaric Oxygen?

I sstumbled upon this article (from a few years back) ...but seemed to have some good information in it.

http://www.hyperbaricexperts.com/hea...onditions.html

Just found this article that seems to question the benefits vs risks of it.


http://www.ahrq.gov/clinic/epcsums/hypoxsum.htm

I have not read the two articles you linked. I did research HBOT in the past. The research showed that it was only helpful with specific severe brain injuries that caused coma.

The profit motive causes many HBOT centers to exaggerate its value.

It usually requires $5000 or more spent before improvements are noticeable, if at all.

I also researched HBOT and realised that alot of the research is heavily profit motivated. That does necessarily correlate with the research being useless but it definitely puts a lid on things. I would still like to try it as a treatment option though.

I read a promising study a few months back which showed good results in 16 US veterans with PTSD and TBI:

http://medicalxpress.com/news/2011-1...-tbi-ptsd.html Short version

http://online.liebertpub.com/doi/pdf.../neu.2011.1895 long version

In the long version under "Author Disclosure Statement" quite a few of the researchers still have competing interests so I have to say i´m still a bit skeptical.

I also found additional information about the future prospect of HBOT in the treatment of TBI in veterans based on the above study:

http://www.prbuzz.com/politics-a-pub...5248-hbot.html

GlassHead,

Be prepared to let the money 'burn' rather than provide a benefit.

Don't risk money you can not afford to risk.

What symptoms are you hoping to get relief from?

I can´t afford the treatment anyway so it´s not really an option :)

I would like to regain my ability to concentrate and as far as i know, no other therapy helps in that regard.

Maybe QEEG neurofeedback can be used instead of the HBOT.

The best way you can relearn to concentrate starts at a very basic level. The first thing you need to do is reduce and/or eliminate excess stimuli. I wrote about this on another thread. I'll see if I can find the discussion.

It's been working for me
 

See my painfully detailed response in the thread 'Has anyone tried Hyperbaric Oxygen Therapy?': neurotalk.psychcentral.com/thread164251.html

Sorry to post in an old, dormant thread rather than in this one - I didn't realize that this new thread existed.

Bottom line is that I have had a good experience.

qEEG Biofeedback
 

Also, GlassHead - I tried qEEG feedback about a year ago. As with HBOT, it was a bit difficult to tell how effective it was, but I have liked HBOT much better. With qEEG, I did feel pretty good at the end of the month or so that I did it (3x/week) but each session made me feel tired and foggy.

The overall improvement could be due to the qEEG biofeedback or due to time. As I said in my post on the other thread, I tend to improve slowly (over the course of many months) unless I experience a setback.

The worsening of symptoms after each session could be because the session was making my injury worse, or because my brain was tired but rebuilding (like muscle soreness after a workout). Since they use visual or audio stimulation to provide the feedback - I used a video-game-like interface, watched movies, and listened to beeps at various points in my therapy - my brain was really irritated even though it might have been learning new, better patterns.

Eventually I stopped going because I didn't like feeling crummy after each session.

Also, I believe qEEG was even more expensive than HBOT, but I don't remember exactly off the top of my head.

Hope this helps, good luck if you do try it.

Thx for the feedback, glad you had good experiences with the treatments. I will think about these treatment options as the next step in my recovery plan.
Might be years before I can afford them though.

keg,

It would be great if you could elaborate about your experience with HBOT.

How many sessions? How often?

What improvements did you notice?

How far into your recovery did you start the HBOT?

How much did you have to pay?

Your qEEG neurofeedback sessions were likely too long. Shorter sessions more frequently might have been better. Exercising the brain to fatigue would be counter productive. Most neurofeedback is designed for ADD/ADHD where the longer sessions are not a cause of fatigue.

Was it the kind of neurofeedback where you tried to modify the wave forms as a sort of video game?

HBOT Experience
 

Mark,

I posted many details in the thread "Has Anyone Tried Hyperbaric Oxygen Therapy?". I'm reposting my entire response below. It's quite lengthy, but you can scroll down to the bottom for a short summary.

I will agree that my neurofeedback sessions were likely too long. You are right with your guesses that the office was probably ADD/ADHD-focused and that the feedback was delivered in the form of a video game. We did try multiple versions of feedback, including:

• straight up video game (a la Asteroids) - you score more points if you make the correct wave patterns
• listening to beeps - the beeps get louder and steadier if you make the correct wave pattern [this one was the WORST - not recommended for MTBI patients!]
• watching a movie - playback stops if you make the wrong wave patterns
• reading on the internet - screen goes black if you make the wrong wave patterns

Ultimately, all of them made me feel less than great. However, this doesn't mean neurofeedback itself is useless; it just means that I wasn't using it correctly. Some of the problems could have been:

• I was using feedback mechanisms that were too stimulating
• I was doing it for too long
• We were targeting the wrong areas of my brain (unlike in ADHD, there is no specific area that is responsible for MTBI symptoms)
• We were manipulating the wrong brain waves (again, I believe is no broad agreement on which waves - e.g. alpha, beta, delta - are implicated in MTBI symptoms, plus every injury is unique)
• The office environment itself made me feel bad (many fluorescent lights), and this negated the treatment's positive effects

If you are desperate for help, as I was, I would not write off qEEG neurofeedback, though I would seek out a practitioner who works with brain injury patients. I would try HBOT first, though.

I disagree with you about "if you're feeling desperate you should try..."

I think desperate people are looking for miracle cures and could easily be separated from a lot of their cash with these very expensive healing modalities - which are not backed up by Neurologists. Don't you think neurologists want people to get better and would recommend anything that might actually work?

In addition, the neurofeedback has been known to cause additional damage and even seizures in people healing from mild traumatic brain injuries. If it does work for some people then they got lucky - very lucky. There is no way to see the actually damage inside one's brain who is recovering from an mTBI, guessing which areas were damaged isn't good enough. It might be interesting to see how it works after diffuse tensor imaging is confirmed as a reliable method to see what's going on inside a person's brain after an mTBI and then to use neurofeedback - but I wouldn't risk further harm for a maybe that costs thousands of dollars.

@EsthersDoll

Research done on QEEG and its effectiveness in diagnosing/treating PCS has been confirmed in several studies done in this area of research. Although I can not say anything about the quality of these studies or if they were financially motivated.

Many of these studies and their findings have been dealt with in this article:

http://www.ncbi.nlm.nih.gov/pubmed/15493535 [Abstract]

http://sydney-neurofeedback.com.au/d...ff,%202004.pdf [Full article]

I think the main problem with this therapy is the large amount of stimulation in the therapy session and probably also the lack of PCS knowledge in many of the practitioners.

EsthersDoll,

I wonder if you are confusing neurofeedback with neurotherapy such as LENS and ROSHI. The non-volitional neurotherapy systems do have a problem with seizures and other adverse events.

The neurofeedback that uses volitional therapy has a very good and safe record. Its goal is to teach the client to get better control of their mind and body. Think of bio-feedback for control of Blood Pressure and Pulse. This neurofeedback asks for the client to make thought changes to change the wave-forms to a targeted wave form. It can be highly effective with ADD/ADHD.

With PCS, it can help the client develop under-developed skills to use to overcome some PCS symptoms. Sometimes, the PCS client has allowed some brain systems to get lazy. This can help strengthen those lazy skills.

Unfortunately, there are many therapists who have tried to put non-volitional neurotherapy under the same name as volitional neurofeedback. They do this to get the treatments included in the range of treatments approved for their therapy specialty. I read the online minutes of a large eastern US therapists association where this was discussed as a primary goal.

But, in keg's situation, it was likely used well past the fatigue point of his brain.

His comments regarding HBOT lead me to believe that he is not necessarily getting true healing. Rather, he is getting a booster shot of oxygenated brain cells and some very disciplined rest, relaxation and breathing. This makes me believe that keg is not getting good brain oxygenation during his normal sleep cycles. This is a big problem for me as I have struggled with Central Sleep Apnea since my injury in 2001.

But, what many of us would pay to have those great days of oxygenated and alive brains. I have wondered about trying to get a prescription for an oxygen concentrator and nasal cannula to breath more concentrated oxygen when I sleep. Dreaming with a fully oxygenated brain is so nice.

Hi EsthersDoll,

I apologize for not being clear on this. I do NOT mean to tell anyone what they "should" do. This is why my posts are long and sometimes ambivalent. I only mean to share my story and explain what I would do, given my personal experience, if I were in the same situation again.

For me, the financial cost of treatment is negligible compared to the opportunity cost of being homebound and unable to work. Most people are not so lucky, and if my finances were tighter I would think twice before experimenting with alternative therapies.

Perhaps I should have used a different adjective. When I said 'desperate', I meant people like myself for whom the traditional 'rest and recuperate' advice has not worked. At some point, I may accept that I will always have my mTBI symptoms and forego further medical treatment, but for now I continue to search for ways to improve my condition.

However, I blanche at the idea that I am looking for a "miracle cure". I'm not expecting to wake up tomorrow and be magically better. I stick to treatment ideas that sound plausible to me; I'm not going around rubbing rabbits' feet.

People like me who go "above and beyond" typical therapies are separated from a lot of their cash! That's why I joined this board - because I know most people don't have the luxury of experimenting with alternative treatments, and if they do, it's really difficult to compare them and decide between the different options. I want to share information about the therapies I have tried to help people decide whether to (or not to) use them.

One person's story doesn't mean much in the grand scheme of things, but since there's very little data to go off of for these treatments, I think every little bit helps.

I do think that neurologists want people to get better, but because of the way our medical system is set up, they are not able to recommend anything that might actually work. Most of the time, this is a good thing. While our healthcare system isn't perfect, I'm glad it's based in science and not wild theories. Right now, though, I am ready to go past what is proven.

Also, in my perspective, neurologists don't seem to have a very good understanding of the etiology of concussions. They may know a bit more than a layman, but there is still so much that is unknown.

In my case, neurologists have only prescribed drugs to cover up symptoms, never to address the underlying cause. They literally read my chart, pick my most severe symptom (e.g. "trouble focusing" or "headaches") and choose a drug that might help ("I'm prescribing amitriptyline because you say you have headaches, and I've used it before with some of my other headache patients"). This is not my cup of tea. I don't want to use prescription drugs for years on end, so if they are not going to heal my underlying problem, I'm not interested.

My current neurologist is a well-regarded concussion specialist. He has been a bit better than the others, but still does not have much to offer besides "rest". I am ready to go beyond that (though rest is still a cornerstone of my life) and he has blessed that decision, even though he can do little beyond referring me to other specialists (who I have visited).

Re. neurofeedback -

I did not know that it has been shown to cause additional damage; thanks for the insight. I am not trying to make a recommendation for or against it, though I understand if my post came off that way (sorry!). My point is that my experience with it was not great, but that it is impossible for me to say why. I hope my anecdotal experience helps others to make informed decisions, but if there is evidence that it is dangerous, that should obviously be taken into account.

Unfortunately, one of the problems with treatments like neurofeedback and HBOT seems to be that there is a dearth of clinical-grade evidence in general. (At least I have not been able to find much, and right now I don't have the energy to search for any).


Finally (phew!), Mark, I am very curious to learn more about the Central Sleep Apnea you have experienced since your injury. This experience with HBOT has indeed made me wonder if I could have it or something similar, but the possibility has never crossed my mind before. How were you diagnosed? How do you treat it?

Apologies if you have talked about this elsewhere already, if that's the case just let me know and I will dig it up on my own.

Thank you all for your replies!

I certainly may have confused a few of the modalities, but only because some of the practitioners seem to have touted what they do as the same when it may in fact be different.

I will do some more reading in these areas.

Thanks again! :)

For me, my Central Sleep Apnea seems to be tied to neck position. If I sleep with my head forward or leaning to the left, after a while, I will go through cycles of no breathing that last 2 to 3 minutes before my brain recognized the lack of oxygen and starts me breathing again. A couple minutes later, the cycles repeats.

My wife notices this and can connect it to a need for me to nap more during that day. The ability to fall asleep/nap easily during the day is a common symptom of sleep apnea.

We all were envious of my father's ability to take short naps during the day and wake up refreshed after 15 minutes. I believe this ability was due to his apnea. At night, his breathing would slow, getting quieter until it stopped completely. After 2 minutes or so, he would start huffing and puffing until he resumed normal breathing and repeat the cycle.

And keg, If you have sleep apnea, HBOT would provide quite an invigorating oxygenation to your brain that would decrease as you O2 levels returned to normal then decreased after the next apnea episode. Oxygen debt leaves the brain in a depleted state until oxygen levels can brought back to normal.

There are some researchers who believe concussion damages the capillaries that are where oxygen transfers to the neurons, etc.

Hyperbaric Oxygen Update
 

Hi everyone,

I am back with another update about my hyperbaric oxygen therapy. I have now undergone 23 60-minute treatments in the last 5 weeks. My first 12 treatments were at 1.5 ATA, and the last 11 have been at 1.75 ATA.

The negative side effects I experienced after early HBOT treatments have disappeared. I continue to feel better (mainly, more alert and focused, and less headache-y) during and immediately after HBOT sessions. When I increased from 1.5 to 1.75 ATA, I noticed that this good feeling started earlier in my session, at around 15-20 minutes in rather than 30-40 minutes in.

My condition has continued to improve slowly and steadily. I can now do significantly more activity, and have significantly fewer symptoms.

Below are some numbers that help to communicate my improvement. I track both daily activity and daily symptoms in a spreadsheet on scales from 0 to 25.

For activity,
0 = lying in bed vegetating,
25 = a busy day with a light workout or a stressful situation. What most people would consider "normal".

For symptoms,
0 = no symptoms,
25 = in such agony I cannot move or open my eyes (fortunately, I've never had a day like this).

My current goal is to sustain an activity level of 20 with zero symptoms.

The week before I began HBOT, my average activity level was 11 and my average symptom level was 16. I spent my days lounging around my apartment, reading, napping, and resting. It was a big accomplishment when I walked around the corner to pick up some takeout. I had continual brain fog, was very tired, and occasionally felt nauseous.

The week I first reported on my treatment (March 29), my average activity level increased to 14 and my average symptom level decreased to 12. I still spent most of my days lounging around and napping, but I was able to work for a few hours each day, and I had a couple of days that were quite high-energy (traveling, a friend's wedding, etc.). I still had frequent brain fog and fatigue, but it was no longer constant. The nausea disappeared. Unfortunately, I did start experiencing achy and stiff limbs when I woke up in the morning, an old symptom I hadn't had in a while. My symptoms were erratic: I'd have one day when I felt great, followed by two days of feeling terrible.

This week, my average activity level increased again, to 17, and my average symptom level decreased to 9.5. My symptoms have been much less erratic, and I have really enjoyed my increased energy levels. My sleep has improved a bit and my achiness has been decreasing. On my best day this week, I got up early, walked a half mile to the grocery store, came home, walked a mile to the library, where I spent a couple of hours finishing up my taxes and chatted with a friend I ran into, walked home, cooked lunch, talked on the phone, walked a mile to the mall and back, and stopped at a restaurant for dinner. I did take a nap in the afternoon because of a headache, but for me, this activity level was nothing short of amazing. I'm trying not to have too many days like this, because my main focus is on symptom reduction, and for that I want to rest as much as possible.

So is this improvement due to HBOT? It's really tough to say. As I mentioned before, I usually make slow progress given time and rest, and I don't know if I'm improving more rapidly right now than I did after previous PCS flares.

Additionally, I see one doctor who is both an MD and an acupuncturist. When I saw him last week and described how helpful HBOT has been for me, he gave me some supplements to increase my blood oxygenation levels and cellular energy production at other times of day, too (the main things he gave me were CoQ10, pantothenic acid, and something called ChlorOxygen - chlorophyll in a capsule!). These supplements seem to have also helped my symptoms stabilize at a lower level. Unfortunately, they also make it more difficult to draw conclusions about HBOT.

My neurologist has been pleased with my progress and has told me to "keep doing whatever you're doing". I'm inclined to agree. My plan is to continue HBOT at least until I get to 40 sessions, and possibly for longer. I do not want to oversell the benefits of this treatment, as it's extremely unclear how much of my improvement I should attribute to it, but it seems to be working for me and I want to maximize my chances of continuing to progress.

Again, I hope this is helpful for anyone considering HBOT, and I'm happy to answer questions.

Pantothenic acid is just another name for Vitamin B-5. It is included in a B-50 or B-100 complex. CoQ10 is something I'd take if it was not so expensive.

Does anybody else take CoQ10?

Hi Mark,

I have seen CoQ10 before, but I haven't taken it.

I found it here: http://www.vitacost.com/vitacost-coq...g-120-capsules

I buy a lot of the supplements I take from Vitacost - I think their prices tend to be the best and if you buy $50 worth of items, they ship it for free.

I am thinking of taking just based on your desire to take it - you recommend it?

Thanks!

HBOT update
 

I have now had 31 hyperbaric oxygen treatments in the last eight weeks, and I'm back with another update.

My overall condition has continued to improve. Using my previously explained rating scale, my average symptom level this week was 7.5 and my average activity level was 17. Basically, I am doing the same amount of activity as I was a few weeks ago, but with fewer symptoms.

My biggest victory is that I had one day that was nearly symptom-free: I felt great until the early evening, when I got tired and had a mild headache.

However, my recovery has not been perfectly smooth. I spent nearly all of one weekend this month lying in bed after I did a little too much for too many days in a row. Today I am feeling pretty tired, likely for the same reason.

So now the big question: how much is HBOT helping? It's still impossible to say that it's behind my reduction in headaches and fatigue.

There is one thing I directly attribute to it, though: a marked improvement in my sense of well-being. I was never depressed, or even considered myself unhappy, but now I feel an expansive happiness that I never felt before. I notice and feel grateful for really little things, like a sunny day or the chance to talk to a friend. I can sit and do nothing for long stretches of time, just feeling good. I am more aware of my feelings and emotions, and I am less consumed by them. This is especially helpful when I am experiencing PCS pain.

I attribute this to HBOT because of its meditation-like effects. During a treatment, I sit for an hour and a half doing absolutely nothing, and for an hour of that time, I wear a mask that accentuates the sound of my breathing. This biofeedback focuses my mind on my breath in a way that is easy and natural. I might think about other things, but my mind always comes back to my breath. I spend much of the time just counting up and down as I breathe in and out.

I have never really studied meditation, but I see a lot of parallels between my experience and its practice and results. Last week, I listened to an hourlong tape of meditation instruction and practice. Before HBOT, such a tape would have left me thinking, "I don't really get it. What are they talking about? Am I doing this right?". Instead, I thought, "I know exactly what they're trying to say. I regularly experience the mental state they're getting at. The problem is that words don't do it justice."

I have read reports of HBOT clearing up PTSD in veterans diagnosed with both it and PCS. I can see why. Whether it's because of the oxygen or just because of the calming biofeedback, HBOT has definitely improved my mental state - something I wasn't even hoping for when I began treatment.

I'm continuing to have treatments 4-5 times a week. In a few weeks, I'll have reached the 40 treatments used in many research protocols. I hope to have more good news to report then!

I have completed somewhere in the ballpark of 80 sessions of HBOT, and it has done wonders for me. I also do neurofeedback and I'm on Hormone Replacement Therapy as well as nutritional therapy. I have had close to 30 concussions from playing sports and car accidents, and thanks to the therapy I have done, I am about 90% healed.

The HBOT will only work well for you though if you have eliminated inflammation and given your body the "fuel" it needs to heal itself. So, because it is very expensive, before you begin HBOT, make sure you have your thyroid, testosterone, cortisol, growth hormone, food allergies, etc. checked out and treated before beginning the treatments. Usually those who don't do well with HBOT have some type of road block in the way, such as the ones I mentioned above. Btw, those things are actually very common in people who have suffered a brain injury, especially those who had have had multiple brain injuries.

So, I highly recommend HBOT but make sure that you do your due diligence with your body before beginning treatment. And the cool thing is that in some cases, getting your body treated can actually heal your brain injury.

It's nearly impossible for someone dealing with severe environmental allergies, like me, to reduce inflammation, let alone eliminate it altogether. So, thanks for letting us know that this will not work in instances like that.

Hyperbaric Oxygen
 

Hi,

My daughter's injury was in Jan 2008 at age 13. She did oxygen therapy in Nov and Dec 2008. She did 40 treatments - 2x per week. We spent $7,000 on this. I did not see any improvements. The doctor wanted to do another 40 but I just could not justify that money.

It wasn't until March 2010 when we did QEEG guided neuro-feedback with Dr. Walker, a neurologist, in Dallas, TX that we have had significant improvements. She completed 212 treatments in Dec 2011 and she has had no more seizures, no more fatigue, less headaches, less severe headaches and recovers faster. She can tolerate noise for about an hour before she gets a headache. She can now read for 20 minutes 4x per day. So she is still very limited but life is more bearable. She just started vision therapy and that is spiking migraines. It is hard very hard to see her like this she is 18 now. She missed high-school. I wish I had better news.

I'm would like to try acupuncture I've heard several had improvements with that. Dr. Bynum in Dallas, TX had a TBI and she became an acupuncturist because of it. We did meet with her when we were in TX but my daughter doesn't feel comfortable with the needle idea.

Our neuro-psychologist recommends osteopathic treatments - cranial sacral but that really set off a terrible migraine.

Everyone seems to get help from different treatments. Don't give up. I'm not. Magnesium helps her.

Hyperbaric Oxygen treatment
 

I have also tried hyperbaric oxygen treatment 80 one hour treatments at either 1.5 or 2 ATA.

I think that it helped me and there is even some recent evidence from a clinical trial:
http://www.hyperbaricmedicalfoundati...rchJan2012.pdf

I was advised to do the treatment without too much time in between treatments in order to get a cumulative effect, preferably 5 or 6 times a week. I actually only managed 3 or 4 times a week and felt that that was enough for me.

Linda, I see that you were only trying twice a week. This may not have been frequent enough to get the best effects. I do completely accept that different things work for different people, but perhaps your daughter might benefit from trying again, doing the treatments more frequently. I was lucky in being able to get HBOT at a much cheaper rate than you were paying, but I do sympathize with the expense. However, 40 treatments five times a week might be better than 40 treatments twice a week.

I know that you said that you didn't see any benefit. But it is perhaps difficult to know what a 13 year old girl is feeling. Younger people are not always quick to express what they are feeling to their parents, particularly if they have had a brain injury. It would be hard for a parent to know whether or not a treatment was of any use. The communication part, at least, might be better now that your daughter is 18.

All the best to you both.
CS

Has Worked Incredible Well
 

Hello!
Yes, hyperbaric oxygen therapy has worked so well for me. I have had four concussions. I have tried many helpful things and many not so helpful things. I never found one that made me feel like myself again. My most recent concussion was in November of 2012. Within two days half of my face was bright red hot and tingly feeling, a terrible headache, super slow speech and motor skills, and I was having a hard time functioning and even thinking.

After getting out of the HBOT, for the first 10 minutes I could see clearly and talk well. Then it all slowed down again. Every session after that, I continuously felt progress for longer periods of time. I am now doing my second set of 40 treatments. Although I am down to my last dollars on my last credit card, I have no doubts as to whether I should be investing in this or not.
Rocky Mountain Hyperbaric Institute in Louisville, CO has a non-profit that can help. They are an incredibly experienced, honest, and caring group of people. These treatments are definitely worth asking anyone you know if they can pitch in some money so that you can get better.

Trier,

Welcome to NeuroTalk. Your experience with HBOT is not common. You are fortunate to be getting good results. Are they doing 1.5 atmospheres " What oxygen percentage ? How long are sessions ?

The VA is doing a study right now. Most studies have been anecdotal and done by HBOT organizations. The most promise is shown with TBI patients who are comatose. It speeds return to consciousness but has not improve long term outcomes.

What other things have you tried that helped and did not help ?

We are always interested in new ideas.

How old are you and how did you get your concussions ?

Mark, as a Respiratory Therapist, i would not recommend this idea for you. You have Central Sleep Apnea which means your neuro system "forgets" to breathe, you say it "remembers" to kick in when your oxygen falls. If you had that much oxygen it would not kick in again.

In order for it to work, you'd need to switch to a BiPAP machine, which means it guarantees so many breaths per minute and it pushes in a preset inspiratory air pressure, as well as maintain the expiratory pressure. CPAP is just expiratory pressure, it does not ensure that you take a breath, and it is more used for Obstructive Sleep Apnea (i.e. tongue falls back and obstructs breath efforts).

Neither would an O2 cannula; it would in fact fool your neuro system into not breathing anymore since lack of oxygen is what triggers your breathing. Is your CPAP really adequate and ensures you take enough breaths?? Really not likely, and if I were you I'd get another sleep study titration done at a different place that understands the difference between OSA = CPAP and CSA = BiPAP!

For oxygen, your BiPAP machine can have an adapter for O2 tubing going to the concentrator. For BiPAP, you would need another sleep study to determine the settings you need. For Oxygen to be prescribed along with it, you'd need documentation that your O2 sat falls down while you're sleeping. (At least in order for your insurance to pay for it.)

BEST WISHES Mark -- stay safe!! (P.S. I wonder too if this issue may be causing a lot of your PCS mud days, fatigue, etc... CPAP is just most often not adequate for CSA.) Tell me what your current setting is, just in case you do in fact have a BiPAP machine and not just CPAP, just so we all understand the difference; some people seem to use CPAP as a generic term. Is your setting one number, like 5, or is it two numbers, like 10 / 5 ?