To the Editor: We were interested to read the article by Tirlapur and Mir1 and the accompanying editorial2 in the January 21 issue. Although we agree with the basic premise that nocturnal oxygen therapy may be beneficial in patients with chronic obstructive respiratory disease, and probably in other disorders involving nocturnal and sleep-related hypoxemia, we urge caution in its administration. We recently studied the effect of low-flow oxygen therapy in patients with alveolar hypoventilation, including several who resembled“blue bloaters.”The blue-bloater patients were obese, hypoxic, hypercapnic, and polycythemic but had only mildly impaired daytime respiratory function. During nocturnal polysomnography,. . .
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