Medical Professionals

Starting Patients on the Apogee

Doctor Oxygen Patient

Dynaris is proud to work alongside patients and doctors to provide what’s best for every individual’s needs. We strongly direct patients to consult with their healthcare provider to determine whether the Dynaris Apogee is right for them.

Read through the letter below for a summary of the Apogee’s functionality and patient benefits. The letter is also available for download.

Also on this page:

  • Medical Necessity Letter: Download and send this to patients’ insurance carriers to recommend they cover the Apogee Delivery System.
  • Apogee Prescription Template
  • Testimonials on Dynaris from Medical Professionals
  • Summary and full study link to a Texas State University study on the Nasal Cycle

If you haven’t already, visit the Apogee Page and read through the comparisons to other standard oxygen systems that exist today. On this same page, the main components of the Apogee Dynamic Oxygen Delivery System are described in detail.

Why Apogee May Be Right for Your Patients

The Apogee Dynamic Oxygen Delivery System excels where conservers and portable oxygen concentrators often fall short.

Recent studies show that we naturally breathe through a dominant nasal passage that alternates throughout the day. This process is called the “nasal cycle.” It is believed this occurs to allow each side of the nose time to rest and rehydrate. The Apogee’s patented technology leverages the nasal cycle by detecting and delivering pulsed oxygen only to the dominant nostril — so no oxygen is wasted on the blocked side.

The Apogee is effective for all patients requiring portable oxygen, especially in conditions where one nostril remains blocked — such as with a deviated septum, turbinate hypertrophy, nasal valve collapse, and sinus infection. The Apogee, with its 1 to 6 settings are ideal when higher liter flows are required and the patient needs a longer-lasting portable system.

Benefits include:

Improved Therapy

  • Many users achieve more consistent saturation levels (All other systems can lose up to 50% of O₂ due to the nasal cycle).
  • Oxygen volume delivered remains constant with each breath unlike portable concentrators and conservers that deliver ‘minute volume’. They reduce the oxygen — when you need it the most — as the breath rate increases.
  • Highest Purity — The Apogee uses any size oxygen cylinder that contains up to 99% pure oxygen (Guidelines for portable concentrators is 85%; the smaller the POC, the less O2 produced.)
  • Earliest inspiratory detection and delivery — Patented sensors enable the fastest published response time. This optimizes alveolar ventilation, where in the lung gas exchange occurs. Systems that trigger late may lose oxygen to the dead space in the airway.
  • Improved Comfort — Less nasal drying and irritation (The blocked nasal passage has time to rest and rehydrate while the other nasal passage receives oxygen.)

Increased Cylinder Duration

  • Oxygen cylinders last 5 times longer at comparable continuous flow settings.

Convenience & Economy

  • A 4-pound cylinder can last approximately 7 hours at a setting of 2. An E-size cylinder on a cart can last over 25 hours. This enables longer periods to ambulate with smaller cylinders — requiring fewer deliveries and cylinder exchanges.

Medical Necessity & Prescription Template

The Medical Necessity document below is recommended for Doctors to download and fill out for each patient. This letter should be sent to a patient’s insurance provider to ensure individuals can receive the healthcare benefits they’re entitled to.

The Prescription Template below is available to view, download and print. You may fax us your patients’ ambulatory oxygen prescription however you see fit. It can be written exactly how you’re used to with other oxygen systems. The format of our template is simply for added guidance if necessary.


Fax patient prescriptions to our offices to 636-778-1050

What the Experts Are Saying

This efficient targeted oxygen delivery should not only enhance oxygen saturation, but will virtually cut oxygen use by half. A brilliant discovery!”

Dr. Tim Curran

Austin, Texas

“Patients no longer need to suffer nasal irritation for the benefits of life-sustaining oxygen.”

Oscar Carillo

Researcher & Clinical Advisor

University Study on the Nasal Cycle

We have summarized below a study on the nasal cycle taken place at Texas State University in April 2016. The full case study document is available to read from the link below our summary.

Our Summary:

Nasal Cannula Flow Delivery And Nasal Cycling

Respiratory Care Journal – April 2016; Editor’s Choice Study

“Right Versus Left Prong Nasal Cannula Flow Delivery and the Effects of Nasal Cycling on Inspired FIO2 in an Adult Model”


  • S. Gregory Marshall PhD, RRT, RPSGT, RST
  • Nicholas R. Henry MSc, RRT-ACCS, RRT-NPS AE-C
  • Christopher J. Russian PhD, RRT-NPS, RPSGT, RST

The study measured the effects on oxygen concentrations entering the airway when one nasal passage becomes blocked, a common occurrence of the “nasal cycle.”

Here the authors found that the “traditional nasal cannula may be inefficient in the presence of the nasal cycle.” The authors concluded that “traditional nasal cannula usage in the presence of the human nasal cycle may result in oxygen waste for the patients receiving long-term oxygen therapy and a failure to deliver the prescribed amount of oxygen to the patient.”

The Nasal Cycle

The Nasal Cycle was first reported over 100 years ago – Nearly 80% of the healthy population appear to exhibit a regular nasal cycle day and night. It is present in infants, children, adults, and the majority of mammals as well (rats, rabbits, dogs, cats).

The nose is separated into 2 independent passages, and the phenomenon known as nasal cycling is the spontaneous change in unilateral airflow as a result of congestion and decongestion of the right or left nasal venous sinuses. The right and left prong of the nasal cannula is designed to deliver oxygen to their respective naris. There are no previous studies comparing right and left prong oxygen flow for nasal cannula adjuncts at various therapeutic flow settings.

Testing Methods

Oxygen flow from Right and Left Nasal Cannula prongs were measured simultaneously using thermal mass flow meters. Five cannulas from different manufacturers were used. An adult mannequin head with correct airways was connected to a test lung.

To accurately imitate the human nasal cycle, data was recorded with:

  • Both nasals open
  • Right side blocked with the left side open
  • Left side blocked with the right side open

Results & Conclusion

  • There were statistical differences between right and left nasal cannula prong oxygen flows
  • No significant differences in nasal cannula flow between the differences in 5 cannulas from different manufacturers.
  • Significant differences when alternative nostrils were blocked and the other open.

Evaluating the flow of oxygen from nasal cannula prongs comparing 5 brands of nasal cannula devices revealed a statistically significant difference between right and left nasal cannula prong flow; however, the difference may not be clinically important. Delivering oxygen by nasal cannula during nasal cycling, causing a completely obstructed naris, may be insufficient for oxygen patient demands. Traditional nasal cannula usage in the presence of the human nasal cycle may result in oxygen waste for patients and fail to deliver the prescribed amount of oxygen to the patient. Because of this, clinicians should consider the effects of nasal cycling when delivering low-flow oxygen by nasal cannula.