Chest
Original ResearchOccupational And Environmental Lung DiseasesPatients With Obstructive Sleep Apnea Syndrome Benefit From Acetazolamide During an Altitude Sojourn: A Randomized, Placebo-Controlled, Double-Blind Trial
Section snippets
Design Overview
We performed a randomized, placebo-controlled, double-blind, crossover trial to evaluate the effect of acetazolamide on nocturnal breathing, sleep, and daytime performance in patients with untreated OSA at altitude. The trial comprised two altitude sojourns of 3 days each, separated by a 2-week washout period spent at < 600 m (Fig 1). In the 3 nights before and during the altitude sojourns, patients discontinued CPAP, but used it during washout. Patients were not allowed to drive a car or
Results
Of 75 patients who applied for study participation, 49 met the inclusion criteria and were randomized (Fig 2). One patient had to withdraw from the study after the first night at 2,590 m because of an acute peripheral vestibulopathy. Data from three patients had to be excluded after study completion according to the predefined criteria, because baseline polysomnography at Zurich revealed an obstructive AHI < 10/h in two patients and predominant central sleep apnea in one patient. Data from 45
Discussion
We evaluated the effect of acetazolamide on sleep and breathing disturbances in patients with OSA discontinuing CPAP therapy during a temporary stay at moderate altitude. Our randomized, double-blind, placebo-controlled trial revealed a significantly improved nocturnal Spo2 related to an increase in ventilation and a decrease in the AHI by acetazolamide mainly because of a reduction of central events. Because the drug alleviated sleep-related breathing disturbances, improved subjective
Acknowledgments
Author contributions: Dr Nussbaumer-Ochsner takes full responsibility for the integrity of all data and the accuracy of the data analysis.
Dr Nussbaumer-Ochsner: contributed to designing the study, collecting the data, analyzing the data, and writing the manuscript.
Dr Latshang: contributed to designing the study, collecting the data, analyzing the data, and revising the manuscript.
Dr Ulrich: contributed to collecting the data, analyzing the data, and revising the manuscript.
Dr Kohler:
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Funding/Support: This study was supported by the Swiss National Science Foundation [Grant 32003B-122081]; the Lung League of Zurich and Schaffhausen; the Center for Clinical Research, University Hospital of Zurich; and the University of Zurich, Switzerland.
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