higher altitude problemsA research concluded recently has revealed its findings that those who are suffering from obstructive sleep apnea (OSA) may control the sleep issue while traveling to higher altitudes if they can combine auto-adjusted continuous positive airway pressure (autoCPAP) with acetazolamide.

“Our study provides important information for patients with OSA planning a stay at altitude because they can continue using their CPAP in auto-adjusting mode during altitude travel and enhance this treatment with acetazolamide if they want to spend less time awake at night, to achieve a higher arterial oxygen saturation and an optimal control of sleep apnea,” said Konrad Bloch, from University Hospital of Zurich in Switzerland.

Researchers conducted two specific trips to higher altitude destinations with 51 OSA patients living below an altitude of 800 m and receiving CPAP therapy . These patients were randomly assigned to receive either auto-CPAP therapy plus placebo (autoCPAP alone) or auto-CPAP therapy plus acetazolamide 750 mg during two 3-day trips to mountain villages at 1630 m and 2590 m. The two trips were separated by a 2-week washout period at 800 m, after which participants received the alternative treatment combination.

Findings of this research study have been published in the JAMA, and established the facts that nocturnal oxygen saturation was 1% higher with auto-CPAP plus acetazolamide than with auto-CPAP alone at 1630 m and 2% higher at 2590 m. At 2590 m, patients receiving acetazolamide in addition to auto-CPAP spent a median 13% of the night with oxygen saturation below 90% compared with a median of 57% for those receiving auto-CPAP alone.

The combination of auto-CPAP and acetazolamide was also reported as more beneficial for controlling sleep apnea, with significant median reductions on the apnea/hypopnea index (AHI) of 3.2 events/hour at 1630 m and 9.2 events/hour at 2590 m, compared with auto-CPAP alone.

“This reduction was mainly due to a decrease in the number of central apneas/hypopneas, particularly during non-rapid eye movement sleep”, according to the researchers.

“To prevent one patient from experiencing an increase of the AHI to greater than 10/h or a decrease of the oxygen saturation to less than 90% at 2590 m, two patients or three patients, respectively, had to be treated with acetazolamide”, say the researchers.

Concluding remarks of the research states as ,”Alleviating hypoxemia at rest and during exercise at altitude by acetazolamide may potentially contribute to reducing the risk of adverse effects of altitude exposure, in particular in patients with OSA and cardiovascular comorbidities.”

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