Combination therapy may help decrease sleep apnea symptoms at higher altitudes

December 11, 2012

For individuals with obstructive sleep apnea traveling to higher altitudes (which may exacerbate symptoms), use of a combination therapy resulted in improvement in symptoms including reduced insomnia and better control of sleep apnea, according to a preliminary study published in the December 12 issue of JAMA.

As travel to the mountains for professional and recreational activities is increasingly popular, involving millions of persons worldwide, the estimated number of patients with obstructive (OSA) among mountain tourists is also high, and may involve several hundred thousand persons each year, which may expose them to hypoxemia (abnormally low levels of oxygen in the blood) and of sleep apnea. "The treatment in this setting is not established," according to background information in the article.

Tsogyal D. Latshang, M.D., of the University of Zurich, Switzerland, and colleagues conducted a study to evaluate whether taking of the drug acetazolamide (a respiratory used to treat and high-altitude periodic breathing) combined with auto-adjusted continuous positive (autoCPAP, computer-controlled continuous mask pressure adjustment) would provide better oxygenation and control of sleep-related breathing disturbances than autoCPAP alone in patients with OSA spending a few days at moderate altitude. The included 51 patients with OSA living below an altitude of 800 meters (2,625 feet) and receiving CPAP therapy who underwent studies at a university hospital at 490 meters (1,608 feet) and resorts in Swiss mountain villages at 1,630 meters (5,348 feet) and 2,590 meters (8,497 feet) in the summer of 2009. Patients were studied during 2 stays of 3 days each in the mountain villages. At altitude, patients either took acetazolamide (750 mg/d) or placebo in addition to autoCPAP.

The researchers found that at 1,630 meters and 2,590 meters, combined acetazolamide and autoCPAP treatment was associated with higher oxygen saturation and a lower apnea/hypopnea index (AHI) compared with placebo and autoCPAP. AutoCPAP and acetazolamide increased the median [midpoint] nocturnal oxygen saturation by 1.0 percent at 1,630 meters and by 2.0 percent at 2,590 meters. Also, acetazolamide and autoCPAP resulted in better control of sleep apnea at these altitudes than placebo and autoCPAP: median apnea/ hypopnea index was 5.8 events per hour (5.8/h) and 6.8/h vs. 10.7/h and 19.3/h, respectively; median reduction was 3.2/h and 9.2/h. Median night-time spent with oxygen saturation less than 90 percent at 2,590 meters was 13 percent vs. 57 percent.

"The current randomized, placebo-controlled, double-blind trial provides several novel findings that are clinically relevant for patients with OSA traveling to altitude. First, the data show that combined therapy with acetazolamide and autoCPAP provides a better during sleep and wakefulness, prevents an exacerbation of sleep apnea at altitude, and reduces the time spent awake during nights compared with autoCPAP alone. Second, the results demonstrate that autoCPAP alone is an effective therapy for obstructive apneas/hypopneas even at altitude where central apneas/hypopneas emerge," the authors write.

"Our study provides important information for patients with OSA planning a stay at altitude because they can continue using their CPAP in autoadjusting 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."

Explore further: Treatment of obstructive sleep apnea improves blood pressure in men

More information: JAMA. 2012;308(22):2390-2398

Related Stories

Treatment of obstructive sleep apnea improves blood pressure in men

October 13, 2012
A new study suggests that when prescribed by physicians in routine practice and used appropriately by patients, treatment for obstructive sleep apnea (OSA) could reduce blood pressure in men with hypertension.

Is that sleepiness during pregnancy normal or a sign of sleep apnea?

February 10, 2012
(Medical Xpress) -- Most pregnant women complain of being tired. Some of them however, could be suffering more than normal fatigue associated with their pregnancy; they may have developed obstructive sleep apnea (OSA), a ...

Study links obstructive sleep apnea to blood vessel abnormalities

July 11, 2011
Obstructive sleep apnea may cause changes in blood vessel function that reduces blood supply to the heart in people who are otherwise healthy, according to new research reported in Hypertension: Journal of the American Heart ...

Sleep apnea treatment may protect against heart failure

March 13, 2012
A nightly breathing treatment may do more than help people with obstructive sleep apnea get a good night's rest — it may also help prevent heart failure.

Recommended for you

Anti-nausea drug could help treat sleep apnea

June 6, 2017
An old pharmaceutical product may be a new treatment for obstructive sleep apnea, according to new research presented today by University of Illinois at Chicago and Northwestern University scientists at the SLEEP 2017 annual ...

New disposable, wearable patch found to effectively detect sleep apnea

June 4, 2017
Results of a definitive clinical trial show that a new, disposable diagnostic patch effectively detects obstructive sleep apnea across all severity levels.

Childhood sleep apnoea is common but hard to diagnose

April 28, 2017
The cessation of breathing during sleep caused by enlarged tonsils is common in preschool-age children and can cause serious complications, but the methods normally used to diagnose the condition are subjective and unreliable. ...

Curbing sleep apnea might mean fewer night trips to bathroom

March 27, 2017
(HealthDay)—Millions of Americans battle bothersome nighttime conditions, such as sleep apnea or the need to get up frequently to urinate.

Untreated sleep apnea in children can harm brain cells tied to cognition and mood

March 17, 2017
A study comparing children between 7 and 11 years of age who have moderate or severe obstructive sleep apnea to children the same age who slept normally, found significant reductions of gray matter - brain cells involved ...

Dietary supplement derived from tree bark shows promise for treating obstructive sleep apnea

February 24, 2017
Obstructive sleep apnea, which causes people to briefly stop breathing while asleep, affects an estimated 5 percent of the population, not including the many more who don't even realize they suffer from the disorder.

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.