For individuals with obstructive sleep apnea (OSA) 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.
“The current randomized, placebo-controlled, double-blind trial provides several novel findings that are clinically relevant for patients with OSA traveling to altitude”, according to the authors. “First, the data show that combined therapy with acetazolamide, the drug often branded as Diamox and prescribed to help patients with altitude sickness, and auto continuous positive airway pressure (CPAP) provides a better oxygenation during sleep and wakefulness, prevents an exacerbation of sleep apnea at altitude and reduces the time spent awake during nights compared with auto CPAP alone. Second, the results demonstrate that auto CPAP alone is an effective therapy for obstructive apneas/hypopneas even at altitude where central apneas/hypopneas emerge.”
The study was published in the December 12 issue of The Journal of the American Medical Association (JAMA). The randomized trial 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 auto CPAP.
The researchers found that at 1,630 meters and 2,590 meters, combined acetazolamide and auto CPAP treatment was associated with higher oxygen saturation and a lower apnea/hypopnea index (AHI) compared with placebo and auto CPAP.
“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.”
