Effect of Acetazolamide and AutoCPAP Therapy on Breathing Disturbances Among Patients With Obstructive Sleep Apnea Syndrome Who Travel to Altitude

Latshang, Tsogyal D.; Nussbaumer-Ochsner, Yvonne; Henn, Rahel M.; Ulrich, Silvia; Cascio, Christian M. Lo; Ledergerber, Bruno; Kohler, Malcolm; Bloch, Konrad E.

doi:10.1001/jama.2012.94847

Cited by 86 publications

(96 citation statements)

References 30 publications

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“…Latshang et al 46 recently showed that combined therapy with acetazolamide and auto-continuous positive airway pressure ventilation, as compared with positive air pressure ventilation alone, provides an improvement in nocturnal oxygen saturation, and an almost complete control of sleep apnea at altitude in patients with obstructive sleep apnea syndrome. Our results contribute to strengthen Latshang's suggestion that alleviating hypoxemia at altitude by acetazolamide may potentially contribute to reducing the risk of adverse effects of altitude exposure, in particular in patients with cardiovascular comorbidities.…”

Section: Acetazolamidementioning

confidence: 99%

Changes in Subendocardial Viability Ratio With Acute High-Altitude Exposure and Protective Role of Acetazolamide

et al. 2013

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Abstract-High-altitude tourism is increasingly frequent, involving also subjects with manifest or subclinical coronary artery disease. Little is known, however, on the effects of altitude exposure on factors affecting coronary perfusion. The aim of our study was to assess myocardial oxygen supply/demand ratio in healthy subjects during acute exposure at high altitude and to evaluate the effect of acetazolamide on this parameter. Forty-four subjects (21 men, age range: 24-59 years) were randomized to double-blind acetazolamide 250 mg bid or placebo. Subendocardial viability ratio and oxygen supply/demand ratio were estimated on carotid artery by means of a validated PulsePen tonometer, at sea level, before and after treatment, and after acute and more prolonged exposure to high altitude (4559 m). On arrival at high altitude, subendocardial viability ratio was reduced in both placebo (from 1.63±0.

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Section: Acetazolamidementioning

confidence: 99%

Changes in Subendocardial Viability Ratio With Acute High-Altitude Exposure and Protective Role of Acetazolamide

et al. 2013

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“…Our study supports findings from prior studies that suggest that individuals with OSA ascending to altitude are inadequately treated with either the same or minimally increased PAP baseline settings. One study that monitored patients with PAP-treated OSA at altitude demonstrated that CSA was worse at higher altitudes (18). This study occurred with a 3-day period in which patients might have had some acclimatization.…”

Section: Discussionmentioning

confidence: 99%

Effects of Positive Airway Pressure on Patients with Obstructive Sleep Apnea during Acute Ascent to Altitude

et al. 2015

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Rationale: In acute ascent to altitude, untreated obstructive sleep apnea (OSA) is often replaced with central sleep apnea (CSA). In patients with obstructive sleep apnea who travel to altitude, it is unknown whether their home positive airway pressure (PAP) settings are sufficient to treat their obstructive sleep apnea, or altitude-associated central sleep apnea.Methods: Ten participants with positive airway pressure-treated obstructive sleep apnea, who reside at 1,320 m altitude, underwent polysomnography on their home positive airway pressure settings at 1,320 m and at a simulated altitude of 2,750 m in a hypobaric chamber. Six of the participants were subsequently studied without positive airway pressure at 2,750 m.Measurements and Main Results: At 1,320 m, all participants' sleep apnea was controlled with positive airway pressure on home settings; at 2,750, no participants' sleep apnea was controlled. At higher altitude, the apnea-hypopnea index was higher (11 vs. 2 events/h; P , 0.01), mostly due to hypopneas (10.5 vs. 2 events/h; P , 0.01). Mean oxygen saturations were lower (88 vs. 93%; P , 0.01) and total sleep time was diminished (349 vs. 393 min; P = 0.03). Four of six participants without positive airway pressure at 2,750 m required supplemental oxygen to prevent sustained oxygen saturation (as determined by pulse oximetry) less than 80%. Positive airway pressure also was associated with reduced central sleep apnea (0 vs. 1; P = 0.03), improved sleep time (358 vs. 292 min; P = 0.06), and improved sleep efficiency (78 vs. 63%; P = 0.04).Conclusions: Acute altitude exposure in patients with obstructive sleep apnea treated with positive airway pressure is associated with hypoxemia, decreased sleep time, and increased frequency of hypopneas compared with baseline altitude. Application of positive airway pressure at altitude is associated with decreased central sleep apnea and increased sleep efficiency.

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“…[8] в своей работе продемонстрировали, что прием теофиллина и ацетазола-мида уменьшает нарушение дыхания во время сна при пребыва-нии на больших высотах (3454 м). Ученые из Университетской клиники Цюриха (Швейцария) также предположили, что прием ацетазоламида может уменьшить явления гипоксемии, сонливо-сти, предупредить нарушения дыхания у пациентов с СОАС во время пребывания в горах [9,10].…”

Section: терапевтический архив 01 2017unclassified

Obstructive sleep apnea at high altitude

Myrzaakhmatova

2017

Terapevticheskii arkhiv

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Синдром обструктивного апноэ во сне в условиях высокогорья А.К. МЫРЗААХМАТОВАНациональный центр кардиологии и терапии им. акад. М. Миррахимова, Бишкек, Киргизская Республика Аннотация Синдром обструктивного апноэ во сне (СОАС) -важная и социально значимая проблема современной медицины, отно-сящаяся к числу наиболее распространенных патологических состояний. Проблема СОАС особенно актуальна для жите-лей высокогорных регионов, так как сочетание климатических, социальных и культурных факторов может оказывать зна-чительное влияние на течение болезни как у коренных горцев, так и у лиц, временно пребывающих на больших высотах. В статье представлен обзор современной литературы, освещающий проблему СОАС в условиях высокогорья. Приведены данные отечественной и зарубежной литературы, затрагивающие особенности патогенеза и клинической картины СОАС. Проанализированы современные данные о влиянии высокогорья на течение СОАС у коренных жителей высокогорья и у лиц, временно пребывающих на больших высотах. Подчеркнута роль гипобарической гипокапнии как важнейшего фак-тора развития центральных апноэ во сне на фоне обструктивных и усугубляющих течение болезни. Obstructive sleep apnea (OSA) is an important and socially relevant problem of modern medicine, which is referred to as a most common pathological condition. The problem of OSA is especially urgent for inhabitants of high mountainous regions, as a combination of climatic, social, and cultural factors can significantly affect the course of the disease in both indigenous highlanders and people temporarily residing at high altitude. The paper reviews the current literature covering the problem of OSA at high altitude. It gives the data of Russian and foreign literature on the pathogenesis and clinical presentation of OSA. The author also analyzes an update on the impact of high altitude on the course of OSA in indigenous highlanders and people temporarily living at high altitude. She emphasizes the role of hypobaric hypocapnia as the most important factor for the development of central sleep apnea in the presence of conditions that are obstructive and aggravating the course of the disease.

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Effect of Acetazolamide and AutoCPAP Therapy on Breathing Disturbances Among Patients With Obstructive Sleep Apnea Syndrome Who Travel to Altitude

Cited by 86 publications

References 30 publications

Changes in Subendocardial Viability Ratio With Acute High-Altitude Exposure and Protective Role of Acetazolamide

Changes in Subendocardial Viability Ratio With Acute High-Altitude Exposure and Protective Role of Acetazolamide

Effects of Positive Airway Pressure on Patients with Obstructive Sleep Apnea during Acute Ascent to Altitude

Obstructive sleep apnea at high altitude

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