Combination therapyA combination of acetazolamide and autoCPAP therapy provides improvement in the nocturnal oxygen saturation and apnea/hypopnea index for patients with obstructive sleep apnea who travel to higher altitudes, according to research published in JAMA. The results were relative to those achieved through autoCPAP alone.


“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,” the authors wrote.


The randomized, placebo-controlled, double-blind trial provided several novel findings that are clinically relevant for patients with OSA traveling to altitude, according to the authors.


For the study, 51 patients with OSA living below an altitude of 2,625 feet and receiving CPAP therapy participated in studies at 1,608 feet, 5,348 feet, and 8,497 feet. Patients were studied during two stays of 3 days each at the different altitudes. At altitude, patients took either acetazolamide (750 mg/d) or placebo in addition to autoCPAP.


Investigators discovered that at 5,348 and 8,497 feet, combined acetazolamide and autoCPAP treatment was associated with higher oxygen saturation and a lower apnea/hypopnea index compared with placebo and autoCPAP. The combination therapy also resulted in better control of sleep apnea at these altitudes than placebo and autoCPAP.