Continuous Positive Airway Pressure and Acetazolamide to Treat Sleep Apnea Syndrome Patients at Altitude - Full Text View

Purpose

The purpose of the study is to investigate the effect of nasal continuous positive airway pressure in combination with acetazolamide as a treatment for sleep related breathing disturbances in patients with the obstructive sleep apnea syndrome living at low altitude during a sojourn at moderate altitude.

Condition	Intervention	Phase
Obstructive Sleep Apnea Syndrome	Drug: acetazolamide Procedure: nocturnal continuous positive airway pressure Drug: placebo	Phase 4


Study Type:	Interventional
Study Design:	Allocation: Randomized Endpoint Classification: Efficacy Study Intervention Model: Crossover Assignment Masking: Double Blind (Subject, Caregiver, Investigator, Outcomes Assessor) Primary Purpose: Treatment
Official Title:	Continuous Positive Airway Pressure (CPAP) and Acetazolamide for Treatment of Patients With the Obstructive Sleep Apnea Syndrome at Altitude

Resource links provided by NLM:

MedlinePlus related topics: Sleep Apnea

Drug Information available for: Acetazolamide Acetazolamide sodium

U.S. FDA Resources

Further study details as provided by University of Zurich:

Primary Outcome Measures:

sleep disordered breathing and oxygenation [ Time Frame: day 2 and 3 at altitude ] [ Designated as safety issue: No ]

Secondary Outcome Measures:

sleep quality, vigilance, acute mountain sickness, blood pressure [ Time Frame: day 2 and 3 at altitude ] [ Designated as safety issue: No ]


Enrollment:	51
Study Start Date:	June 2009
Study Completion Date:	November 2009
Primary Completion Date:	November 2009 (Final data collection date for primary outcome measure)

Arms	Assigned Interventions
Experimental: acetazolamide combination of acetazolamide and nocturnal continuous positive airway pressure ventilation	Drug: acetazolamide acetazolamide 250mg 1/0/2 Other Name: Diamox (trade name) Procedure: nocturnal continuous positive airway pressure continuous positive airway pressure Other Name: placebo capsules
Placebo Comparator: placebo capsules combination of placebo and nocturnal continuous positive airway pressure ventilation	Procedure: nocturnal continuous positive airway pressure continuous positive airway pressure Other Name: placebo capsules Drug: placebo placebo capsules Other Name: placebo capsules

Eligibility


Ages Eligible for Study:	20 Years to 80 Years
Genders Eligible for Study:	Both
Accepts Healthy Volunteers:	No

Criteria

Inclusion Criteria:

Obstructive sleep apnea syndrome, successfully on CPAP therapy
Residence at low altitude (< 800 m)
Obstructive apnea/hypopnea index >20/h and a complaint of excessive daytime sleepiness before introduction of CPAP therapy
> 15 oxygen desaturations/h (> 3% dips) during an ambulatory nocturnal pulse oximetry performed at the end of a 4-night period without CPAP

Exclusion Criteria:

Sleep disorders other than OSA
More than mild cardiovascular disease, unstable cardiovascular disease
Any lung disease, pulmonary hypertension
Chronic rhinitis
Treatment with drugs that affect respiratory center drive (benzodiazepines or other sedatives or sleep inducing drugs, morphine or codeine derivates), stimulants (modafinil, methylphenidate, theophylline)
Internal, neurologic or psychiatric disease that interfere with sleep quality
Previous intolerance to moderate or low altitude (< 2600 m)
Exposure to altitudes > 1500m for > 1 day within the last 4 weeks before the study

Contacts and Locations

Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the Contacts provided below. For general information, see Learn About Clinical Studies.

Please refer to this study by its ClinicalTrials.gov identifier: NCT00928655

Locations


Switzerland
University Hospital of Zurich, Pulmonary Division and Sleep Disorders Centre
Zurich, Switzerland, CH-8091

Sponsors and Collaborators

University of Zurich

Investigators


Study Director:	Konrad E Bloch, MD	University Hospital of Zurich, Pulmonary Division and Sleep Disorders Centre, Zurich, Switzerland

More Information

Publications:

Latshang TD, Nussbaumer-Ochsner Y, Henn RM, Ulrich S, Lo Cascio CM, Ledergerber B, Kohler M, Bloch KE. Effect of acetazolamide and autoCPAP therapy on breathing disturbances among patients with obstructive sleep apnea syndrome who travel to altitude: a randomized controlled trial. JAMA. 2012 Dec 12;308(22):2390-8. doi: 10.1001/jama.2012.94847.

Latshang TD, Bloch KE, Lynm C, Livingston EH. JAMA patient page. Traveling to high altitude when you have sleep apnea. JAMA. 2012 Dec 12;308(22):2418. doi: 10.1001/jama.2012.4097.

Latshang TD, Bloch KE. How to treat patients with obstructive sleep apnea syndrome during an altitude sojourn. High Alt Med Biol. 2011 Winter;12(4):303-7. doi: 10.1089/ham.2011.1055.

Stadelmann K, Latshang TD, Nussbaumer-Ochsner Y, Tarokh L, Ulrich S, Kohler M, Bloch KE, Achermann P. Impact of acetazolamide and CPAP on cortical activity in obstructive sleep apnea patients. PLoS One. 2014 Apr 7;9(4):e93931. doi: 10.1371/journal.pone.0093931. eCollection 2014.


Responsible Party:	University of Zurich
ClinicalTrials.gov Identifier:	NCT00928655 History of Changes
Other Study ID Numbers:	EK-1522A#1-4
Study First Received:	June 22, 2009
Last Updated:	May 18, 2014
Health Authority:	Switzerland: Ethikkommission

Keywords provided by University of Zurich:


apnea sleep altitude	hypoxia treatment CPAP

Additional relevant MeSH terms:


Apnea Sleep Apnea Syndromes Sleep Apnea, Obstructive Syndrome Disease Dyssomnias Nervous System Diseases Pathologic Processes Respiration Disorders Respiratory Tract Diseases Signs and Symptoms Signs and Symptoms, Respiratory Sleep Disorders	Sleep Disorders, Intrinsic Acetazolamide Anticonvulsants Carbonic Anhydrase Inhibitors Cardiovascular Agents Central Nervous System Agents Diuretics Enzyme Inhibitors Molecular Mechanisms of Pharmacological Action Natriuretic Agents Pharmacologic Actions Physiological Effects of Drugs Therapeutic Uses

ClinicalTrials.gov processed this record on February 27, 2015