Affiliation:
1. Department of Respiratory Medicine, University Hospital of Zurich , Zurich , Switzerland
2. Swiss-Kyrgyz High Altitude Medicine and Research Initiative , Zurich , Switzerland
3. Swiss-Kyrgyz High Altitude Medicine and Research Initiative , Bishek , Kyrgyz Republic
4. Department of Respiratory Medicine, National Center for Cardiology and Internal Medicine , Bishkek , Kyrgyzstan
Abstract
Abstract
Study Objectives
To assess altitude-induced sleep and nocturnal breathing disturbances in healthy lowlanders 40 y of age or older and the effects of preventive acetazolamide treatment.
Methods
Clinical examinations and polysomnography were performed at 760 m and in the first night after ascent to 3100 m in a subsample of participants of a larger trial evaluating altitude illness. Participants were randomized 1:1 to treatment with acetazolamide (375 mg/day) or placebo, starting 24 h before and while staying at 3100 m. The main outcomes were indices of sleep structure, oxygenation, and apnea/hypopnea index (AHI).
Results
Per protocol analysis included 86 participants (mean ± SE 53 ± 7 y old, 66% female). In 43 individuals randomized to placebo, mean nocturnal pulse oximetry (SpO2) was 94.0 ± 0.4% at 760 m and 86.7 ± 0.4% at 3100 m, with mean change (95%CI) −7.3% (−8.0 to −6.5); oxygen desaturation index (ODI) was 5.0 ± 2.3 at 760 m and 29.2 ± 2.3 at 3100 m, change 24.2/h (18.8 to 24.5); AHI was 11.3 ± 2.4/h at 760 m and 23.5 ± 2.4/h at 3100 m, change 12.2/h (7.3 to 17.0). In 43 individuals randomized to acetazolamide, altitude-induced changes were mitigated. Mean differences (Δ, 95%CI) in altitude-induced changes were: ΔSpO2 2.3% (1.3 to 3.4), ΔODI -15.0/h (−22.6 to −7.4), ΔAHI -11.4/h (−18.3 to −4.6). Total sleep time, sleep efficiency, and N3-sleep fraction decreased with an ascent to 3100 m under placebo by 40 min (17 to 60), 5% (2 to 8), and 6% (2 to 11), respectively. Acetazolamide did not significantly change these outcomes.
Conclusions
During a night at 3100 m, healthy lowlanders aged 40 y or older revealed hypoxemia, sleep apnea, and disturbed sleep. Preventive acetazolamide treatment improved oxygenation and nocturnal breathing but had no effect on sleep duration and structure.
Trial registration
The trial is registered at Clinical Trials, https://clinicaltrials.gov, NCT03561675
Funder
Swiss Lung Association
Swiss National Science Foundation
Publisher
Oxford University Press (OUP)
Subject
Physiology (medical),Neurology (clinical)
Reference34 articles.
1. Exercise performance and symptoms in lowlanders with COPD ascending to moderate altitude: randomized trial;Furian;Int J Chron Obstruct Pulmon Dis.,2018
2. Effect of hypoxia and hyperoxia on exercise performance in healthy individuals and in patients with pulmonary hypertension: a systematic review;Ulrich;J Appl Physiol.,2017
3. Acclimatization improves submaximal exercise economy at 5533 m;Latshang;Scand J Med Sci Sports.,2013
4. Clinical practice: ACUTE high-altitude illnesses;Bartsch;N Engl J Med.,2013
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