title: Theophylline and acetazolamide reduce sleep-disordered breathing at high altitude.
abstract: A randomised, double-blind, placebo-controlled study was conducted to evaluate the effects of theophylline and acetazolamide in the treatment of sleep-disordered breathing (SDB) after fast ascent to high altitude (3,454 m). The study was conducted at a high-altitude research laboratory and included 30 healthy male volunteers. Study medication was either oral slow release theophylline (2x250 mg x day(-1)), oral acetazolamide (2x250 mg x day(-1)) or a matched placebo tablet. Polysomnographic measurements were performed during two consecutive nights, and acute mountain sickness, pulse rate, oxyhaemoglobin saturation and arterial blood gases were assessed three times a day. Without active medication, the apnoea/hypopnoea index (AHI) was highly pathological (median 16.2 x h(-1), range 2-92). Both theophylline and acetazolamide normalised SDB (median AHI 2.5 x h(-1), range 0-11; 4.2 x h(-1), range 0-19, respectively) and reduced oxyhaemoglobin desaturations during sleep (median desaturation index placebo 41.5 x h(-1), range 6-114; acetazolamide 6.5 x h(-1), range 3-28; theophylline 8.5 x h(-1), range 3-32). Compared with the high amount of central apnoeas or hypopnoeas, the number of obstructive events during sleep was very low in all groups (<4 x h(-1)). In contrast to theophylline, acetazolamide significantly improved basal oxyhaemoglobin saturation during sleep (86.2 +/- 1.7% versus 81.0 +/- 3.0%). The authors conclude that both oral slow release theophylline and acetazolamide are effective to normalise high-altitude sleep-disordered breathing.
authors.affiliation: Dept of Medicine, Division of Pneumology, Medizinische Klinik--Innenstadt, University of Munich, Munich, Germany. rainald.fischer@med.uni-muenchen.de
authors.forename: R
authors.initials: R
authors.lastname: Fischer
authors.forename: S M
authors.initials: SM
authors.lastname: Lang
authors.forename: M
authors.initials: M
authors.lastname: Leitl
authors.forename: M
authors.initials: M
authors.lastname: Thiere
authors.forename: U
authors.initials: U
authors.lastname: Steiner
authors.forename: R M
authors.initials: RM
authors.lastname: Huber
mesh_terms: D000086:Acetazolamide / Q000008:administration & dosage / Q000627:therapeutic use*; D000284:Administration, Oral; D000531:Altitude; D000532:Altitude Sickness / Q000517:prevention & control; D001049:Apnea / Q000517:prevention & control*; D012898:Autacoids; D001784:Blood Gas Analysis; D004311:Double-Blind Method; D006801:Humans; D008297:Male; D010108:Oxyhemoglobins / Q000032:analysis; D017286:Polysomnography; D011674:Pulse; D012891:Sleep Apnea Syndromes / Q000517:prevention & control*; D013806:Theophylline / Q000008:administration & dosage / Q000627:therapeutic use*
chemical_list: D012898:Autacoids; D010108:Oxyhemoglobins; D013806:Theophylline; D000086:Acetazolamide