The effect of acetazolamide on sleep apnea at high altitude

A systematic review and meta-analysis

Hsin Ming Liu, I. Jen Chiang, Ken N. Kuo, Cher Ming Liou, Chiehfeng Chen

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

Background: Acetazolamide has been investigated for treating sleep apnea in newcomers ascending to high altitude. This study aimed to assess the effect of acetazolamide on sleep apnea at high altitude, determine the optimal therapeutic dose, and compare its effectiveness in healthy trekkers and obstructive sleep apnea (OSA) patients. Methods: PubMed, Embase, Scopus, Cochrane Library, and Airiti Library databases were searched up to July 2015 for randomized controlled trials (RCTs) performed above 2500 m in lowlanders and that used acetazolamide as intervention in sleep studies. Studies including participants with medical conditions other than OSA were excluded. Results: Eight studies of 190 adults were included. In healthy participants, the pooled mean effect sizes of acetazolamide on Apnea-Hypopnea Index (AHI), percentage of periodic breathing time, and nocturnal oxygenation were 34.66 [95% confidence interval (CI) 25.01-44.30] with low heterogeneity (p = 0.7, I2 = 0%), 38.56% (95% CI 18.92-58.19%) with low heterogeneity (p = 0.24, I2 = 28%), and 4.75% (95% CI 1.35-8.15%) with high heterogeneity (p < 0.01, I2 = 87%), respectively. In OSA patients, the pooled mean effect sizes of acetazolamide on AHI and nocturnal oxygenation were 13.18 (95% CI 9.25-17.1) with low heterogeneity (p = 0.33, I2 = 0%) and 1.85% (95% CI 1.08-2.62%) with low heterogeneity (P = 0.56, I2 = 0%). Conclusions: Acetazolamide improves sleep apnea at high altitude by decreasing AHI and percentage of periodic breathing time and increasing nocturnal oxygenation. Acetazolamide is more beneficial in healthy participants than in OSA patients, and a 250 mg daily dose may be as effective as higher daily doses for healthy trekkers.

Original languageEnglish
Pages (from-to)20-29
Number of pages10
JournalTherapeutic Advances in Respiratory Disease
Volume11
Issue number1
DOIs
Publication statusPublished - Jan 1 2017

Fingerprint

Acetazolamide
Sleep Apnea Syndromes
Meta-Analysis
Obstructive Sleep Apnea
Confidence Intervals
Apnea
Libraries
Healthy Volunteers
Respiration
PubMed
Sleep
Randomized Controlled Trials
Databases

Keywords

  • acetazolamide
  • altitude
  • sleep apnea syndromes

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Pharmacology (medical)

Cite this

The effect of acetazolamide on sleep apnea at high altitude : A systematic review and meta-analysis. / Liu, Hsin Ming; Chiang, I. Jen; Kuo, Ken N.; Liou, Cher Ming; Chen, Chiehfeng.

In: Therapeutic Advances in Respiratory Disease, Vol. 11, No. 1, 01.01.2017, p. 20-29.

Research output: Contribution to journalArticle

Liu, Hsin Ming ; Chiang, I. Jen ; Kuo, Ken N. ; Liou, Cher Ming ; Chen, Chiehfeng. / The effect of acetazolamide on sleep apnea at high altitude : A systematic review and meta-analysis. In: Therapeutic Advances in Respiratory Disease. 2017 ; Vol. 11, No. 1. pp. 20-29.
@article{07b74f725f1349519030dbd84f49b860,
title = "The effect of acetazolamide on sleep apnea at high altitude: A systematic review and meta-analysis",
abstract = "Background: Acetazolamide has been investigated for treating sleep apnea in newcomers ascending to high altitude. This study aimed to assess the effect of acetazolamide on sleep apnea at high altitude, determine the optimal therapeutic dose, and compare its effectiveness in healthy trekkers and obstructive sleep apnea (OSA) patients. Methods: PubMed, Embase, Scopus, Cochrane Library, and Airiti Library databases were searched up to July 2015 for randomized controlled trials (RCTs) performed above 2500 m in lowlanders and that used acetazolamide as intervention in sleep studies. Studies including participants with medical conditions other than OSA were excluded. Results: Eight studies of 190 adults were included. In healthy participants, the pooled mean effect sizes of acetazolamide on Apnea-Hypopnea Index (AHI), percentage of periodic breathing time, and nocturnal oxygenation were 34.66 [95{\%} confidence interval (CI) 25.01-44.30] with low heterogeneity (p = 0.7, I2 = 0{\%}), 38.56{\%} (95{\%} CI 18.92-58.19{\%}) with low heterogeneity (p = 0.24, I2 = 28{\%}), and 4.75{\%} (95{\%} CI 1.35-8.15{\%}) with high heterogeneity (p < 0.01, I2 = 87{\%}), respectively. In OSA patients, the pooled mean effect sizes of acetazolamide on AHI and nocturnal oxygenation were 13.18 (95{\%} CI 9.25-17.1) with low heterogeneity (p = 0.33, I2 = 0{\%}) and 1.85{\%} (95{\%} CI 1.08-2.62{\%}) with low heterogeneity (P = 0.56, I2 = 0{\%}). Conclusions: Acetazolamide improves sleep apnea at high altitude by decreasing AHI and percentage of periodic breathing time and increasing nocturnal oxygenation. Acetazolamide is more beneficial in healthy participants than in OSA patients, and a 250 mg daily dose may be as effective as higher daily doses for healthy trekkers.",
keywords = "acetazolamide, altitude, sleep apnea syndromes",
author = "Liu, {Hsin Ming} and Chiang, {I. Jen} and Kuo, {Ken N.} and Liou, {Cher Ming} and Chiehfeng Chen",
year = "2017",
month = "1",
day = "1",
doi = "10.1177/1753465816677006",
language = "English",
volume = "11",
pages = "20--29",
journal = "Therapeutic Advances in Respiratory Disease",
issn = "1753-4658",
publisher = "SAGE Publications Ltd",
number = "1",

}

TY - JOUR

T1 - The effect of acetazolamide on sleep apnea at high altitude

T2 - A systematic review and meta-analysis

AU - Liu, Hsin Ming

AU - Chiang, I. Jen

AU - Kuo, Ken N.

AU - Liou, Cher Ming

AU - Chen, Chiehfeng

PY - 2017/1/1

Y1 - 2017/1/1

N2 - Background: Acetazolamide has been investigated for treating sleep apnea in newcomers ascending to high altitude. This study aimed to assess the effect of acetazolamide on sleep apnea at high altitude, determine the optimal therapeutic dose, and compare its effectiveness in healthy trekkers and obstructive sleep apnea (OSA) patients. Methods: PubMed, Embase, Scopus, Cochrane Library, and Airiti Library databases were searched up to July 2015 for randomized controlled trials (RCTs) performed above 2500 m in lowlanders and that used acetazolamide as intervention in sleep studies. Studies including participants with medical conditions other than OSA were excluded. Results: Eight studies of 190 adults were included. In healthy participants, the pooled mean effect sizes of acetazolamide on Apnea-Hypopnea Index (AHI), percentage of periodic breathing time, and nocturnal oxygenation were 34.66 [95% confidence interval (CI) 25.01-44.30] with low heterogeneity (p = 0.7, I2 = 0%), 38.56% (95% CI 18.92-58.19%) with low heterogeneity (p = 0.24, I2 = 28%), and 4.75% (95% CI 1.35-8.15%) with high heterogeneity (p < 0.01, I2 = 87%), respectively. In OSA patients, the pooled mean effect sizes of acetazolamide on AHI and nocturnal oxygenation were 13.18 (95% CI 9.25-17.1) with low heterogeneity (p = 0.33, I2 = 0%) and 1.85% (95% CI 1.08-2.62%) with low heterogeneity (P = 0.56, I2 = 0%). Conclusions: Acetazolamide improves sleep apnea at high altitude by decreasing AHI and percentage of periodic breathing time and increasing nocturnal oxygenation. Acetazolamide is more beneficial in healthy participants than in OSA patients, and a 250 mg daily dose may be as effective as higher daily doses for healthy trekkers.

AB - Background: Acetazolamide has been investigated for treating sleep apnea in newcomers ascending to high altitude. This study aimed to assess the effect of acetazolamide on sleep apnea at high altitude, determine the optimal therapeutic dose, and compare its effectiveness in healthy trekkers and obstructive sleep apnea (OSA) patients. Methods: PubMed, Embase, Scopus, Cochrane Library, and Airiti Library databases were searched up to July 2015 for randomized controlled trials (RCTs) performed above 2500 m in lowlanders and that used acetazolamide as intervention in sleep studies. Studies including participants with medical conditions other than OSA were excluded. Results: Eight studies of 190 adults were included. In healthy participants, the pooled mean effect sizes of acetazolamide on Apnea-Hypopnea Index (AHI), percentage of periodic breathing time, and nocturnal oxygenation were 34.66 [95% confidence interval (CI) 25.01-44.30] with low heterogeneity (p = 0.7, I2 = 0%), 38.56% (95% CI 18.92-58.19%) with low heterogeneity (p = 0.24, I2 = 28%), and 4.75% (95% CI 1.35-8.15%) with high heterogeneity (p < 0.01, I2 = 87%), respectively. In OSA patients, the pooled mean effect sizes of acetazolamide on AHI and nocturnal oxygenation were 13.18 (95% CI 9.25-17.1) with low heterogeneity (p = 0.33, I2 = 0%) and 1.85% (95% CI 1.08-2.62%) with low heterogeneity (P = 0.56, I2 = 0%). Conclusions: Acetazolamide improves sleep apnea at high altitude by decreasing AHI and percentage of periodic breathing time and increasing nocturnal oxygenation. Acetazolamide is more beneficial in healthy participants than in OSA patients, and a 250 mg daily dose may be as effective as higher daily doses for healthy trekkers.

KW - acetazolamide

KW - altitude

KW - sleep apnea syndromes

UR - http://www.scopus.com/inward/record.url?scp=85008488170&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85008488170&partnerID=8YFLogxK

U2 - 10.1177/1753465816677006

DO - 10.1177/1753465816677006

M3 - Article

VL - 11

SP - 20

EP - 29

JO - Therapeutic Advances in Respiratory Disease

JF - Therapeutic Advances in Respiratory Disease

SN - 1753-4658

IS - 1

ER -