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PLoS One. 2014 Apr 7;9(4):e93931. doi: 10.1371/journal.pone.0093931. eCollection 2014.

Impact of acetazolamide and CPAP on cortical activity in obstructive sleep apnea patients.

Author information

1
Institute of Pharmacology and Toxicology, University of Zurich, Zurich, Switzerland; Zurich Center for Integrative Human Physiology, University of Zurich, Zurich, Switzerland.
2
Pulmonary Division, University Hospital Zurich, Zurich, Switzerland.
3
Institute of Pharmacology and Toxicology, University of Zurich, Zurich, Switzerland; University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland.
4
Zurich Center for Integrative Human Physiology, University of Zurich, Zurich, Switzerland; Pulmonary Division, University Hospital Zurich, Zurich, Switzerland.

Abstract

STUDY OBJECTIVES:

1) To investigate the impact of acetazolamide, a drug commonly prescribed for altitude sickness, on cortical oscillations in patients with obstructive sleep apnea syndrome (OSAS). 2) To examine alterations in the sleep EEG after short-term discontinuation of continuous positive airway pressure (CPAP) therapy.

DESIGN:

Data from two double-blind, placebo-controlled randomized cross-over design studies were analyzed.

SETTING:

Polysomnographic recordings in sleep laboratory at 490 m and at moderate altitudes in the Swiss Alps: 1630 or 1860 m and 2590 m.

PATIENTS:

Study 1: 39 OSAS patients. Study 2: 41 OSAS patients.

INTERVENTIONS:

Study 1: OSAS patients withdrawn from treatment with CPAP. Study 2: OSAS patients treated with autoCPAP. Treatment with acetazolamide (500-750 mg) or placebo at moderate altitudes.

MEASUREMENTS AND RESULTS:

An evening dose of 500 mg acetazolamide reduced slow-wave activity (SWA; approximately 10%) and increased spindle activity (approximately 10%) during non-REM sleep. In addition, alpha activity during wake after lights out was increased. An evening dose of 250 mg did not affect these cortical oscillations. Discontinuation of CPAP therapy revealed a reduction in SWA (5-10%) and increase in beta activity (approximately 25%).

CONCLUSIONS:

The higher evening dose of 500 mg acetazolamide showed the "spectral fingerprint" of Benzodiazepines, while 250 mg acetazolamide had no impact on cortical oscillations. However, both doses had beneficial effects on oxygen saturation and sleep quality.

PMID:
24710341
PMCID:
PMC3977962
DOI:
10.1371/journal.pone.0093931
[Indexed for MEDLINE]
Free PMC Article

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