Central Sleep Apnea: Improvement With Acetazolamide Therapy

doi:10.1001/archinte.1982.00340230056012

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Vol. 142 No. 10, October 1982

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Central Sleep Apnea

Improvement With Acetazolamide Therapy

David P. White, MD; Clifford W. Zwillich, MD; Cheryl K. Pickett; Neil J. Douglas, MRCP; Larry J. Findley, MD; John V. Weil, MD

Arch Intern Med. 1982;142(10):1816-1819.

Abstract

• Respiratory rhythm during sleep may be dependent on bloodpH with apneas being associated with alkalosis. Acidificationmay therefore have therapeutic value in some forms of sleepapnea. We administered acetazolamide to six patients with symptomaticcentral sleep apnea, a disorder of respiratory rhythm with littleor no upper airway obstruction. Sleep studies were carried outbefore and after one week of drug therapy, during which timethe mean arterial pH decreased from 7.42 to 7.34. All six patientshad significant improvement, demonstrating a 69% reduction intotal apneas. Five of the six patients reported better-qualitysleep and decreased daytime hypersomnolence. Subsequent studiesin normal subjects showed that acetazolamide, like other agentsknown to produce a metabolic acidosis, shifted the hypercapnicventilatory response to the left 5±0.54 mm Hg. This maybe important in mediating the observed decrease in apneas.

(Arch Intern Med 1982;142:1816-1819).

Author Affiliations

From the Division of Pulmonary Sciences, The Cardiovascular Pulmonary Research Laboratory, University of Colorado Health Sciences Center, Denver. Dr White is now with the Department of Medicine, Milton S. Hershey Medical Center, Hershey, Pa.

Footnotes

Accepted for publication June 4, 1982.

Presented at the American Thoracic Society Meeting, Detroit,May 11, 1981.

Reprint requests to Department of Medicine, Pulmonary Division,Milton S. Hershey Medical Center, Hershey, PA 17033 (Dr White).

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