Randomised trial shows acetazolamide reduces OSA severity in REM sleep, suggesting new treatment potential.
Key Points
This study aims to evaluate the effect of acetazolamide on obstructive sleep apnoea severity during REM sleep and its underlying physiological mechanisms.
11 participants with REM-predominant OSA were randomly assigned to acetazolamide or placebo in a crossover design.
Acetazolamide was administered at a dose of 500 mg for three nights, with the first night at half dose.
Polysomnography recorded diaphragm and genioglossus electromyography to assess physiological effects.
Acetazolamide significantly reduced the apnoea hypopnoea index (AHI) by 35.5% and hypoxic burden by 35.9% compared to placebo.
Unexpectedly, acetazolamide did not improve dips in ventilatory drive, measured during REM sleep.
The treatment increased overall ventilation and improved pharyngeal muscle responsiveness under eupneic drive.