The effect of acetazolamide on the improvement of central apnea caused by abusing opioid drugs in the clinical trial

Sleep Breath. 2020 Dec;24(4):1417-1425. doi: 10.1007/s11325-019-01968-3. Epub 2019 Dec 5.

Abstract

Purpose: Acetazolamide is utilized as a treatment which falls effective in treating some type of CSA. Hence, it might be effective as far as opium addicts who suffer from CSA are concerned.

Materials and method: The current study was a double-blind, placebo-controlled, cross-over study ( clinicalTrials.gov ID: NCT02371473). The whole procedures were identical for both placebo and acetazolamide phases of clinical research. There were 14 CSA more than 5/h and more than 50% of apnea-hypopnea index (AHI). Out of these 14 patients, 10 volunteered to participate in the study. Fast Fourier transformation was used to separate heart rate variability (HRV) into its component VLF (very low frequency band), LF (low frequency band), and HF (high frequency band) rhythms that operate within different frequency ranges.

Result: There are significant results in terms of decreased mix apnea and central apnea together due to acetazolamide compared with placebo (P < 0.023). Time of SatO2 < 90% is decreased as well (P < 0.1). There is also decrease of SDNN and NN50 after treatment with acetazolamide respectively (P < 0.001). Regarding fast Fourier transformation, there is increase of pHF and decrease of pLF after acetazolamide treatment (P < 0.001).

Conclusion: Acetazolamide seems to be effective in improving oxygenation and a decrease of mixed and central apnea events together. In HRV analysis section, LF power has decreased significantly, which may more likely improve prognosis of the patients.

Keywords: Acetazolamide; CSA; Opioid drug; RCT.

Publication types

  • Clinical Trial

MeSH terms

  • Acetazolamide / therapeutic use*
  • Analgesics, Opioid / adverse effects*
  • Cross-Over Studies
  • Double-Blind Method
  • Female
  • Humans
  • Male
  • Middle Aged
  • Opioid-Related Disorders / physiopathology*
  • Sleep Apnea, Central / chemically induced*
  • Sleep Apnea, Central / drug therapy*
  • Treatment Outcome

Substances

  • Analgesics, Opioid
  • Acetazolamide

Associated data

  • ClinicalTrials.gov/NCT02371473