What is the best way to manage sleep apnea when traveling to high altitude? A study published in the December 12, 2012, issue of JAMA reports treatments to minimize the risk of altitude-related illness for patients with sleep apnea. At altitude, the reduced oxygen content of the blood induces breathing instability, with periods of deep and rapid breathing alternating with central apnea. This breathing pattern is called high-altitude periodic breathing. It occurs even in healthy persons at altitudes above 6000 ft. It may lead to sleep disturbances with frequent awakenings and a feeling of lack of air.
High-altitude periodic breathing in healthy mountain travelers and in patients with preexisting obstructive sleep apnea can be prevented or treated with acetazolamide, a drug that is also used for acute mountain sickness.
Travelers to high altitude (>2500 m/>8000 ft above sea level) should ascend slowly and drink sufficient amounts of water. Sleeping altitude should be as low as possible. People with a history of severe altitude sickness should consult their doctor regarding the use of acetazolamide before traveling to a high altitude. Patients with obstructive sleep apnea who travel to high altitude should continue to use their CPAP machine while traveling as they do at home. Such patients might benefit from preventive treatment with acetazolamide when staying at an altitude higher than 1600 m; they should consult their doctor about this possibility. Patients with obstructive sleep apnea who do not use CPAP should consult with their doctor before traveling to high altitude about the potential use of CPAP and acetazolamide or a dental appliance.
International Society for Mountain Medicine www.ismmed.org/index.php /altitude.html
American Sleep Apnea Association www.sleepapnea.org
American Academy of Sleep Medicine www.aasmnet.org
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Sources: Harrison's Textbook of Medicine, 18th ed; Latshang TD, Bloch KE. How to treat patients with obstructive sleep apnea syndrome during an altitude sojourn. High Alt Med Biol. 2011;12(4): 303-307.
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Topic: PULMONARY MEDICINE
Latshang TD, Bloch KE, Lynm C, Livingston EH. Traveling to High Altitude When You Have Sleep Apnea. JAMA. 2012;308(22):2418. doi:10.1001/jama.2012.4097