{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,28]],"date-time":"2026-10-28T05:47:23Z","timestamp":1793166443490,"version":"4.5.0"},"reference-count":29,"publisher":"European Respiratory Society (ERS)","issue":"5","license":[{"start":{"date-parts":[[2024,5,29]],"date-time":"2024-05-29T00:00:00Z","timestamp":1716940800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001711","name":"Schweizerischer Nationalfonds zur F\u00f6rderung der Wissenschaftlichen Forschung","doi-asserted-by":"publisher","award":["166666"],"award-info":[{"award-number":["166666"]}],"id":[{"id":"10.13039\/501100001711","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["publications.ersnet.org"],"crossmark-restriction":true},"short-container-title":["ERJ Open Res"],"accepted":{"date-parts":[[2024,5,20]]},"published-print":{"date-parts":[[2024,9]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Patients with pulmonary vascular disease (PVD) often suffer from nocturnal hypoxaemia, but also from sleep apnoea. Short-term use of acetazolamide increases ventilation due to metabolic acidosis and also reduces loop gain. We investigated whether prolonged use of acetazolamide improves sleep disordered breathing in PVD.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>In a randomised controlled crossover trial, patients with PVD were randomly assigned to acetazolamide 250\u2005mg and placebo twice daily for 5\u2005weeks. Patients underwent respiratory polygraphy at baseline and at the end of each intervention phase. Outcomes of interest were the effect of acetazolamide on mean nocturnal oxygen saturation (<jats:italic>S<\/jats:italic><jats:sub>pO<jats:sub>2<\/jats:sub><\/jats:sub>), time with oxygen saturation &lt;90% (<jats:italic>t<\/jats:italic><jats:sub>&lt;90<\/jats:sub>), apnoea\u2013hypopnoea index (AHI) and sleep apnoea severity.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In 20 patients with PVD (55% women, nine with pulmonary arterial hypertension, 11 with distal chronic thromboembolic pulmonary hypertension; mean\u00b1<jats:sc>sd<\/jats:sc>nocturnal<jats:italic>S<\/jats:italic><jats:sub>pO<jats:sub>2<\/jats:sub><\/jats:sub>88.8\u00b13.5%, obstructive AHI 12.6\u00b112.3\u2005events\u00b7h<jats:sup>\u22121<\/jats:sup>), 5\u2005weeks of acetazolamide resulted in a significant improvement in nocturnal oxygenation compared to placebo (mean nocturnal<jats:italic>S<\/jats:italic><jats:sub>pO<jats:sub>2<\/jats:sub><\/jats:sub>+2.3% (95% CI 1.3\u20133.3%); p&lt;0.001 and<jats:italic>t<\/jats:italic><jats:sub>&lt;90<\/jats:sub>\u221218.8% (95% CI \u221229.6\u2013\u2009\u22128.0%); p=0.001). Acetazolamide increased the proportion of patients with mean nocturnal<jats:italic>S<\/jats:italic><jats:sub>pO<jats:sub>2<\/jats:sub><\/jats:sub>\u226590% from 45% to 85%. The percentage of patients with AHI &gt;5\u2005events\u00b7h<jats:sup>\u22121<\/jats:sup>was reduced from 75% to 60% and with AHI &gt;15\u2005events\u00b7h<jats:sup>\u22121<\/jats:sup>from 30% to 15%. Two patients discontinued the study because of mild side-effects.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Acetazolamide given for 5\u2005weeks reduces nocturnal hypoxaemia in PVD to a clinically relevant level and reduces the proportion of patients with obstructive sleep apnoea.<\/jats:p><\/jats:sec>","DOI":"10.1183\/23120541.00040-2024","type":"journal-article","created":{"date-parts":[[2024,5,29]],"date-time":"2024-05-29T15:45:14Z","timestamp":1716997514000},"page":"00040-2024","update-policy":"https:\/\/doi.org\/10.1183\/ers-crossmark-policy","source":"Crossref","is-referenced-by-count":5,"title":["Effects of acetazolamide on sleep disordered breathing in pulmonary vascular disease: a randomised controlled trial"],"prefix":"10.1183","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8840-981X","authenticated-orcid":false,"given":"Esther I.","family":"Schwarz","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3278-6277","authenticated-orcid":false,"given":"St\u00e9phanie","family":"Saxer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4485-1758","authenticated-orcid":false,"given":"Mona","family":"Lichtblau","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3635-0515","authenticated-orcid":false,"given":"Simon R.","family":"Schneider","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4059-5937","authenticated-orcid":false,"given":"Julian","family":"M\u00fcller","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Mayer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2377-7387","authenticated-orcid":false,"given":"Konrad E.","family":"Bloch","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5250-5022","authenticated-orcid":false,"given":"Silvia","family":"Ulrich","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"81","published-online":{"date-parts":[[2024,5,29]]},"reference":[{"key":"2024102804150659000_10.5.00040-2024.1","doi-asserted-by":"publisher","DOI":"10.1159\/000341182"},{"key":"2024102804150659000_10.5.00040-2024.2","doi-asserted-by":"publisher","DOI":"10.1378\/chest.06-1378"},{"key":"2024102804150659000_10.5.00040-2024.3","doi-asserted-by":"publisher","DOI":"10.1378\/chest.11-3124"},{"key":"2024102804150659000_10.5.00040-2024.4","doi-asserted-by":"crossref","first-page":"3076","DOI":"10.1253\/circj.CJ-18-0636","article-title":"Nocturnal hypoxemia, but not sleep apnea, is associated with a poor prognosis in patients with pulmonary arterial hypertension","volume":"82","author":"Nagaoka","year":"2018","journal-title":"Circ J"},{"key":"2024102804150659000_10.5.00040-2024.5","doi-asserted-by":"publisher","DOI":"10.1378\/chest.07-3035"},{"key":"2024102804150659000_10.5.00040-2024.6","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.02.00225102"},{"key":"2024102804150659000_10.5.00040-2024.7","doi-asserted-by":"publisher","DOI":"10.1378\/chest.120.3.894"},{"key":"2024102804150659000_10.5.00040-2024.8","doi-asserted-by":"publisher","DOI":"10.1016\/j.sleep.2012.11.013"},{"key":"2024102804150659000_10.5.00040-2024.9","doi-asserted-by":"publisher","DOI":"10.5664\/jcsm.3528"},{"key":"2024102804150659000_10.5.00040-2024.10","doi-asserted-by":"crossref","first-page":"2002258","DOI":"10.1183\/13993003.02258-2020","article-title":"Sleep-related breathing disorders and pulmonary hypertension","volume":"57","author":"Adir","year":"2021","journal-title":"Eur Respir J"},{"key":"2024102804150659000_10.5.00040-2024.11","doi-asserted-by":"crossref","first-page":"zsac113","DOI":"10.1093\/sleep\/zsac113","article-title":"Central sleep apnea: pathophysiologic classification","volume":"46","author":"Javaheri","year":"2023","journal-title":"Sleep"},{"key":"2024102804150659000_10.5.00040-2024.12","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.201103-0577OC"},{"key":"2024102804150659000_10.5.00040-2024.13","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/eht540"},{"key":"2024102804150659000_10.5.00040-2024.14","doi-asserted-by":"publisher","DOI":"10.1093\/europace\/euv122"},{"key":"2024102804150659000_10.5.00040-2024.15","doi-asserted-by":"publisher","DOI":"10.1186\/s12890-015-0005-3"},{"key":"2024102804150659000_10.5.00040-2024.16","doi-asserted-by":"publisher","DOI":"10.1378\/chest.14-0495"},{"key":"2024102804150659000_10.5.00040-2024.17","doi-asserted-by":"crossref","first-page":"e15071","DOI":"10.14814\/phy2.15071","article-title":"Effects of acetazolamide on control of breathing in sleep apnea patients: mechanistic insights using meta-analyses and physiological model simulations","volume":"9","author":"Schmickl","year":"2021","journal-title":"Physiol Rep"},{"key":"2024102804150659000_10.5.00040-2024.18","doi-asserted-by":"crossref","first-page":"2632","DOI":"10.1016\/j.chest.2020.06.078","article-title":"Acetazolamide for OSA and central sleep apnea: a comprehensive systematic review and meta-analysis","volume":"158","author":"Schmickl","year":"2020","journal-title":"Chest"},{"key":"2024102804150659000_10.5.00040-2024.19","doi-asserted-by":"crossref","first-page":"362","DOI":"10.1016\/j.pulmoe.2022.11.004","article-title":"Effect of 5\u2005weeks of oral acetazolamide on patients with pulmonary vascular disease: a randomized, double-blind, cross-over trial","volume":"30","author":"Lichtblau","year":"2024","journal-title":"Pulmonology"},{"key":"2024102804150659000_10.5.00040-2024.20","doi-asserted-by":"publisher","DOI":"10.1183\/13993003.01032-2015"},{"key":"2024102804150659000_10.5.00040-2024.21","doi-asserted-by":"publisher","DOI":"10.5664\/jcsm.2172"},{"key":"2024102804150659000_10.5.00040-2024.22","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.c332"},{"key":"2024102804150659000_10.5.00040-2024.23","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.l4378"},{"key":"2024102804150659000_10.5.00040-2024.24","doi-asserted-by":"crossref","first-page":"1900276","DOI":"10.1183\/13993003.002762019","article-title":"Effect of domiciliary oxygen therapy on exercise capacity and quality of life in patients with pulmonary arterial or chronic thromboembolic pulmonary hypertension: a randomised, placebo-controlled trial","volume":"54","author":"Ulrich","year":"2019","journal-title":"Eur Respir J"},{"key":"2024102804150659000_10.5.00040-2024.25","doi-asserted-by":"crossref","first-page":"948","DOI":"10.1016\/j.healun.2018.03.010","article-title":"Use of supplemental oxygen in patients with pulmonary arterial hypertension in REVEAL","volume":"37","author":"Farber","year":"2018","journal-title":"J Heart Lung Transplant"},{"key":"2024102804150659000_10.5.00040-2024.26","doi-asserted-by":"crossref","first-page":"791423","DOI":"10.3389\/fmed.2022.791423","article-title":"The impact of breathing hypoxic gas and oxygen on pulmonary hemodynamics in patients with pulmonary hypertension","volume":"9","author":"Carta","year":"2022","journal-title":"Front Med"},{"key":"2024102804150659000_10.5.00040-2024.27","doi-asserted-by":"crossref","first-page":"744","DOI":"10.1016\/j.chest.2017.06.011","article-title":"Personalized management approach for OSA","volume":"153","author":"Carberry","year":"2018","journal-title":"Chest"},{"key":"2024102804150659000_10.5.00040-2024.28","doi-asserted-by":"publisher","DOI":"10.1136\/thorax-2023-220184"},{"key":"2024102804150659000_10.5.00040-2024.29","doi-asserted-by":"publisher","DOI":"10.1183\/13993003.01660-2023"}],"container-title":["ERJ Open Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1183\/23120541.00040-2024","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,2,24]],"date-time":"2025-02-24T05:37:38Z","timestamp":1740375458000},"score":1,"resource":{"primary":{"URL":"https:\/\/publications.ersnet.org\/lookup\/doi\/10.1183\/23120541.00040-2024"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,5,29]]},"references-count":29,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2024,10,28]]},"published-print":{"date-parts":[[2024,9]]}},"alternative-id":["10.1183\/23120541.00040-2024"],"URL":"https:\/\/doi.org\/10.1183\/23120541.00040-2024","relation":{},"ISSN":["2312-0541"],"issn-type":[{"value":"2312-0541","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,5,29]]}}}