Research Mentor Name
Safwan Badr
Research Mentor Email Address
SBadr@med.wayne.edu
Institution / Department
John D. Dingell VA Medical Center / Sleep Medicine
Document Type
Research Abstract
Research Type
clinicalresearch
Graduate Level Research
no
Abstract
Background: Effective Treatment of central sleep apnea (CSA) remains elusive. CPAP may be an efficacious treatment for CSA, but it rarely eliminates CSA. The purpose of this investigation was to determine the efficacy of adding acetazolamide, low-flow oxygen, or both to CPAP therapy for CSA treatment.
Methods: A controlled, double-blinded, crossover study evaluated the efficacy of acetazolamide, supplemental oxygen, and their combination in reducing sleep-disordered breathing compared with standard PAP therapy. All 82 participants completed full polysomnography under five conditions: (1) Baseline, (2) Baseline PAP, (3) Acetazolamide at 250 mg at bedtime, (4) low-flow Oxygen ( 2-4 L/min), and (5) Acetazolamide plus Oxygen, with conditions (3) and (4) administered in a randomized order. Primary outcomes include the Central Apnea–Hypopnea Index (CAHI), Central Apnea Index (CAI), Obstructive Apnea Index (OAI), Obstructive Hypopnea Index (OHI), Central Hypopnea Index (CHI), and Total Apnea–Hypopnea Index (AHI). An analysis of variance (ANOVA) model compared intervention effects across groups, with “Baseline” and “Baseline PAP” as reference categories.
Results: We randomized 32 male participants with diagnosed central sleep apnea, defined as AHI≥10/hour with CAHI≥5/hour. CPAP therapy ameliorated central apnea. The addition of acetazolamide, or supplement oxygen, resulted in the resolution of CSA, evidenced by a substantial decrease in AHI, CAI, and CAHI.
Conclusion: Nasal CPAP therapy resulted in amelioration of central sleep apnea. The addition of acetazolamide or low-flow oxygen led to further improvement and normalization of respiratory indices. These findings support the use of combined therapy of PAP plus a pharmacologic intervention.
Disciplines
Medicine and Health Sciences
Recommended Citation
Mustapha, Ali J.; Fatima, Maria; Shanker, S.; Aldiwaikat, A.; Habra, M.; Jackson, K.; Habra, S.; Bawa, M.; Moustapha, A.; Pandya, N.; Gosh, S.; Sankari, A.; and Badr, M.S., "Enhanced Control of Central Sleep Apnea with Adjunctive Therapy: CPAP Plus Oxygen and/or Acetazolamide." (2026). Medical Student Research Symposium. 494.
https://digitalcommons.wayne.edu/som_srs/494