Acetazolamide for selected cases of sleep apnea-related hypercapnia
Abstract
Acetazolamide is a diuretic used in treatment and prophylaxis of mountain sickness. But its mechanism of action may offer utility in selected cases of sleep-apnea-related hypercapnia. We report three case examples where carefully monitored use of acetazolamide was safe and expedited reversal of hypercapnia.
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References
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10. Tojima H, Kunitomo F, Kimura H, Tatsumi K, Kuriyama T, Honda Y. Effects of acetazolamide in patients with the sleep apnoea syndrome. Thorax
. 1988 Feb;43(2):113-9.
. 2000 May;161(5):1524-9.
2. Dunn WF, Nelson SB, Hubmayr RD. Oxygen-induced hypercarbia in obstructive pulmonary disease. Am Rev Respir Dis 1991 Sep;144(3 Pt 1):526-30.
3. Ritchie ND, Baggott AV, Todd WTA. Acetazolamide for the prevention of acute mountain sickness--a systematic review and meta-analysis. J Travel Med
. 2012 Sep-Oct;19(5):298-307.
4. Berger KI, Norman RG, Ayappa I, Oppenheimer BW, Rapoport DM, Goldring RM. Potential mechanism for transition between acute hypercapnia during sleep to chronic hypercapnia during wakefulness in obstructive sleep. Adv Exp Med Biol 2008; 605:431-6.
5. Norman RG, Goldring RM, Clain JM, Oppenheimer BW, Charney AN, Rapoport DM, Berger KI. Transition from acute to chronic hypercapnia in patients with periodic breathing: predictions from a computer model. J Appl Physiol 2006 May; 100(5):1733-41.
6. Adamson R, Swenson ER. Acetazolamide use in severe chronic obstructive pulmonary disease. Pros and Cons. Ann Am Thorac Soc. 2017 Jul;14(7):1086-1093.
7. Wagenaar M, Vos P, Heijdra H, Teppema L, Folgering H. Comparison of acetazolamide and medroxyprogesterone as respiratory stimulants in hypercapnic patients with COPD. Chest
. 2003 May;123(5):1450-9.
8. Jones PW, Greenstone M. Carbonic anhydrase inhibitors for hypercapnic ventilatory failure in chronic obstructive pulmonary disease. Cochrane Database Syst Rev 2001;2001(1): CD002881.
9. Bemand TJ; Chatoor R; Natale P; Strippoli G; Delaney A. Acetazolamide for metabolic alkalosis complicating respiratory failure with chronic obstructive pulmonary disease or obesity Thorax ; 2023/05/22 21:38
10. Tojima H, Kunitomo F, Kimura H, Tatsumi K, Kuriyama T, Honda Y. Effects of acetazolamide in patients with the sleep apnoea syndrome. Thorax
. 1988 Feb;43(2):113-9.
Published
2026-10-20
How to Cite
Manthous, C. (2026). Acetazolamide for selected cases of sleep apnea-related hypercapnia. The Southwest Journal of Medicine, 14(61). https://doi.org/10.12746/swjm.v14i61.1667
Section
Case Reports
Copyright (c) 2026 Constantine Manthous
This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.
