A randomized trial of temazepam versus acetazolamide in high altitude sleep
disturbance.
Author(s): Tanner JB(1), Tanner SM, Thapa GB, Chang Y, Watson KL, Staunton E, Howarth C,
Basnyat B, Harris NS.
Affiliation(s): Author information:
(1)1 Division of Wilderness Medicine, Department of Emergency Medicine,
Massachusetts General Hospital , Boston, Massachusetts.
Publication date & source: 2013, High Alt Med Biol. , 14(3):234-9
This study is the first comparative trial of sleep medications at high altitude.
We performed a randomized, double-blind trial of temazepam and acetazolamide at
an altitude of 3540 meters. 34 healthy trekkers with self-reports of
high-altitude sleep disturbance were randomized to temazepam 7.5 mg or
acetazolamide 125 mg taken at bedtime for one night. The primary outcome was
sleep quality on a 100 mm visual analog scale. Additional measurements were
obtained with actigraphy; pulse oximetry; and questionnaire evaluation of sleep,
daytime drowsiness, daytime sleepiness, and acute mountain sickness. Sixteen
subjects were randomized to temazepam and 18 to acetazolamide. Sleep quality on
the 100 mm visual analog scale was higher for temazepam (59.6, SD 20.1) than
acetazolamide (46.2, SD 20.2; p=0.048). Temazepam also demonstrated higher
subjective sleep quality on the Groningen Sleep Quality Scale (3.5 vs. 6.8,
p=0.009) and sleep depth visual analog scale (60.3 vs. 41.4, p=0.028). The
acetazolamide group reported significantly more awakenings to urinate (1.8 vs.
0.5, p=0.007). No difference was found with regards to mean nocturnal oxygen
saturation (84.1 vs. 84.4, p=0.57), proportion of the night spent in periodic
breathing, relative desaturations, sleep onset latency, awakenings, wake after
sleep onset, sleep efficiency, Stanford Sleepiness Scale scores, daytime
drowsiness, or change in self-reported Lake Louise Acute Mountain Sickness
scores. We conclude that, at current recommended dosing, treatment of
high-altitude sleep disturbance with temazepam is associated with increased
subjective sleep quality compared to acetazolamide.
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