Nocturnal oxygen therapy benefits COPD patients during high altitude travel: JAMA

The researchers enrolled 32 patients (mean age, 65.6 years; 53% women) with moderate to severe COPD. They were lowlanders living below 800m and had FEV1 between 30% and 80% predicted, pulse oximetry of at least 92%, no oxygen therapy requirement, and no history of sleep apnea. The baseline assessments were performed at the University Hospital Zurich, which is located at 490 m altitudes and then during two stays (2 days, 2 nights) at a Swiss Alpine hotel, located at 2,048 m altitude. After which patients were randomly assigned to NOT (3 L/min) or placebo. Between the two evaluations, patients were required to spend at least 2 weeks at low altitude.

Coprimary outcomes were differences between NOT and placebo intervention in an altitude-induced change in mean nocturnal oxygen saturation (SpO2). This was measured by pulse oximetry and apnea-hypopnea index (AHI) measured by polysomnography during night 1 at 2048 m and analyzed according to the intention-to-treat principle. 

"Lowlanders with COPD experienced hypoxemia, sleep apnea, and impaired well-being when staying at 2048 m. Because NOT significantly mitigated these undesirable effects, patients with moderate to severe COPD may benefit from preventive NOT during high altitude travel," concluded the authors.

The study, "Effect of Nocturnal Oxygen Therapy on Nocturnal Hypoxemia and Sleep Apnea Among Patients With Chronic Obstructive Pulmonary Disease Traveling to 2048 Meters: A Randomized Clinical Trial," was published in JAMA Network Open.

DOI: 10.1001/jamanetworkopen.2020.7940