Role of protriptyline and acetazolamide in the sleep apnea/hypopnea syndrome

Sleep. 1988 Oct;11(5):463-72. doi: 10.1093/sleep/11.5.463.


The role of drug therapy in the treatment of the sleep apnea/hypopnea syndrome is unclear. In a randomised, double-blind, placebo-controlled study, we investigated the value of 14-day therapy with protriptyline (20 mg daily) or acetazolamide (250 mg 4 times per day) on symptoms and on the frequency of apneas, hypopneas, arousals, and 4% desaturations in 10 patients with obstructive sleep apnea/hypopnea syndrome. Overall, protriptyline did not have a significant effect either on symptoms or on any of the above polysomnographic criteria. Acetazolamide reduced the apnea/hypopnea frequency [placebo 50 +/- 26 (SD); acetazolamide 26 +/- 20/h of sleep, p less than 0.03] and tended to decrease the frequency of 4% desaturations (placebo 29 +/- 20; acetazolamide 19 +/- 16/h of sleep, p = 0.06). Despite these physiological improvements, acetazolamide did not significantly improve symptoms and paraesthesiae were common. Contrary to earlier studies, we conclude that protriptyline may have a limited role in the treatment of the sleep apnea syndrome. The reason why acetazolamide produced a physiological, but not a symptomatic, response requires further investigation.

Publication types

  • Clinical Trial
  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Acetazolamide / adverse effects
  • Acetazolamide / therapeutic use*
  • Adult
  • Aged
  • Clinical Trials as Topic
  • Dibenzocycloheptenes / therapeutic use*
  • Double-Blind Method
  • Female
  • Humans
  • Male
  • Middle Aged
  • Monitoring, Physiologic
  • Protriptyline / adverse effects
  • Protriptyline / therapeutic use*
  • Sleep Apnea Syndromes / drug therapy*


  • Dibenzocycloheptenes
  • Protriptyline
  • Acetazolamide