Effect of dexamethasone on nocturnal breathing in lowlanders with COPD travelling to 3200m

Objective: We investigated the effect of preventive dexamethasone (DEX) treatment on sleep related breathing disturbances in lowlanders with COPD staying at 3200m. Methods: 112 COPD patients (mean±SD age 54.7±9.3y,FEV1 85±21%pred) were randomised to receive DEX (2x4mg/d) or placebo at 760m, before departure, and during a 3 day stay at 3200m. Sleep studies were performed at 760m and in the first and second night at 3200m. Results: Compared to patients using placebo, patients using DEX had a higher arterial oxygen saturation and a lower apnea/hypopnea index and heart rate at 3200m (table). Conclusions: Lowlanders with COPD travelling to high altitude may benefit from preventive DEX treatment as it improves arterial oxygen saturation and stabilizes control of breathing, possibly related to a reduction in sympathetic tone as suggested by a reduced rise in heart rate.