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The purpose of this study is to investigate the effect of travelling to moderate altitude and of nocturnal oxygen therapy during a stay at moderate altitude on breathing and sleep of patients with pulmonary hypertension or with interstitial lung disease.
Patients with pulmonary hypertension or with interstitial lung disease living below 800 m will be invited to participate in a randomized, cross-over field trial evaluating the hypotheses that: a), breathing and sleep during a 2 day sojourn at moderate altitude are impaired in comparison to low altitude; b), breathing and sleep during a 2 day sojourn at moderate altitude are improved by nocturnal oxygen therapy compared to room air (sham oxygen) administered during nights at altitude. Outcomes will be assessed at low altitude (Zurich, 490 m, baseline), and during 2 study periods of 2 days each spent at moderate altitude (St. Moritz Salastrains, 2048 m), separated by a wash-out period of at least 2 weeks spent at low altitude (<800 m). The order of stays at the different altitudes and of the treatments will be randomized.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Moderate altitude sojourn | Experimental | Sojourn at moderate altitude (2048 m) |
|
| Low altitude sojourn | Experimental | Sojourn at low altitude (490 m, baseline) |
|
| Oxygen | Active Comparator | Oxygen administration via a nasal cannula at a rate of 3 L/min during nights spent at 2048 m |
|
| Sham oxygen (room air) | Placebo Comparator | Sham oxygen (room air) administration via a nasal cannula at a rate of 3 L/min during nights |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Moderate altitude sojourn | Behavioral | Participants will travel from Zurich (490 m) to St. Moritz Salastrains (2048 m) and stay there for 2 days |
|
| Measure | Description | Time Frame |
|---|---|---|
| Mean nocturnal oxygen saturation measured by pulse oximetry | Difference in mean nocturnal oxygen saturation between measurements at 2048 m (altitude) and 490 m (baseline); and between the oxygen and sham oxygen treatment periods at 2048 m. | Approximately 8 hours (during the first night at 2048 m) |
| Apnea/hypopnea index measured by polysomnography | Difference in apnea/hypopnea index between measurements at 2048 m (altitude) and 490 m (baseline); and between the oxygen and sham oxygen treatment periods at 2048 m. | Approximately 8 hours (during the first night at 2048 m) |
| Measure | Description | Time Frame |
|---|---|---|
| Mean nocturnal oxygen saturation measured by pulse oximetry | Difference in mean nocturnal oxygen saturation between measurements at 2048 m (altitude) and 490 m (baseline); and between the oxygen and sham oxygen treatment periods at 2048 m. | Approximately 8 hours (during the second night at 2048 m) |
| Apnea/hypopnea index measured by polygraphy |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Konrad E Bloch, MD | University Hospital, Zürich | Study Chair |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| University Hospital Zurich, Pulmonary Division | Zurich | CH-8091 | Switzerland |
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|
| Low altitude sojourn | Behavioral | Low altitude baseline evaluations will be performed during a stay at Zurich (490) |
|
|
| Oxygen | Drug | Oxygen administration via a nasal cannula at a rate of 3 L/min during nights spent at 2048 m |
|
|
| Sham oxygen (room air) | Drug | Sham oxygen (room air) administration via a nasal cannula at a rate of 3 L/min during nights at 490 m and 2048 m |
|
|
Difference in apnea/hypopnea index between measurements at 2048 m (altitude) and 490 m (baseline); and between the oxygen and sham oxygen treatment periods at 2048 m. |
| Approximately 8 hours (during the second night at 2048 m) |
| Sleep quality visual analog scale score | Difference in subjective sleep quality between visual analog scale measurements at 2048 m (altitude) and 490 m (baseline); and between the oxygen and sham oxygen treatment periods at 2048 m. | Approximately 8 hours (during the first night at 2048 m) |
| Psychomotor vigilance test reaction time | Difference in reaction time between measurements at 2048 m (altitude) and 490 m (baseline); and between the oxygen and sham oxygen treatment periods at 2048 m. | Approximately at 10 a.m. on the second day at 2048 m |
| Severe hypoxemia | Number of participants in whom arterial oxygen saturation measured by pulse oximetry is less than 75% for more than 30 min during the sojourn at 2048 m (altitude) and 490 m (baseline); and during the oxygen and sham oxygen treatment periods at 2048 m. | Approximately 72 hours, Day 1 to 3 at 2048 m |
| Subjective sleep quality visual analog scale score | Difference in subjective sleep quality between visual analog scale measurements at 2048 m (altitude) and 490 m (baseline); and between the oxygen and sham oxygen treatment periods at 2048 m. | Approximately 8 hours (during the second night at 2048 m) |
| ID | Term |
|---|---|
| D017563 | Lung Diseases, Interstitial |
| D006976 | Hypertension, Pulmonary |
| D011658 | Pulmonary Fibrosis |
| ID | Term |
|---|---|
| D008171 | Lung Diseases |
| D012140 | Respiratory Tract Diseases |
| D006973 | Hypertension |
| D014652 | Vascular Diseases |
| D002318 | Cardiovascular Diseases |
| D005355 | Fibrosis |
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |
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| ID | Term |
|---|---|
| D000074584 | WW Domain-Containing Oxidoreductase |
| D010100 | Oxygen |
| ID | Term |
|---|---|
| D000074583 | Short Chain Dehydrogenase-Reductases |
| D064430 | NAD (+) and NADP (+) Dependent Alcohol Oxidoreductases |
| D000429 | Alcohol Oxidoreductases |
| D010088 | Oxidoreductases |
| D004798 | Enzymes |
| D045762 | Enzymes and Coenzymes |
| D025521 | Tumor Suppressor Proteins |
| D009363 | Neoplasm Proteins |
| D011506 | Proteins |
| D000602 | Amino Acids, Peptides, and Proteins |
| D018011 | Chalcogens |
| D004602 | Elements |
| D007287 | Inorganic Chemicals |
| D005740 | Gases |
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