OSA is a highly prevalent disorder that has major consequences for cardiovascular health,
neurocognitive function, risk of traffic accidents, daytime sleepiness and quality of life.
In particular, REM sleep is accompanied by more frequent and longer obstructive events, that
yield more profound hypoxemia than during non-REM (nREM). Exaggerated OSA severity in REM is
the consequence of ventilatory drive dips, particularly during phasic eye movements [18].
Unfortunately, the leading treatment for REM and nREM OSA, CPAP-which acts to pneumatically
splint the pharynx open-is intolerable for many patients. Treatment outcomes for REM OSA are
burdened by further incomplete CPAP adherence later in the night, which commonly leaves REM
periods undertreated. In this protocol, the investigators will test the effect of
Acetazolamide on REM OSA and on ventilatory parameters such as genioglossus muscle activity
and ventilatory drive.