NCT06521476

Brief Summary

Patients with opioid use disorder treated with either methadone or buprenorphine are at risk of developing central sleep apnea (CSA) from these medications. Investigators will conduct a mechanistic trial using acetazolamide, a medicine known to improve CSA in other settings, to determine if acetazolamide can improve CSA due to medication for opioid use disorder and whether this leads to physiologic changes that might lead to reduced drug craving. Patients treated with medication for opioid use disorder and who have central sleep apnea will be randomized to treatment with acetazolamide or matching placebo for 7 days. At the end of the 7 days, they will undergo an overnight sleep study to assess the impact on breathing during sleep as well as sleep quality. In addition, measures of sympathetic tone, anxiety, arousal, cognition, and drug craving will be measured to determine if treatment of CSA with acetazolamide can produce physiologic changes that might contribute to improved health.

Trial Health

77
On Track

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Enrollment
40

participants targeted

Target at P25-P50 for phase_2

Timeline
21mo left

Started Sep 2025

Geographic Reach
1 country

1 active site

Status
recruiting

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

Study Progress26%
Sep 2025Feb 2028

First Submitted

Initial submission to the registry

July 19, 2024

Completed
7 days until next milestone

First Posted

Study publicly available on registry

July 26, 2024

Completed
1.2 years until next milestone

Study Start

First participant enrolled

September 30, 2025

Completed
2.3 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

February 1, 2028

Expected
Same day until next milestone

Study Completion

Last participant's last visit for all outcomes

February 1, 2028

Last Updated

October 16, 2025

Status Verified

October 1, 2025

Enrollment Period

2.3 years

First QC Date

July 19, 2024

Last Update Submit

October 14, 2025

Conditions

Keywords

AcetazolamideOpioid Use DisorderMedication for opioid use disorder (MOUD)MethadoneBuprenorphine

Outcome Measures

Primary Outcomes (1)

  • Central Apnea Index (CAI)

    The number of central apneas per hour of sleep, assessed by overnight polysomnography. * It can range from 0 to undefined events per hour. * Higher values indicate more severe central sleep apnea.

    7 days

Secondary Outcomes (2)

  • Low frequency / high-frequency ratio (LF/HF ratio)

    7 days

  • Apnea Hypopnea Index (AHI)

    7 days

Other Outcomes (7)

  • Overnight urinary norepinephrine levels

    7 days

  • Pre-ejection period

    7 days

  • Pre-sleep Arousal Scale (PSAS) score

    7 days

  • +4 more other outcomes

Study Arms (2)

Acetazolamide

EXPERIMENTAL

All participants in this group will receive one acetazolamide 250 mg pill in the evening for 7 days.

Drug: Acetazolamide

Placebo

PLACEBO COMPARATOR

All participants in this group will receive one matching placebo pill in the evening for 7 days.

Drug: Placebo

Interventions

Oral acetazolamide 250 mg daily for 7 days

Acetazolamide

Oral placebo daily for 7 days

Placebo

Eligibility Criteria

Age18 Years - 100 Years
Sexall
Healthy VolunteersNo
Age GroupsAdult (18-64), Older Adult (65+)

You may qualify if:

  • Patients on Medication for Opioid Use Disorder (MOUD) with central sleep apnea.

You may not qualify if:

  • Sleep-related Hypoventilation.
  • Other causes of Central Sleep Apnea besides Opioid Use.
  • Pregnancy.
  • Contraindications for Acetazolamide.

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (1)

University of Pittsburgh

Pittsburgh, Pennsylvania, 15213, United States

RECRUITING

MeSH Terms

Conditions

Opioid-Related Disorders

Interventions

Acetazolamide

Condition Hierarchy (Ancestors)

Narcotic-Related DisordersSubstance-Related DisordersChemically-Induced DisordersMental Disorders

Intervention Hierarchy (Ancestors)

ThiadiazolesThiazolesSulfur CompoundsOrganic ChemicalsAzolesHeterocyclic Compounds, 1-RingHeterocyclic Compounds

Study Officials

  • Sanjay R Patel, MD

    University of Pittsburgh

    PRINCIPAL INVESTIGATOR

Central Study Contacts

Elizabeth Stempkowski

CONTACT

Julia Sherman

CONTACT

Study Design

Study Type
interventional
Phase
phase 2
Allocation
RANDOMIZED
Masking
QUADRUPLE
Who Masked
PARTICIPANT, CARE PROVIDER, INVESTIGATOR, OUTCOMES ASSESSOR
Masking Details
Placebo pill matched to look like active drug.
Purpose
TREATMENT
Intervention Model
PARALLEL
Model Details: Participants will be randomized in 1:1 fashion to one of two parallel arms (active drug versus placebo).
Sponsor Type
OTHER
Responsible Party
SPONSOR INVESTIGATOR
PI Title
Professor

Study Record Dates

First Submitted

July 19, 2024

First Posted

July 26, 2024

Study Start

September 30, 2025

Primary Completion (Estimated)

February 1, 2028

Study Completion (Estimated)

February 1, 2028

Last Updated

October 16, 2025

Record last verified: 2025-10

Data Sharing

IPD Sharing
Will share

Individual Participant Data (IPD) from this clinical trial will be shared with other researchers. The IPD to be shared includes final closed dataset (after de-identification). All data will be released according to the specific timelines stated in the National Institutes of Health (NIH) Policy, ensuring no compromise to privacy, confidentiality, proprietary interests, national security, or law enforcement activities. These data will be submitted to a NIH-funded data registry for data sharing purposes.

Shared Documents
STUDY PROTOCOL
Time Frame
The IPD will become available within 1 year of analysis of primary outcome. This data will be accessible on an NIH-sponsored platform for as long as the agency maintains it.
Access Criteria
IPD will be available through a NIH funded registry. Access to the IPD will be governed by the policies and procedures of NIH.

Locations