*7.3.4 Others*

Additional drugs that may be helpful reported by case series include theophylline and the integripetal rhodiola herb, which is a widely used traditional Chinese herb in Tibetan areas. However, strong clinical evidence from randomized controlled trials supporting the effectiveness and safety of these agents has not been demonstrated.

#### **7.4 Recommendations**

Evidence from current available studies support the routing use of supplemental oxygen during sleep to increase arterial blood oxygen saturation. Acute dietary NO3 supplementation reduces flow limitation and induces more pronounced SaO2 desaturations during sleep at high altitude. Acetazolamide at 250 mg daily dose is effective in reducing sleep apnea, decreasing AHI and PB, and increasing nocturnal oxygenation. Both zaleplon and zolpidem improved the objective sleep architecture without impairing ventilation.
