Children at high altitude have less nocturnal periodic breathing than adults

Kohler, Malcolm; Kriemler, Susi; Wilhelm, Elisabeth; Brunner-LaRocca, Hans Peter; Zehnder, M.; Bloch, Konrad E.

doi:10.1183/09031936.00119807

Cited by 45 publications

(51 citation statements)

References 38 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The overall picture of the symptom distribution was similar in all groups. Differences in prevalence rates among generations were explained by less sleep disturbances in children that might be explained by the finding that children had less periodic breathing and therefore less arousal during the night than adults (Kohler et al, 2008). Children and adolescents from AMS affected parents showed OR of 3.4 to 6.5 to be affected as well compared to those from AMS-free parents.…”

Section: Discussionmentioning

confidence: 91%

“…Although similar prevalence and severity of AMS in children of different age in comparison to adults has been suggested (Pollard et al, 2001;Kohler et al, 2008;, it has never been proven in sufficiently large, standardized trials. The prevalence of AMS in our study was comparable to other studies in adults (Maggiorini et al, 1990;Hackett and Roach, 2001) and adolescents ), although some higher or lower rates have also been reported (Hackett and Roach, 2001).…”

Section: Comparison With Other Studiesmentioning

confidence: 99%

See 1 more Smart Citation

Prevalence of Acute Mountain Sickness at 3500 m Within and Between Families: A Prospective Cohort Study

Kriemler

Bürgi

Wick

et al. 2014

High Altitude Medicine & Biology

View full text Add to dashboard Cite

AIM: To investigate symptoms, prevalence and associated factors of acute mountain sickness (AMS) in families upon a fast ascent to 3450 m. Methods: 87 children, 70 adolescents, and 155 parents (n=312) were assessed for AMS 8-10 and 20-24 hours after fast passive ascent by the Lake Louise Score (LLS). Pain sensitivity and oxygen saturation (SO2) were measured and familial clustering was assessed. RESULTS: AMS prevalence was significantly lower in children (21%) compared to adolescents (34%) and adults (39%) on day 1 (p<0.05), but not on day 2 (18% vs. 19% and 25%). Cumulative prevalence of AMS was 30, 37, and 45% in children, adolescents, and adults, respectively (p<0.001). Familial clustering of AMS was consistent and explained 25%-50% of variability in AMS. Pain sensitivity significantly increased from low to high altitude and was higher at low altitude in those with compared to those without AMS. SO2 at high altitude was not related to the presence of AMS. CONCLUSIONS: After fast ascent to 3500 m, AMS prevalence was lower in children than in adolescents and adults on day 1, but not on day 2. Thus, children may travel at least as safely to an altitude of 3500 m as adolescents and adults, even if risk factors (pain sensitivity and heredity) are present. Methods: 87 children, 70 adolescents, and 155 parents (n = 312) were assessed for AMS 8-10 and 20-24 hours after fast passive ascent by the Lake Louise Score (LLS). Pain sensitivity and oxygen saturation (SO 2 ) were measured and familial clustering was assessed.Results: AMS prevalence was significantly lower in children (21%) compared to adolescents (34%) and adults (39%) on day 1 ( p < 0.05), but not on day 2 (18% vs. 19% and 25%). Cumulative prevalence of AMS was 30, 37, and 45% in children, adolescents, and adults, respectively ( p < 0.001). Familial clustering of AMS was consistent and explained 25%-50% of variability in AMS. Pain sensitivity significantly increased from low to high altitude and was higher at low altitude in those with compared to those without AMS. SO 2 at high altitude was not related to the presence of AMS. Conclusions: After fast ascent to 3500 m, AMS prevalence was lower in children than in adolescents and adults on day 1, but not on day 2. Thus, children may travel at least as safely to an altitude of 3500 m as adolescents and adults, even if risk factors (pain sensitivity and heredity) are present.

show abstract

Section: Discussionmentioning

confidence: 91%

Section: Comparison With Other Studiesmentioning

confidence: 99%

Prevalence of Acute Mountain Sickness at 3500 m Within and Between Families: A Prospective Cohort Study

Kriemler

Bürgi

Wick

et al. 2014

High Altitude Medicine & Biology

View full text Add to dashboard Cite

show abstract

“…It has wide applications, including evaluation of sleep-related breathing disorders [2,3,4], and respiratory monitoring in critical care and anesthesia [5,6] as well as in other areas of physiologic and clinical research [7,8]. Unlike optometric respiratory monitoring [9], RIP is available as portable equipment and can be applied in unrestrained ambulatory subjects during daily activities [7,10].…”

Section: Introductionmentioning

confidence: 99%

Respiratory Monitoring by Inductive Plethysmography in Unrestrained Subjects Using Position Sensor-Adjusted Calibration

et al. 2009

View full text Add to dashboard Cite

Background: Portable respiratory inductive plethysmography (RIP) is promising for noninvasive monitoring of breathing patterns in unrestrained subjects. However, its use has been hampered by requiring recalibration after changes in body position. Objectives: To facilitate RIP application in unrestrained subjects, we developed a technique for adjustment of RIP calibration using position sensor feedback. Methods: Five healthy subjects and 12 patients with lung disease were monitored by portable RIP with sensors incorporated within a body garment. Unrestrained individuals were studied during 40–60 min while supine, sitting and upright/walking. Position was changed repeatedly every 5–10 min. Initial qualitative diagnostic calibration followed by volume scaling in absolute units during 20 breaths in different positions by flow meter provided position-specific volume-motion coefficients for RIP. These were applied during subsequent monitoring in corresponding positions according to feedback from 4 accelerometers placed at the chest and thigh. Accuracy of RIP was evaluated by face mask pneumotachography. Results: Position sensor feedback allowed accurate adjustment of RIP calibration during repeated position changes in subjects and patients as reflected in a minor mean difference (bias) in breath-by-breath tidal volumes estimated by RIP and flow meter of 0.02 liters (not significant) and limits of agreement (±2 SD) of ±19% (2,917 comparisons). An average of 10 breaths improved precision of RIP (limits of agreement ±14%). Conclusions: RIP calibration incorporating position sensor feedback greatly enhances the application of RIP as a valuable, unobtrusive tool to investigate respiratory physiology and ventilatory limitation in unrestrained healthy subjects and patients with lung disease during everyday activities including position changes.

show abstract

“…The apnea threshold was graphically measured as the end-tidal CO 2 of the last full breath preceding a central apnea, as described by Kohler (2008). Every central apnea with clear recording was counted into the measure of average apnea threshold.…”

Section: Co 2 Measuresmentioning

confidence: 99%

Dead Space Mask Eliminates Central Apnea at Altitude

Patz

Patz²,

Hackett³

2013

High Altitude Medicine & Biology

View full text Add to dashboard Cite

Travelers to high altitude may have disturbed sleep due to periodic breathing with frequent central apneas. We tested whether a mask with added dead space could reduce the central apneas of altitude. 16 subjects were recruited, age 18-35, residing at 4600 ft (1400 m). They each slept one night with full polysomnographic monitoring, including end tidal CO2, in a normobaric hypoxia tent simulating 12,000 ft. (3658 m) altitude. Those who had a central apnea index (CAI) >20/h returned for a night in the tent for dead space titration, during which they slept with increasing amounts of dead space, aiming for a CAI <5/h or <10% of baseline. Then each subject slept another night with the titrated amount of dead space. Of the 16 subjects, 5 had a central apnea index >20/h mean 49.1, range 21.4-131.5/hr. In each of the 5, the dead space mask reduced the CAI by at least 88% to a mean of 3.1, range 0.9-7.1/h, (p=0.04). Hypopnea index was unchanged. Three subjects required 500 cc of dead space or less. One subject required 860 cc, and one required 2.1 L. Morning symptoms and arousal index were not significantly affected by the dead space mask. Dead space did not appear to increase the CO2 reserve. At 12,000 ft., central apneas can be effectively reduced with a dead space mask, but clinical utility will require further evaluation.

show abstract

Children at high altitude have less nocturnal periodic breathing than adults

Cited by 45 publications

References 38 publications

Prevalence of Acute Mountain Sickness at 3500 m Within and Between Families: A Prospective Cohort Study

Prevalence of Acute Mountain Sickness at 3500 m Within and Between Families: A Prospective Cohort Study

Respiratory Monitoring by Inductive Plethysmography in Unrestrained Subjects Using Position Sensor-Adjusted Calibration

Dead Space Mask Eliminates Central Apnea at Altitude

Contact Info

Product

Resources

About