Impact of rapid ascent to high altitude on sleep

Tseng, Chun Hsien; Lin, Fang Chi; Chao, Hsi-Lu; Tsai, Hsiao Ya; Shiao, Guang-Ming; Chang, Shi Chuan

doi:10.1007/s11325-014-1093-7

Cited by 32 publications

(25 citation statements)

References 32 publications

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“… 24 In 40 healthy volunteers (mean age, 40 years) ascending from 555 to 3150 m, the mean Sp o 2 during the first night at high altitude was 83%, and the AHI was 7.4 events/h. 25 …”

Section: Discussionmentioning

confidence: 99%

Effect of Dexamethasone on Nocturnal Oxygenation in Lowlanders With Chronic Obstructive Pulmonary Disease Traveling to 3100 Meters

et al. 2019

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Key Points Question Does preventive dexamethasone treatment mitigate altitude-related nocturnal hypoxemia in lowlanders with chronic obstructive pulmonary disease traveling to a high altitude? Findings In this randomized clinical trial of 118 patients with chronic obstructive pulmonary disease who lived below 800 m, dexamethasone, 4 mg, orally twice daily, starting 24 hours before ascent and while staying in a clinic at 3100 m, significantly mitigated the altitude-induced decrease in mean arterial oxygen saturation during 2 nights at 3100 m by 2% to 3%. In addition, dexamethasone therapy prevented emergence of central sleep apnea and improved subjective sleep quality. Meaning Patients with chronic obstructive pulmonary disease traveling to a high altitude may benefit from preventive dexamethasone treatment in terms of nocturnal oxygenation and sleep quality.

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“… 24 In 40 healthy volunteers (mean age, 40 years) ascending from 555 to 3150 m, the mean Sp o 2 during the first night at high altitude was 83%, and the AHI was 7.4 events/h. 25 …”

Section: Discussionmentioning

confidence: 99%

Effect of Dexamethasone on Nocturnal Oxygenation in Lowlanders With Chronic Obstructive Pulmonary Disease Traveling to 3100 Meters

et al. 2019

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“…TST was significantly reduced with greater simulated altitudes. The disturbance due to the lower F I O 2 seems to impact sleep severely and does not allow longer REM periods [ 21 , 22 ]. If this is due to the low oxygen levels alone or co-affected by the mechanical disturbance due to PB remains to be investigated [ 21 ].…”

Section: Discussionmentioning

confidence: 99%

Periodic breathing in healthy young adults in normobaric hypoxia equivalent to 3500 m, 4500 m, and 5500 m altitude

et al. 2019

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Purpose The occurrence of periodic breathing (PB) at high altitude during sleep and the quality of sleep are individually different and influenced by multiple factors including sex. Although poor sleep quality at high altitude might not be directly linked to oxygen desaturations, the PB upsurge at high altitude leads to significant oscillations in oxygen saturation. Methods Thirty-three students were recruited. Participants were randomly assigned to three groups (A, B, C) sleeping one full night in a dormitory with normobaric hypoxia at a F I O2 of 14.29% (A), a F I O2 of 12.47% (B), or a F I O2 of 10.82% (C). Full polysomnography was performed in each participant. Results Mean total sleeping time decreased significantly with increasing hypoxia ( p < 0.001). Respiratory events changed from central hypopneas to central apneas (CA) with increasing hypoxia: CA = 17.8%, 50.0%, 92.2% of AHI (37.96 events per hour ( n /h), 68.55 n /h, 93.44 n /h). AHI ( p = 0.014) and time duration of respiratory events ( p = 0.003) were significantly different between sexes, both greater in men. REM sleep was reduced. Conclusions Men tend to be more prone to PB in normobaric hypoxia. Further research should implicate a longer acclimatization period around simulated 4500 m in order to find out if the exponential increase in PB between 4500 m and 5500 m could be shifted to lower hypoxic levels, i.e., higher altitudes.

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“…At high altitude, athletes often complain of insomnia, frequent awakening, and restless sleep. 8 , 61 , 63 Unacclimated athletes may be more prone to poor sleep quality. 8 , 61 Subjectively, this is characterized by the sensation of suffocation or apnea and relieved by wakening and several deep breaths, resulting in restless sleep.…”

Section: Physiologic Response To Altitude and Medical Considerationsmentioning

confidence: 99%

“… 8 , 61 , 63 Unacclimated athletes may be more prone to poor sleep quality. 8 , 61 Subjectively, this is characterized by the sensation of suffocation or apnea and relieved by wakening and several deep breaths, resulting in restless sleep. 8 , 63 Physiologically, athletes have a cycle of hyperventilation secondary to high altitude–associated hypoxia, subsequent hypocapnia, and decreased respiratory drive, which is followed by apnea and resumption of the cycle.…”

Section: Physiologic Response To Altitude and Medical Considerationsmentioning

confidence: 99%

“… 8 , 63 Physiologically, athletes have a cycle of hyperventilation secondary to high altitude–associated hypoxia, subsequent hypocapnia, and decreased respiratory drive, which is followed by apnea and resumption of the cycle. 61 , 63 Appropriate sleep hygiene and pretravel management of jetlag are recommended. 36 In athletes requiring treatment of sleep disturbance, both acetazolamide and sleep medications (eg, low-dose benzodiazepines) have been effective.…”

Section: Physiologic Response To Altitude and Medical Considerationsmentioning

confidence: 99%

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Athletes at High Altitude

Khodaee

Grothe

Seyfert

et al. 2016

Sports Health: A Multidisciplinary Approach

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Context:Athletes at different skill levels perform strenuous physical activity at high altitude for a variety of reasons. Multiple team and endurance events are held at high altitude and may place athletes at increased risk for developing acute high altitude illness (AHAI). Training at high altitude has been a routine part of preparation for some of the high level athletes for a long time. There is a general belief that altitude training improves athletic performance for competitive and recreational athletes.Evidence Acquisition:A review of relevant publications between 1980 and 2015 was completed using PubMed and Google Scholar.Study Design:Clinical review.Level of Evidence:Level 3.Results:AHAI is a relatively uncommon and potentially serious condition among travelers to altitudes above 2500 m. The broad term AHAI includes several syndromes such as acute mountain sickness (AMS), high altitude pulmonary edema (HAPE), and high altitude cerebral edema (HACE). Athletes may be at higher risk for developing AHAI due to faster ascent and more vigorous exertion compared with nonathletes. Evidence regarding the effects of altitude training on athletic performance is weak. The natural live high, train low altitude training strategy may provide the best protocol for enhancing endurance performance in elite and subelite athletes. High altitude sports are generally safe for recreational athletes, but they should be aware of their individual risks.Conclusion:Individualized and appropriate acclimatization is an essential component of injury and illness prevention.

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Impact of rapid ascent to high altitude on sleep

Abstract: Higher AHI did not cause more frequent awakenings and arousals at high altitude. Central sleep apneas were observed in non-AMS but not in AMS group. Subjects unacclimatized to acute hypobaric hypoxia might have delayed and less REM sleep.

Cited by 32 publications

References 32 publications

Effect of Dexamethasone on Nocturnal Oxygenation in Lowlanders With Chronic Obstructive Pulmonary Disease Traveling to 3100 Meters

Effect of Dexamethasone on Nocturnal Oxygenation in Lowlanders With Chronic Obstructive Pulmonary Disease Traveling to 3100 Meters

Periodic breathing in healthy young adults in normobaric hypoxia equivalent to 3500 m, 4500 m, and 5500 m altitude

Athletes at High Altitude

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