Improvements in sleep‐disordered breathing during acclimatization to 3800 m and the impact on cognitive function

Frost, Shyleen; Orr, Jeremy E.; Oeung, Britney; Puvvula, Nikhil; Pham, Kathy; Brena, R.; DeYoung, Pamela; Jain, Sonia; Sun, Shelly; Malhotra, Atul; Heinrich, Erica C.

doi:10.14814/phy2.14827

Cited by 11 publications

(17 citation statements)

References 32 publications

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“…Respiratory alterations during sleep were increased by hypoxia at HA, which caused neurodegenerative changes in the cerebral region and neurotransmitter systems that are involved in learning, memory, attention, and locomotive activity. Furthermore, under hypoxic conditions, recurrent respiratory interruptions at night might have increased oxidative stress and inflammation and decreased the cellular substrates and molecules of synaptic plasticity ( 30 , 45 ). Studies by de Aquino Lemos et al ( 30 ) and Frost et al ( 45 ) support these findings.…”

Section: Discussionmentioning

confidence: 99%

“…Furthermore, under hypoxic conditions, recurrent respiratory interruptions at night might have increased oxidative stress and inflammation and decreased the cellular substrates and molecules of synaptic plasticity ( 30 , 45 ). Studies by de Aquino Lemos et al ( 30 ) and Frost et al ( 45 ) support these findings. Participants who traveled from low altitude to HA of about 3,800 m showed that their short-term memory did not improve over time.…”

Section: Discussionmentioning

confidence: 99%

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Sleep, short-term memory, and mood states of volunteers with increasing altitude

Wang

et al. 2022

Front. Psychiatry

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PurposeThis study sought to identify the changes and potential association between sleep characteristics and short-term memory, and mood states among volunteers at different altitudes and times.MethodA total of 26 healthy volunteers were recruited from the PLA General Hospital, and we conducted a longitudinal prospective survey for over 1 year from November 2019 to April 2021. First, we collected demographic data, sleep parameters by overnight polysomnography (PSG), short-term memory by digit span test, and mood states by completing a questionnaire with a brief profile of mood states among participants in the plain (53 m). Then, we continuously followed them up to collect data in the 3rd month at an altitude of 1,650 m (on the 3rd month of the 1-year survey period), the 3rd month at an altitude of 4,000 m (on the 6th month of the 1-year survey period), and the 9th month at an altitude of 4,000 m (on the 12th month of the 1-year survey period). Multiple linear regression analysis was used to construct models between sleep parameters and short-term memory, and mood states.ResultsThe prevalence of sleep apnea syndrome (SAS) significantly increased with rising elevation (P < 0.01). The apnea-hypopnea index (AHI), the mean apnea time (MAT), the longest apnea time (LAT), and the duration of time with SaO2 < 90% (TSA90) were increased (P < 0.05), and the mean pulse oxygen saturation (MSpO2), the lowest pulse oxygen saturation (LSpO2), and heart rate were significantly decreased with increasing altitude (P < 0.05). Digit span scores were decreased with increasing altitude (P < 0.001). A negative mood was more severe and a positive mood increasingly faded with rising elevation (P < 0.001). Additionally, linear correlation analysis showed that higher AHI, LAT, and MAT were strongly associated with a greater decline in short-term memory (in the 3rd and 9th month at an altitude of 4,000 m, respectively: rs = −0.897, −0.901; rs = −0.691, −0.749; rs = −0.732, −0.794, P < 0.001), and also were strongly associated with more severe negative mood (in the 3rd month at altitudes of 1,650 m and 4,000 m, respectively: rs = 0.655, 0.715, 0.724; rs = 0.771, 0.638, 0.737, P < 0.000625). Multiple linear regression pointed out that AHI was a significant predictor of negative mood among people at different altitudes (in the 3rd month at an altitude of 1,650 m: TMD = 33.161 + 6.495*AHI; in the 3rd month at an altitude of 4,000 m: TMD = 74.247 + 1.589*AHI, P < 0.05).ConclusionSAS developed easily in high altitudes, most often in CSA (central sleep apnea, CSA). The sleep, short-term memory, and negative mood were significantly more damaged with elevation in volunteers. Sleep parameters were closely associated with short-term memory and mood states in volunteers at high altitudes; the higher the sleep parameters (AHI, LAT, and MAT) scores, the more significant the mood disorders and the more obvious impairment of short-term memory. AHI was a critical predictor of the negative mood of volunteers at different altitudes. This study provides evidence that could help with the prevention and control of sleep disorder, cognitive disorder, and negative mood among populations with high altitudes.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Sleep, short-term memory, and mood states of volunteers with increasing altitude

Wang

et al. 2022

Front. Psychiatry

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“…Desaturation events cause periods of hyperventilation which result in hypocapnia-induced apneas or hypopneas, which lead to subsequent desaturation events and arousals. The severity of this periodic breathing pattern appears to increase at higher elevation and may worsen or improve with acclimatization depending on the elevation and degree of increase in the hypoxic ventilatory response ( Andrews et al, 2012 ; Burgess et al, 2013 ; Orr et al, 2018 ; Frost et al, 2021 ). In long term high-altitude residents, sleep disordered breathing remains common and may be linked to the development of excessive erythrocytosis or chronic mountain sickness as discussed in the next Section.…”

Section: Time Domain 4: Hypoxia and Disease Throughout The Life Coursementioning

confidence: 99%

Time Domains of Hypoxia Responses and -Omics Insights

Non

Heinrich

et al. 2022

Front. Physiol.

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The ability to respond rapidly to changes in oxygen tension is critical for many forms of life. Challenges to oxygen homeostasis, specifically in the contexts of evolutionary biology and biomedicine, provide important insights into mechanisms of hypoxia adaptation and tolerance. Here we synthesize findings across varying time domains of hypoxia in terms of oxygen delivery, ranging from early animal to modern human evolution and examine the potential impacts of environmental and clinical challenges through emerging multi-omics approaches. We discuss how diverse animal species have adapted to hypoxic environments, how humans vary in their responses to hypoxia (i.e., in the context of high-altitude exposure, cardiopulmonary disease, and sleep apnea), and how findings from each of these fields inform the other and lead to promising new directions in basic and clinical hypoxia research.

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“…Decreased sleep quality and mood as well as impairments in cognitive function occur after ascent to high altitude [ 71 ]. Central sleep apnea occurs in practically all people at arrival to high altitude (e.g., elevations above 2500 m).…”

Section: Csa Syndromesmentioning

confidence: 99%

The Pathogenesis of Central and Complex Sleep Apnea

Roberts

Raphelson

Orr

et al. 2022

Curr Neurol Neurosci Rep

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Purpose The purpose of this article is to review the recent literature on central apnea. Sleep disordered breathing (SDB) is characterized by apneas (cessation in breathing), and hypopneas (reductions in breathing), that occur during sleep. Central sleep apnea (CSA) is sleep disordered breathing in which there is an absence or diminution of respiratory effort during breathing disturbances while asleep. In obstructive sleep apnea (OSA), on the other hand, there is an absence of flow despite ongoing ventilatory effort. Recent Findings Central sleep apnea is a heterogeneous disease with multiple clinical manifestations. Summary OSA is by far the more common condition; however, CSA is highly prevalent among certain patient groups. Complex sleep apnea (CompSA) is defined as the occurrence/emergence of CSA upon treatment of OSA. Similarly, there is considerable overlap between CSA and OSA in pathogenesis as well as impacts. Thus, understanding sleep disordered breathing is important for many practicing clinicians.

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Improvements in sleep‐disordered breathing during acclimatization to 3800 m and the impact on cognitive function

Cited by 11 publications

References 32 publications

Sleep, short-term memory, and mood states of volunteers with increasing altitude

Sleep, short-term memory, and mood states of volunteers with increasing altitude

Time Domains of Hypoxia Responses and -Omics Insights

The Pathogenesis of Central and Complex Sleep Apnea

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