Periodic Breathing and Behavioral Awakenings at High Altitude

Abstract

Objectives. To study the relationship between nocturnal periodic breathing episodes and behavioral awakenings at high altitude. Methods. Observational study. It is 6-day ascent of 4 healthy subjects from Besisahar (760 meters) to Manang (3540 meters) in Nepal in March 2012. A recording pulse oximeter was worn by each subject to measure their oxygen saturation and the presence of periodic breathing continuously through the night. An actigraph was simultaneously worn in order to determine nocturnal behavioral awakenings. There were no interventions. Results. 187-hour sleep at high altitude was analyzed, and of this, 145 hours (78%) had at least one PB event. At high altitude, 10.5% (95% CI 6.5–14.6%) of total sleep time was spent in PB while 15 out of 50 awakenings (30%, 95% CI: 18–45%) occurring at high altitudes were associated with PB (P < 0.001). Conclusions. Our data reveals a higher than expected number of behavioral awakenings associated with PB compared to what would be expected by chance. This suggests that PB likely plays a role in behavioral awakenings at high altitude.

Normobaric hypoxia overnight impairs cognitive reaction time

“…As expected, sleep quality was severely impaired in the present study group at simulated 5500 m altitude. A piled occurrence of periodic breathing and a quite short mean total sleeping time of 3 h and 14 min were measured at 5500 m. Progressively, impaired sleep quality with increasing altitude concurs with previous findings of various study groups [ 8 , 10 , 25 ]. Lower medium oxygen saturation during the night was associated with a better cognitive performance, which contradicts our expectations.…”

“…It is well known that sleep quality decays increasingly with severe hypoxia. Especially periodic breathing and central apneas seem to disturb restorative sleep [ 5 – 10 ]. While ascending, alpinists and altitude workers experience their lowest oxygen levels during the night when arbitrary breathing does not happen.…”

Altitude and Breathing during Sleep in Healthy Persons and Sleep Disordered Patients: A Systematic Review

“…Of those 38 studies, 20 were eliminated due to very low quality of evidence, so the final selection included 18 articles ( Figure 1 ). 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 Fifteen reports were based on real ascents to high or moderate elevations, while the other 3 presented studies of simulated altitudes. The data analyzed involved a total of 530 subjects and presented the results of 1,291 sleep studies.…”