Intermittent Hypoxia in Childhood: The Harmful Consequences Versus Potential Benefits of Therapeutic Uses

Abstract

Intermittent hypoxia (IH) often occurs in early infancy in both preterm and term infants and especially at 36–44 weeks postmenstrual age. These episodes of IH could result from sleep-disordered breathing or may be temporally unrelated to apnea or bradycardia events. There are numerous reports indicating adverse effects of IH on development, behavior, academic achievement, and cognition in children with sleep apnea syndrome. It remains uncertain about the exact causative relationship between the neurocognitive and behavioral morbidities and IH and/or its associated sleep fragmentation. On the other hand, well-controlled and moderate IH conditioning/training has been used in sick children for treating their various forms of bronchial asthma, allergic dermatoses, autoimmune thyroiditis, cerebral palsy, and obesity. This review article provides an updated and impartial analysis on the currently available evidence in supporting either side of the seemingly contradictory scenarios. We wish to stimulate a comprehensive understanding of such a complex physiological phenomenon as intermittent hypoxia, which may be accompanied by other confounding factors (e.g., hypercapnia, polycythemia), in order to prevent or reduce its harmful consequences, while maximizing its potential utility as an effective therapeutic tool in pediatric patients.

“Living High-Training Low” improved weight loss and glucagon-like peptide-1 level in a 4-week weight loss program in adolescents with obesity

“…[ 46 ] Previous reviews summarized the usefulness of moderate IH conditioning/training in sick children for treating their various forms of disease but also emphasized the adverse effects that should be noted. [ 47 , 48 ] However, we did not find any subject with discomfort symptoms (hypoxia-induced symptoms such as pulmonary vasoconstriction, hyperventilation, cerebrovascular relaxation, sympathetic nervous activity, etc) during hypoxia intervention period. We have taken this problem into full consideration.…”

Fitness and therapeutic potential of intermittent hypoxia training: a matter of dose

“…Major achievements in this direction were made by scientists from the former Soviet Union [9]. Here we just briefly mention some papers to illustrate the mode of IHT for children.…”

“…This topic is the subject of many articles, reviews and monographs. To avoid repetition we refer readers to the most recent reviews [3][4][5][6][7][8][9][10].…”

Intermittent hypoxia training as non-pharmacologic therapy for cardiovascular diseases: Practical analysis on methods and equipment

“…In general, the biological responses to intermittent hypoxia may be either adaptive or maladaptive, depending on the severity, frequency, and duration of hypoxemia. These complex systemic, cellular, and molecular mechanisms underlying the effects of intermittent hypoxia have been thoroughly described and extensively discussed in several recent review articles [2][3][4][5][6] as well as two monographs that we have previously published. 7,8 The term of ''intermittent hypoxia'' in medical literature is often referred to pathological processes such as obstructive sleep apnea.…”