Prevalence of central sleep apnea during continous positive airway pressure (CPAP) titration in subjects with obstructive sleep apnea syndrome at an altitude of 2640 m

Severe sleep apnea, Cheyne-Stokes respiration and desaturation in patients with decompensated heart failure at high altitude

“…Unlike our study, in both aforementioned studies, the proportion of patients with predominantly central SA (CAI > 50% of total AHI) was significantly lower 17 . Similarly, the central sleep apnea index for the total group of patients with DHF (25.9±22.7) is markedly greater than that described in a previous study conducted by our group at the same altitude in subjects without heart failure, suggesting that the occurrence of central sleep apnea is not explained by altitude alone 19 .…”

Characterization of North–Western Mediterranean coralligenous assemblages by video surveys and evaluation of their structural complexity

“…In the Mediterranean Sea, coralligenous assemblages [65,76] develop in dimlight littoral systems (between 25 − 30 and 150 − 200 m depth) on vertical rocky cliffs and on flat or semi-flat biodetritic bottoms [90,92], wherever irradiance is reduced between 2 − 3% and 0 − 0.5% of the surface irradiance [37] and in relatively constant conditions of temperature, currents and salinity. The unique information available regarding growth dynamics evidences a very low growth rate, 0.19 mm year −1 , ranging from 0.11 to 0.26 mm year −1 [77].…”

Treatment-emergent central sleep apnea: a unique sleep-disordered breathing

“…In a study based on OSA patients living in high altitude areas (2640 m), the prevalence of CSA was 11.6%, which was intermediate compared to the prevalence reported for patients living in areas with lower altitudes. [ 25 ] However, Pagel et al [ 26 ] analyzed OSA patients living in areas at three different altitudes above sea level (1421, 1808, and 2165 m, respectively), and reported that as altitude increases, central apnea becomes more frequent (10.6%, 22%, and 38.7%, respectively). Miao ZB et al [ 27 ] also demonstrated that the prevalence of TECSA increases as altitudes rise.…”

“…Some studies identified several clinical risk factors for TECSA in OSA patients. As these studies reported, older age, [ 21 ] male, [ 13 , 25 , 52 – 54 ] lower body mass index, [ 19 , 52 ] comorbid conditions (especially coronary artery disease, hypertension and CHF, atrial fibrillation, and stroke), [ 23 , 25 , 53 , 54 ] medications (chronic opiate use), [ 18 , 54 ] certain polysomnographic parameters at the time of diagnostic polysomnography (PSG) study (such as higher baseline apnea-hypopnea index [AHI] [ 10 , 18 , 20 , 21 , 23 , 25 , 53 ] and CAI, [ 11 , 18 , 21 , 23 , 25 , 52 , 53 ] higher baseline arousal index, [ 10 , 53 ] and an increase in CAI in non-rapid eye movement supine sleep [ 55 ] ), and titration factors (such as higher residual AHI, [ 10 ] rapid or excessively high titration, [ 3 , 56 ] excessive air leak, [ 3 , 56 ] lower total sleep time, [ 10 ] lower sleep efficiency, [ 10 ] and use of bilevel positive airway pressure (BiPAP) in their titration studies [ 31 ] ) were associated with a higher prevalence of TECSA in OSA patients than those in matched control subjects. Lei F et al [ 57 ] reported that higher baseline mixed sleep apnea, especially in non-rapid eye movement sleep, was related to a higher incidence of TECSA in OSA patients.…”