Sleep respiratory disturbances during the ascent to Mount Aconcagua

Ortiz-Naretto, Alvaro Emilio; Pereiro, Miriam Patricia; Ernst, Glenda; Borsini, Eduardo

doi:10.5935/1984-0063.20180005

Cited by 5 publications

(8 citation statements)

References 9 publications

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“…Sleep Awak did not change in any of the groups during STG in this study. These results are consistent with others that reported no change in sleep arousals or awakenings up to 4500 m (Ortiz‐Naretto et al, 2018; Rojc et al, 2014) but differs from others that reported increased awakenings above 3000 m (Beaumont et al, 2007; Tseng et al, 2015). The lack of consistency between studies in regards to sleep arousals is not well understood but may be related to the controversy over whether periodic breathing results in awakenings (Ainslie et al, 2013; Bloch et al, 2015).…”

Section: Discussionsupporting

confidence: 90%

“…Although wrist actigraphy and pulse oximetry were used to assess sleep quality and quantity, sleep measurements using these devices demonstrate a high correlation with polysomnography measurements (Latshang et al, 2016;Nussbaumer-Ochsner et al, 2011). Studies that have employed polysomnography to study sleep at altitudes similar to the ones utilized in this study have reported an increase in desaturation events at ~3500 m (Beaumont et al, 2007;Fischer et al, 2004;Heinzer et al, 2016;Kohler et al, 2008) and above (Nussbaumer-Ochsner et al, 2012;Orr et al, 2018) with no differences observed below this altitude (Latshang et al, 2013;Ortiz-Naretto et al, 2018). In this study, sleep DeSHr were only increased in the 4300 m group during STG which differs from our hypothesis that both the 3500 and 4300 m groups would experience a greater number of these events.…”

Section: Discussioncontrasting

confidence: 88%

“…To our knowledge, this is the first study that has examined the impact of 2 days of staging at various moderate altitudes (2500–3500 m) on sleep quality and quantity following subsequent ascent to a high altitude (4300 m). Although several studies have examined sleep during high‐altitude mountaineering (Bloch et al, 2009; Ortiz‐Naretto et al, 2018; Tannheimer et al, 2017), the ascent profiles, medication use, physical activity during ascent, and final altitude reached differ dramatically among studies. These differences in study design make quantitative comparisons on the effectiveness of different staging strategies difficult at best.…”

Section: Discussionmentioning

confidence: 99%

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Impact of 2 days of staging at 2500–4300 m on sleep quality and quantity following subsequent exposure to 4300 m

Staab

Muza

Fulco

et al. 2021

Physiological Reports

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The impact of 2 days of staging at 2500–4300 m on sleep quality and quantity following subsequent exposure to 4300 m was determined. Forty‐eight unacclimatized men and women were randomly assigned to stage for 2 days at one of four altitudes (2500, 3000, 3500, or 4300 m) prior to assessment on the summit of Pikes Peak (4300 m) for 2 days. Volunteers slept for one night at sea level (SL), two nights at respective staging altitudes, and two nights at Pikes Peak. Each wore a pulse oximeter to measure sleep arterial oxygen saturation (sSpO2, %) and number of desaturations (DeSHr, events/hr) and a wrist motion detector to estimate sleep awakenings (Awak, awakes/hr) and sleep efficiency (Eff, %). Acute mountain sickness (AMS) was assessed using the Environmental Symptoms Questionnaire and daytime SpO2 was assessed after AMS measurements. The mean of all variables for both staging days (STG) and Pikes Peak days (PP) was calculated. The sSpO2 and daytime SpO2 decreased (p < 0.05) from SL during STG in all groups in a dose‐dependent manner. During STG, DeSHr were higher (p < 0.05), Eff was lower (p < 0.05), and AMS symptoms were higher (p < 0.05) in the 3500 and 4300 m groups compared to the 2500 and 3000 m groups while Awak did not differ (p > 0.05) between groups. At PP, the sSpO2, DeSHr, Awak, and Eff were similar among all groups but the 2500 m group had greater AMS symptoms (p < 0.05) than the other groups. Two days of staging at 2500–4300 m induced a similar degree of sleep acclimatization during subsequent ascent to 4300 m but the 2500 m group was not protected against AMS at 4300 m.

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Section: Discussionsupporting

confidence: 90%

Section: Discussioncontrasting

confidence: 88%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Impact of 2 days of staging at 2500–4300 m on sleep quality and quantity following subsequent exposure to 4300 m

Staab

Muza

Fulco

et al. 2021

Physiological Reports

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“…The prevalence of SAS (CSA and OSA) significantly increased with rising elevation in our study. Ortiz-Naretto et al ( 23 ) reported that no mountaineers had periodic breathing (PB) at sea level, but that PB was frequent above 2,581 m and occurred in all subjects above 4,900 m. Liu et al ( 24 ) demonstrated that newcomers who ascended to HA above 2,500 m often developed sleep-disorder breathing (SDB), manifesting as SAS, PB, and nocturnal hypoxemia, which can weaken already exhausted climbers. The above studies showed that acute exposure to high altitudes can damage sleep and breathing in healthy individuals.…”

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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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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“…It can be triggered by hypoxaemia and hypocapnia occurring during sleep, altitude exposure, stroke, heart failure 3 and interstitial lung disease. 4 This phenomenon has previously been described in hypobaric hypoxia during exercise 5 and sleep 6 and, experimentally, in normobaric hypoxia in healthy young adults and athletes. 7 8 Guidelines indicate supplemental oxygen if there is a fall in SpO 2 below 85% or the use of continuous positive airway pressure (CPAP) devices in patients with already diagnosed sleep disturbances requiring them.…”

mentioning

confidence: 57%