Cheyne stokes breathing at high altitude: a helpful response or a troublemaker?
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Sleep disorders at high altitude are common and well-known for centuries. One symptom of the complex is periodic breathing (PB). PB occurs from a disbalance of the negative feedback loop of ventilation control, and at high altitude, it is increased by a phase shift of 180° between hyperventilation and hypoxia. This paper explains the mechanisms that trigger the problem and discusses whether PB may be of advantage or disadvantage for the person going to high altitude. Up to about 3,000–3,500 m, PB may be of advantage because it stabilizes oxygen saturation at a relatively high level. At higher altitudes, disadvantages predominate because frequent arousals cause total sleep deprivation and mental and physical impairment of the victim. Correct acclimatization and “defensive” altitude profiles are gold standard, which minimize PB and optimizes recreative sleep, although they cannot mask PB completely, especially at extreme altitude.
KeywordsSleep High altitude Periodic breathing Cheyne stokes breathing Acclimatization
The manuscript bases on a lecture held at the 2nd International Hypoxia Symposium, Bad Reichenhall/Germany in January 2007. Thanks to the Academy for Mountains and Health, especially Nik Netzer, Assist. Prof., MD, for the perfect organization of the meeting. A warm “Thank you” as well to the colleagues J. Steffgen, M. Hoefer, and U. Gieseler for their long-lasting cooperation and their fantastic companionship in the mountains!
- 1.Hackett P (1991) The Lake Louise Consensus on the definition and quantification of altitude illness. In: Sutton J, Coates G, Houston C (eds) Advances in the biosciences vol. 84: hypoxia and mountain medicine. Proceedings of the 7th International Hypoxia Symposium, Lake Louise, Canada. Pergamon, Oxford, pp 327–330Google Scholar
- 8.Houston CS (1993) Tell me stories about yesterday. J Wild Med 4:14–16Google Scholar
- 9.Hultgren HN (1997) High altitude medicine. Hultgren, Stanford, pp 448–469Google Scholar
- 10.Bert P (1878) La pression barométrique. ParisGoogle Scholar
- 11.Mosso A (1899) Der Mensch auf den Hochalpen. LeipzigGoogle Scholar
- 12.Zuntz N, Loewy A, Müller F et al (1906) Höhenklima und Bergwanderungen in ihrer Wirkung auf den Menschen. Deutsches Verlagshaus Bong, BerlinGoogle Scholar
- 26.Netzer N, Hoefer M, Steinacker J et al (1999) Theophyllin reduces periodic breathing during sleep at high altitude. In Proceedings of the International Hypoxia Symposium. Jasper, Alberta, CanadaGoogle Scholar