Advertisement

Sleep and Breathing

, Volume 3, Issue 3, pp 75–82 | Cite as

Sleep and Breathing in Recreational Climbers at an Altitude of 4200 and 6400 Meters: Observational Study of Sleep and Patterning of Respiration During Sleep in a Group of Recreational Climbers

  • Nikolaus C. Netzer
  • Kingman P. Strohl
Original Article

Abstract

Background: The increasing popularity of mountain climbing will result in greater numbers of the general population being at risk for the disturbances known to occur with altitude exposure. Methods: Observations of sleep and breathing were made in 6 healthy travellers (5 males and 1 female, 38 to 62 years of age) before, during, and after a recreational climb. We modified a portable seven channel polygraph to record sleep state, oxygen saturation, respiratory movements, body position, and oronasal airflow 4 weeks prior to the expedition at home (500m), at base camp (4200m) and in 3 climbers at 6400m. All had a repeat study at 500m altitude 4 weeks after the expedition. Results: For the group, the total number of obstructive apneas and hypopneas (OA/H) at night increased from 36 at home to 68 at base camp over a one night recording. Separately counted central apneas and hypopneas (CA/CS) increased from 6.7 to 45. In one climber, who had a history of recurrent snoring and observed apneas at home, the number of apneas increased from 201 at 4200m to 322 at 6400m, whereas in 2 climbers measured at 6400m, all apneas decreased. The total sleep time (TST) increased in all 6 climbers by 10% at base camp in comparison to home records. In the 3 climbers attaining an altitude of 6400m, the REM (rapid eye movement) sleep declined by 10% compared to the record at 4200m. Conclusion: Respiratory disturbances at low altitude are amplified by exposure to high and extreme altitude. In those without symptoms of sleep apnea, significant physiologic alterations will occur at high altitude but at extreme altitude regular ventilation is re-established.

Keywords

extreme altitude medicine sleep breathing sleep apnea syndromes 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Douglas CG, Haldane JS. The causes of periodic or Cheyne Stokes breathing. J Physiol 1909;38:404–419Google Scholar
  2. 2.
    Douglas CG, Haldane JS, Henderson Y, Schneider EC. Physiological observations made on Pikes Peak, Colorado, with special reference to adaptation to low barometric pressures. Pilos Trans R Soc Lond Biol 1913;203:185–381Google Scholar
  3. 3.
    Mosso A. Respiration on the mountains. In: Life of Man on the High Alps. London: Fischer Unwin; 1898: pp 31–50Google Scholar
  4. 4.
    Lahiri S, Mulligan E, Mokashi A. Adaptive responses of carotid body chemoreceptors to CO2. Brain Res 1982;234:137–147Google Scholar
  5. 5.
    LöUschke HH. Respiratory chemosensitivity in the medulla oblongata. Acta Neurobiol Exp 1973;33:97–112Google Scholar
  6. 6.
    SchläUfke ME. Central chemosensitivity: A respiratory drive. Rev Physiol Biochem Pharmacol 1981;90:171Google Scholar
  7. 7.
    Reite M, Jackson D, Cahoon RL, Weil JV. Sleep physiology at high altitude. Electroencephalogr Clin Neurophysiol 1975;38:463–471Google Scholar
  8. 8.
    Coote JH. Sleep at high altitude. In: Cooper R, ed. Sleep. London: Chapman and Hall 1994: pp 243–246Google Scholar
  9. 9.
    Nicholson AN, Smith PA, Stone BM. Altitude insomnia: Studies during an expedition to the Himalayas. Sleep 1988;11:354–361Google Scholar
  10. 10.
    Pappenheimer JR. Sleep and respiration of rats during hypoxia. J Physiol 1977;266:191–207Google Scholar
  11. 11.
    Lahiri S, Barnard P. Role of arterial chemoreflexes in breathing during sleep at high altitude. In: Sutton JS, Houston CS, Jones NL, eds. Hypoxia, Exercise and Altitude. New York: Lis 1983: pp 75–85Google Scholar
  12. 12.
    Douglas NJ, White DP, Weil JV, et al. Hypoxic ventilatory response decreases during sleep in normal men. Am Rev Respir Dis 1982;125:286–289PubMedGoogle Scholar
  13. 13.
    Milledge JS, Lahiri S. Respiratory control in lowlanders and Sherpa highlanders at altitude. Respir Physiol 1967;2:310–322Google Scholar
  14. 14.
    Lahiri S, DeLaney RG, Brody JS, et al. Relative role of environmental and genetic factors in respiratory adaptation to high altitude. Nature 1976;261:133–135Google Scholar
  15. 15.
    Finnegan TP, Abraham P, Docherty TB. Ambulatory monitoring of the electroencephalogram in high altitude mountaineers. Electroencephalogr Clin Neurophysiol 1985;60:220–224Google Scholar
  16. 16.
    Anholm JD, Powles ACP, Downey R, et al. Operation Everest II: Arterial oxygen saturation and sleep at extreme simulated altitude. Am Rev Respir Dis 1992;145:817–826Google Scholar
  17. 17.
    Weil JV. Sleep at high altitude. In: Kryger MH, Roth T, Dement WC, eds. Principles and Practice of Sleep Medicine. Philadelphia: WB Saunders 1993: pp 269–275Google Scholar
  18. 18.
    Young T, Palta M, Dempsey J, et al. The occurrence of sleep disordered breathing among middle aged adults. New Engl J Med 1993;328:1230–1235Google Scholar
  19. 19.
    Strohl KP, Beall CM, Decker MJ, Brittenham G. Quantitative genetic analysis of hypoxic ventilatory response at 4000m. Am J Resp Crit Care Med 1995;151:634 (A)Google Scholar
  20. 20.
    Salvaggio A, Insalaco G, Romano S, et al. Periodic breathing during nonREM sleep before and after acclimatization at high altitude. Am J Resp Crit Care Med 1995;151:634 (A)Google Scholar
  21. 21.
    Askenasy JJM, Goldstein R. Environment and sleep: Does a subtropical climate imply a seasonal rhythm in REM sleep. Sleep 1995;18:895–900Google Scholar

Copyright information

© Thieme Medical Publishers, Inc. 1999

Authors and Affiliations

  • Nikolaus C. Netzer
    • 1
    • 2
    • 3
  • Kingman P. Strohl
    • 2
  1. 1.Department of Sports and Rehabilitation MedicineUniversity Hospitals UlmUlmGermany
  2. 2.Department of MedicineCase Western Reserve University, Veterans Administration Medical Center, Cleveland, OhioSleep Disorders Clinic Bayerisch GmainBayerisch GmainGermany
  3. 3.Department of Sports and Rehabilitation MedicineUniversity Hospitals UlmUlmGermany

Personalised recommendations