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Impact of rapid ascent to high altitude on sleep

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Abstract

Purpose

Sleep disturbance at high altitude is common in climbers. In this study, we intended to evaluate the effect of rapid ascent on sleep architecture using polysomnography (PSG) and to compare the differences between subjects with and without acute mountain sickness (AMS).

Methods

The study included 40 non-acclimatized healthy subjects completing PSG at four time points, 3 days before the ascent (T0), two successive nights at 3150 m (T1 and T2), and 2 days after the descent (T3). All subjects were transported by bus from 555 to 3150 m within 3 h. AMS was diagnosed using self-reported questionnaire of Lake Louise score.

Results

Twenty of 40 (50%) subjects developed AMS. At high altitude, awakening percentages increased in AMS group but changed insignificantly in non-AMS group. Arousal index and apnea/hypopnea index (AHI) increased irrespective of AMS. The increases of AHI were more evident in non-AMS group than in AMS group. Compared to subjects without AMS, those with AMS had significantly lower sleep efficiency, lower central apnea index, and longer latencies to sleep and rapid eye movement (REM) sleep at T1 and lower REM sleep percentages at T1 and T2. Subjects with older age and lower minimum arterial oxygen saturation during sleep at sea level were prone to develop AMS.

Conclusions

Higher AHI did not cause more frequent awakenings and arousals at high altitude. Central sleep apneas were observed in non-AMS but not in AMS group. Subjects unacclimatized to acute hypobaric hypoxia might have delayed and less REM sleep.

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Acknowledgments

This work was supported by grants from Taipei Veterans General Hospital (TVGH96-C1-106 and TVGH98-C1-136) and the National Science Council (NSC 99-2314-B-010-033-MY2). The founding sources were not involved in the study design, data analysis and interpretation, and creation and submission of the manuscript. We would like to thank Dr. Benjamin Ing-Tiau Kuo and Miss Hsin-Yi Huang for the kind advice on statistical analysis.

Conflict of interest

The authors declare that they have no conflict of interest.

Author information

Authors and Affiliations

  1. Institute of Emergency and Critical Care Medicine, National Yang-Ming University, #155 Section 2, Linong Street, Taipei, 112, Taiwan

    Chun-Hsien Tseng & Shi-Chuan Chang

  2. Department of Chest Medicine, Taipei Veterans General Hospital, #201 Section 2, Shih-Pai Road, Taipei, 112, Taiwan

    Chun-Hsien Tseng, Fang-Chi Lin, Heng-Sheng Chao, Guang-Ming Shiao & Shi-Chuan Chang

  3. Department of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan

    Fang-Chi Lin & Heng-Sheng Chao

  4. Institute of Biomedical Informatics, National Yang-Ming University, Taipei, Taiwan

    Heng-Sheng Chao

  5. Department of Nursing, Taipei Veterans General Hospital, #201 Section 2, Shih-Pai Road, Taipei, 112, Taiwan

    Han-Chen Tsai

  6. Center of Sleep Medicine, Taipei Veterans General Hospital, #201 Section 2, Shih-Pai Road, Taipei, 112, Taiwan

    Chun-Hsien Tseng & Shi-Chuan Chang

Authors
  1. Chun-Hsien Tseng
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  2. Fang-Chi Lin
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Corresponding author

Correspondence to Shi-Chuan Chang.

Additional information

Chun-Hsien Tseng and Fang-Chi Lin contributed equally to this work.

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Tseng, CH., Lin, FC., Chao, HS. et al. Impact of rapid ascent to high altitude on sleep. Sleep Breath 19, 819–826 (2015). https://doi.org/10.1007/s11325-014-1093-7

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  • DOI: https://doi.org/10.1007/s11325-014-1093-7

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