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Sleep and Breathing at High Altitude

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Abstract

Sleep at high altitude is characterized by poor subjective quality, increased awakenings, frequent brief arousals, marked nocturnal hypoxemia, and periodic breathing. A change in sleep architecture with an increase in light sleep and decreasing slow-wave and REM sleep have been demonstrated. Periodic breathing with central apnea is almost universally seen amongst sojourners to high altitude, although it is far less common in long-standing high altitude dwellers. Hypobaric hypoxia in concert with periodic breathing appears to be the principal cause of sleep disruption at altitude. Increased sleep fragmentation accounts for the poor sleep quality and may account for some of the worsened daytime performance at high altitude. Hypoxic sleep disruption contributes to the symptoms of acute mountain sickness. Hypoxemia at high altitude is most severe during sleep. Acetazolamide improves sleep, AMS symptoms, and hypoxemia at high altitude. Low doses of a short acting benzodiazepine (temazepam) may also be useful in improving sleep in high altitude.

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Authors and Affiliations

  1. Pulmonary and Intensive Care Section, Department of Internal Medicine, Loma Linda University School of Medicine, Loma Linda, California

    Himanshu Wickramasinghe M.D. & James D. Anholm M.D.

  2. Pulmonary Section 111P, Jerry L.Pettis Memorial Veterans Medical Center, 11201 Benton Street, Loma Linda, CA, 92357

    James D. Anholm M.D.

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  1. Himanshu Wickramasinghe M.D.
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  2. James D. Anholm M.D.
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Wickramasinghe, H., Anholm, J.D. Sleep and Breathing at High Altitude. Sleep Breath 3, 89–101 (1999). https://doi.org/10.1007/s11325-999-0089-1

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