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CC BY-NC-ND 4.0 · Sleep Sci 2023; 16(01): 117-126
DOI: 10.1055/s-0043-1767745
Review Article

Altitude and Breathing during Sleep in Healthy Persons and Sleep Disordered Patients: A Systematic Review

Stephanie Rojas-Córdova
1   La Portada Municipal Hospital, Pulmonology Service, La Paz, La Paz, Bolivia
,
Martha Guadalupe Torres-Fraga
2   National Institute of Respiratory Diseases, Sleep Medicine Unit, Mexico City, Mexico City, Mexico
,
Yadira Guadalupe Rodríguez-Reyes
2   National Institute of Respiratory Diseases, Sleep Medicine Unit, Mexico City, Mexico City, Mexico
,
Selene Guerrero-Zúñiga
2   National Institute of Respiratory Diseases, Sleep Medicine Unit, Mexico City, Mexico City, Mexico
,
Juan Carlos Vázquez-García
2   National Institute of Respiratory Diseases, Sleep Medicine Unit, Mexico City, Mexico City, Mexico
,
José Luis Carrillo-Alduenda
2   National Institute of Respiratory Diseases, Sleep Medicine Unit, Mexico City, Mexico City, Mexico
› Institutsangaben Sources of Funding The authors declare that the article entitled “did not receive external funding and was carried out with the resources of the National Institute of Respiratory Diseases of Mexico.
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Abstract

Objetive The aim of this systematic review is to analyze the recent scientific evidence of the clinical effects of altitude on breathing during sleep in healthy persons and sleep disordered patients.

Material and Methods A search was carried out in PubMed and Scopus looking for articles published between January 1, 2010 and December 31, 2021, in English and Spanish, with the following search terms: “sleep disorders breathing and altitude”. Investigations in adults and carried out at an altitude of 2000 meters above mean sea level (MAMSL) or higher were included. The correlation between altitude, apnea hypopnea index (AHI) and mean SpO2 during sleep was calculated.

Results 18 articles of the 112 identified were included. A good correlation was found between altitude and AHI (Rs = 0.66 P = 0.001), at the expense of an increase in the central apnea index. Altitude is inversely proportional to oxygenation during sleep (Rs = −0.93 P = 0.001), and an increase in the desaturation index was observed (3% and 4%). On the treatment of respiratory disorders of sleeping at altitude, oxygen is better than servoventilation to correct oxygenation during sleep in healthy subjects and acetazolamide controlled respiratory events and oxygenation during sleep in patients with obstructive sleep apnea under treatment with CPAP.

Conclusions Altitude increases AHI and decreases oxygenation during sleep; oxygen and acetazolamide could be an effective treatment for sleep-disordered breathing at altitude above 2000 MAMSL.

Keywords

altitude - sleep apnea, obstructive - sleep apnea, central - hypoxia - sleep apnea syndromes


Publikationsverlauf

Eingereicht: 12. Oktober 2021

Angenommen: 28. Juni 2022

Artikel online veröffentlicht:
19. April 2023

© 2023. Brazilian Sleep Association. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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