Related Experiment Video
Updated: May 6, 2026
Employing the Forced Oscillation Technique for the Assessment of Respiratory Mechanics in Adults
Published on: February 9, 2022
Respiratory and polysomnographic values in 3- to 5-year-old normal children at higher altitude
Casey J Burg1, Hawley E Montgomery-Downs, Pamela Mettler
1University of Colorado School of Medicine and Children's Hospital Colorado, Aurora, CO.
Insights
Children living at higher altitudes exhibit distinct sleep patterns compared to those at sea level. These differences in sleep parameters, including apnea and limb movement indices, necessitate altitude-adjusted normative values for accurate clinical interpretation.
Area of Science:
- Pediatric Sleep Medicine
- Environmental Physiology
- Respiratory Medicine
Background:
- Altitude can influence physiological processes, including sleep.
- Understanding sleep in children at high altitude is crucial for accurate diagnosis.
Purpose of the Study:
- To compare polysomnographic parameters in children residing at high altitude versus sea level.
- To identify significant differences in sleep indices between these two groups.
Main Methods:
- Prospective study involving 45 healthy children aged 3-5 years living above 1,600 meters.
- Overnight polysomnography was conducted in a tertiary care hospital.
- Sleep data was compared to established sea-level normative values.
Main Results:
- Children at altitude showed significantly higher apnea-hypopnea index (1.8 vs 0.9) and central apnea-hypopnea index (1.7 vs 0.8).
- Higher desaturation index (3.9 vs 0.3) and periodic limb movement in series index (10.1 vs 3.6) were observed in the altitude group.
- Mean end-tidal CO2 levels were also higher at altitude (42.3 vs 40.6 mm Hg).
Conclusions:
- Significant differences exist in central apnea, apnea-hypopnea, desaturation, and periodic limb movement indices between children at altitude and sea level.
- Clinical providers must consider altitude-adjusted normative values when interpreting pediatric sleep studies.
- Incorporating altitude-specific data aids in accurate therapeutic decision-making for children's sleep disorders.
Study Objectives:
To determine polysomnographic parameter differences in children living at higher altitude to children living near sea level.
Design And Setting:
Prospective study of non-snoring, normal children recruited from various communities around Denver, CO. In-lab, overnight polysomnograms were performed at a tertiary care children's hospital. All children required residence for greater than one year at an elevation around 1,600 meters.
Participants:
45 children (62% female), aged 3-5 years, 88.9% non-Hispanic white with average BMI percentile for age of 47.8% ± 30.7%.
Measurements And Results:
Standard sleep indices were obtained and compared to previously published normative values in a similar population living near sea level (SLG). In the altitude group (AG), the apnea-hypopnea index was 1.8 ± 1.2 and the central apnea-hypopnea index was 1.7 ± 1.1, as compared to 0.9 ± 0.8 and 0.8 ± 0.7, respectively, (P ≤ 0.005) in SLG. Mean end-tidal CO2 level in AG was 42.3 ± 3.0 mm Hg and 40.6 ± 4.6 mm Hg in SLG (P = 0.049). The ≥ 4% desaturation index was 3.9 ± 2.0 in AG compared to 0.3 ± 0.4 in SLG (P < 0.001). Mean periodic limb movement in series index was 10.1 ± 12.3 in AG and 3.6 ± 5.4 in SLG (P = 0.001).
Conclusion:
Comparison of altitude and sea level sleep studies in healthy children reveals significant differences in central apnea, apneahypopnea, desaturation, and periodic limb movement in series indices. Clinical providers should be aware of these differences when interpreting sleep studies and incorporate altitude-adjusted normative values in therapeutic-decision making algorithms.
Related Concept Videos
01:24Factors Affecting Respiration
01:19Special considerations while measuring oxygen saturation
Ensuring accuracy in vital sign recordings while prioritizing patient comfort and minimizing anxiety is...
01:20Assessment of Ventilation I: Respiratory Rate
A Ventilation assessment is critical for monitoring a patient's health status. Respiration, one of the most accessible vital signs, provides insights into the function of numerous body systems and can indicate serious health issues, such as brainstem injuries from head trauma.
Critical Guidelines for Assessing Ventilation:
01:30Alterations in Respiration II
In Biot's breathing, the respiratory rate and depth are irregular, alternating between periods of deep gasping and apnea. Common causes...
01:26Respiratory Volumes and Capacities I
01:25Hyperpnea and Hyperventilation