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Study Looking at End Expiratory Pressure for Altitude Illness Decrease (SLEEP-AID).

Grant S Lipman1, Nicholas C Kanaan2, Caleb Phillips3

  • 11 Stanford University School of Medicine , Stanford, California.

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|May 8, 2015
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Summary
This summary is machine-generated.

Expiratory positive airway pressure (EPAP) did not prevent acute mountain sickness (AMS) in trekkers. However, EPAP reduced headache and dizziness incidence while improving nighttime oxygenation.

Keywords:
acclimatizationacute mountain sicknesshypobaric hypoxiapressure support ventilationsleep at high altitude

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Area of Science:

  • Altitude Medicine
  • Sleep Physiology
  • Respiratory Medicine

Background:

  • Acute mountain sickness (AMS) affects millions of high-altitude travelers annually, with hypoxia and nocturnal desaturations as significant contributing factors.
  • Preventing AMS and improving sleep quality at high altitudes remain critical challenges for trekkers and mountaineers.

Purpose of the Study:

  • To evaluate the efficacy of expiratory positive airway pressure (EPAP) nasal strips in preventing AMS and nocturnal hypoxic events.
  • To assess the impact of EPAP on AMS incidence, severity, and physiological sleep indices in healthy adults at high altitude.

Main Methods:

  • A double-blind, randomized, placebo-controlled trial involving healthy adult participants trekking in the Himalayas.
  • Participants were randomized to receive either a single-use EPAP nasal strip or a visually identical sham device (placebo).
  • AMS incidence and severity were measured using the Lake Louise Questionnaire (LLQ), and sleep indices were monitored using a continuous sleep monitor.

Main Results:

  • EPAP intervention did not significantly decrease the overall incidence of AMS (14% EPAP vs. 17% placebo; p=0.65).
  • However, EPAP use was associated with a reduced incidence of headache (p<0.05) and dizziness (p<0.03) compared to placebo.
  • EPAP significantly improved average nighttime peripheral oxygen saturation (SpO2) (80% vs. 78%; p<0.01) and reduced the percentage of time spent below 80% SpO2 (31% vs. 46%; p<0.03).

Conclusions:

  • Lightweight and inexpensive EPAP devices do not prevent acute mountain sickness but can alleviate specific symptoms like headache and dizziness.
  • EPAP demonstrates a beneficial effect on nocturnal oxygenation, potentially mitigating nocturnal hypoxic events in high-altitude travelers.
  • Further research may explore optimized EPAP strategies for managing altitude-related respiratory challenges.