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The Impact of Altitude on Sleep-Disordered Breathing in Children Dwelling at High Altitude: A Crossover Study

Benjamin H Hughes1,2, John T Brinton1,3, David G Ingram4,5

  • 1School of Medicine, Department of Pediatrics, The University of Colorado Anschutz Medical Campus, Aurora, CO.

Sleep
|September 22, 2017
PubMed

Insights

High altitude significantly worsens sleep-disordered breathing (SDB) outcomes in children. Lower altitude sleep studies underestimate SDB severity, suggesting home sleep apnea testing for high-altitude residents.

Area of Science:

  • Pediatric Sleep Medicine
  • Altitude Physiology
  • Respiratory Medicine

Background:

  • Sleep-disordered breathing (SDB) affects millions of children globally, linked to adverse health.
  • High-altitude living (above 2000m) is common, but its impact on pediatric SDB is unstudied.

Purpose of the Study:

  • To investigate the effect of chronic high-altitude exposure on sleep study results in children with SDB.
  • To compare high-altitude home polysomnography (H-PSG) with lower-altitude laboratory polysomnography (L-PSG).

Main Methods:

  • A crossover study compared H-PSG and L-PSG in school-aged children with SDB symptoms at high altitude.
  • Primary outcome: apnea-hypopnea index (AHI); secondary outcomes: obstructive/central AHI, oxygenation, sleep quality, pulse rate.

Main Results:

  • Median AHI was significantly higher during H-PSG (10.95) versus L-PSG (2.40).
  • Both obstructive and central events contributed to the increased AHI at high altitude.
  • Children experienced worse oxygenation, increased sleep fragmentation, and higher pulse rates during H-PSG.

Conclusions:

  • Altitude has a substantial clinical impact on respiratory, sleep, and cardiovascular outcomes in children with SDB.
  • L-PSG underestimates SDB severity in high-altitude dwelling children compared to H-PSG.
  • Home sleep apnea testing may be valuable for pediatric SDB assessment in high-altitude regions.
Abstract

Keywords:
OSA pathogenesisSleep-disordered breathingaltitudecardiovascularcentral sleep apneaenvironmenthome sleep apnea testingobstructive sleep apneapediatric sleep apneapediatrics

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