Effects of long-term exposure to high-altitude on episodic memory: The moderating role of daytime dysfunction

Chronic exposure to high-altitude hypoxic environments may influence short-term memory and working memory. However, its impact on long-term memory, specifically episodic memory, remains understudied. In this study, we systematically investigated the effects of long-term exposure to high altitude (3650 m) on episodic memory, including item memory and source memory. Moreover, we examined the moderating role of daytime dysfunction on the relationship between altitude and episodic memory. In total, 97 participants were enrolled in the study: 49 were from the high-altitude (HA) group, comprising those born and raised in low altitude (LA) areas (< 500 m) and had migrated to HA for 2∼3 years after turning 18; and 48 were from the LA group, who had never lived at high altitudes. Episodic memory was evaluated using a what-when-where task, whereas daytime dysfunction was measured by the Pittsburgh Sleep Quality Index. For item memory, hit rate and correct rejection rate were significantly lower in the HA group relative to the LA group. For source binding memory, the performance in what-where binding and what-when-where binding were decreased in the HA group, but the what-when binding did not differ between the two groups. Furthermore, the effects of altitude on hit rate, what-where binding, and what-when-where binding were significantly pronounced in individuals with higher levels of daytime dysfunction. These findings suggest that long-term exposure to high-altitude hypoxic environments influences episodic memory performance, including item recognition and source-binding memory. Specifically, spatial source memory is affected by high-altitude exposure, whereas temporal source memory remains unaffected. Moreover, these results highlight the importance of considering sleep quality, especially good daytime function, in maintaining optimal episodic memory function following chronic exposure to high altitudes.