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Updated: Aug 9, 2026
09:54
A Model to Simulate Clinically Relevant Hypoxia in Humans
Published on: December 22, 2016
Central Sleep Apnea at High Altitude: From Pathophysiology to Treatment
Elisa Perger1, Sébastien Baillieul2
1Department of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy; Istituto Auxologico Italiano, IRCCS, Sleep Disorders Center, Milan, Italy.
Sleep Medicine Clinics
|August 7, 2026
Summary
High-altitude central sleep apnea (HA-CSA) occurs above 2500m due to periodic breathing. Management includes descent, oxygen, acetazolamide, and careful hypnotic use.
Area of Science:
- Sleep Medicine
- Altitude Physiology
- Respiratory Medicine
Background:
- High-altitude central sleep apnea (HA-CSA) is characterized by periodic breathing above 2500m.
- It arises from complex interactions between hypoxia, hypocapnia, and increased loop gain during sleep.
Purpose of the Study:
- To integrate the understanding of HA-CSA mechanisms.
- To describe clinical manifestations, ethnic variations, and management strategies for HA-CSA.
Main Methods:
- Review of existing literature on HA-CSA.
- Analysis of physiological mechanisms.
- Clinical case considerations.
Main Results:
- HA-CSA is driven by sleep-related respiratory drive decreases interacting with increased loop gain.
- Clinical severity is reduced by descent or supplemental oxygen.
- Acetazolamide is an effective pharmacologic treatment.
Conclusions:
- HA-CSA is a distinct sleep disorder at high altitudes.
- Effective management strategies exist, including pharmacologic and supportive measures.
- Further research into ethnic and chronic exposure effects is warranted.
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