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Are Nocturnal Breathing, Sleep, and Cognitive Performance Impaired at Moderate Altitude (1,630-2,590 m)?


Latshang, Tsogyal D; Lo Cascio, Christian M; Stöwhas, Anne-Christin; Grimm, Mirjam; Stadelmann, Katrin; Tesler, Noemi; Achermann, Peter; Huber, Reto; Kohler, Malcolm; Bloch, Konrad E (2013). Are Nocturnal Breathing, Sleep, and Cognitive Performance Impaired at Moderate Altitude (1,630-2,590 m)? Sleep, 36(12):1969-1976.

Abstract

STUDY OBJECTIVES: Newcomers at high altitude (> 3,000 m) experience periodic breathing, sleep disturbances, and impaired cognitive performance. Whether similar adverse effects occur at lower elevations is uncertain, although numerous lowlanders travel to moderate altitude for professional or recreational activities. We evaluated the hypothesis that nocturnal breathing, sleep, and cognitive performance of lowlanders are impaired at moderate altitude. DESIGN: Randomized crossover trial. SETTING: University hospital at 490 m, Swiss mountain villages at 1,630 m and 2,590 m. PARTICIPANTS: Fifty-one healthy men, median (quartiles) age 24 y (20-28 y), living below 800 m. INTERVENTIONS: Studies at Zurich (490 m) and during 4 consecutive days at 1,630 m and 2,590 m, respectively, 2 days each. The order of altitude exposure was randomized. Polysomnography, psychomotor vigilance tests (PVT), the number back test, several other tests of cognitive performance, and questionnaires were evaluated. MEASUREMENTS AND RESULTS: The median (quartiles) apnea-hypopnea index at 490 m was 4.6/h (2.3; 7.9), values at 1,630 and 2,590 m, day 1 and 2, respectively, were 7.0/h (4.1; 12.6), 5.4/h (3.5; 10.5), 13.1/h (6.7; 32.1), and 8.0/h (4.4; 23.1); corresponding values of mean nocturnal oxygen saturation were 96% (95; 96), 94% (93; 95), 94% (93; 95), 90% (89; 91), 91% (90; 92), P < 0.05 versus 490 m, all instances. Slow wave sleep on the first night at 2,590 m was 21% (18; 25) versus 24% (20; 27) at 490 m (P < 0.05). Psychomotor vigilance and various other measures of cognitive performance did not change significantly. CONCLUSIONS: Healthy men acutely exposed during 4 days to hypoxemia at 1,630 m and 2,590 m reveal a considerable amount of periodic breathing and sleep disturbances. However, no significant effects on psychomotor reaction speed or cognitive performance were observed. CLINICAL TRIALS REGISTRATION: Clinicaltrials.gov: NCT01130948. CITATION: Latshang TD; Lo Cascio CM; Stöwhas AC; Grimm M; Stadelmann K; Tesler N; Achermann P; Huber R; Kohler M; Bloch KE. Are nocturnal breathing, sleep, and cognitive performance impaired at moderate altitude (1,630-2,590 m)?

Abstract

STUDY OBJECTIVES: Newcomers at high altitude (> 3,000 m) experience periodic breathing, sleep disturbances, and impaired cognitive performance. Whether similar adverse effects occur at lower elevations is uncertain, although numerous lowlanders travel to moderate altitude for professional or recreational activities. We evaluated the hypothesis that nocturnal breathing, sleep, and cognitive performance of lowlanders are impaired at moderate altitude. DESIGN: Randomized crossover trial. SETTING: University hospital at 490 m, Swiss mountain villages at 1,630 m and 2,590 m. PARTICIPANTS: Fifty-one healthy men, median (quartiles) age 24 y (20-28 y), living below 800 m. INTERVENTIONS: Studies at Zurich (490 m) and during 4 consecutive days at 1,630 m and 2,590 m, respectively, 2 days each. The order of altitude exposure was randomized. Polysomnography, psychomotor vigilance tests (PVT), the number back test, several other tests of cognitive performance, and questionnaires were evaluated. MEASUREMENTS AND RESULTS: The median (quartiles) apnea-hypopnea index at 490 m was 4.6/h (2.3; 7.9), values at 1,630 and 2,590 m, day 1 and 2, respectively, were 7.0/h (4.1; 12.6), 5.4/h (3.5; 10.5), 13.1/h (6.7; 32.1), and 8.0/h (4.4; 23.1); corresponding values of mean nocturnal oxygen saturation were 96% (95; 96), 94% (93; 95), 94% (93; 95), 90% (89; 91), 91% (90; 92), P < 0.05 versus 490 m, all instances. Slow wave sleep on the first night at 2,590 m was 21% (18; 25) versus 24% (20; 27) at 490 m (P < 0.05). Psychomotor vigilance and various other measures of cognitive performance did not change significantly. CONCLUSIONS: Healthy men acutely exposed during 4 days to hypoxemia at 1,630 m and 2,590 m reveal a considerable amount of periodic breathing and sleep disturbances. However, no significant effects on psychomotor reaction speed or cognitive performance were observed. CLINICAL TRIALS REGISTRATION: Clinicaltrials.gov: NCT01130948. CITATION: Latshang TD; Lo Cascio CM; Stöwhas AC; Grimm M; Stadelmann K; Tesler N; Achermann P; Huber R; Kohler M; Bloch KE. Are nocturnal breathing, sleep, and cognitive performance impaired at moderate altitude (1,630-2,590 m)?

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Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > University Children's Hospital Zurich > Medical Clinic
04 Faculty of Medicine > Institute of Pharmacology and Toxicology
04 Faculty of Medicine > Center for Child and Adolescent Psychiatry
04 Faculty of Medicine > Center for Integrative Human Physiology
04 Faculty of Medicine > University Hospital Zurich > Clinic for Pneumology
Dewey Decimal Classification:570 Life sciences; biology
610 Medicine & health
Date:1 December 2013
Deposited On:13 Dec 2013 11:33
Last Modified:05 Apr 2016 17:14
Publisher:Associated Professional Sleep Societies
ISSN:0161-8105
Free access at:Publisher DOI. An embargo period may apply.
Publisher DOI:https://doi.org/10.5665/sleep.3242
PubMed ID:24293773

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