Patients with Obstructive Sleep Apnea at Altitude

被引:21
作者
Bloch, Konrad E. [1 ,2 ,3 ]
Latshang, Tsogyal D. [1 ,2 ,3 ]
Ulrich, Silvia [1 ,2 ,3 ]
机构
[1] Univ Zurich Hosp, Div Pulm, Sleep Disorders Ctr, CH-8091 Zurich, Switzerland
[2] Univ Zurich, Ctr Human Integrat Physiol, CH-8006 Zurich, Switzerland
[3] Univ Zurich, Zurich Ctr Interdisciplinary Sleep Res, CH-8006 Zurich, Switzerland
基金
瑞士国家科学基金会;
关键词
POSITIVE AIRWAY PRESSURE; ADULTS; ACETAZOLAMIDE; TRIAL; ACCLIMATIZATION; ASSOCIATION; SOJOURN; RISK; OSA;
D O I
10.1089/ham.2015.0016
中图分类号
Q6 [生物物理学];
学科分类号
071011 ;
摘要
Bloch, Konrad E., Tsogyal D. Latshang, and Silvia Ulrich. Patients with obstructive sleep apnea at altitude. High Alt Med Biol 16:110-116, 2015.Obstructive sleep apnea (OSA) is highly prevalent in the general population, in particular in men and women of older age. In OSA patients sleeping near sea level, the apneas/hypopneas associated with intermittent hypoxemia are predominantly due to upper airway collapse. When OSA patients stay at altitudes above 1600m, corresponding to that of many tourist destinations, hypobaric hypoxia promotes frequent central apneas in addition to obstructive events, resulting in combined intermittent and sustained hypoxia. This induces strong sympathetic activation with elevated heart rate, cardiac arrhythmia, and systemic hypertension. There are concerns that these changes expose susceptible OSA patients, in particular those with advanced age and co-morbidities, to an excessive risk of cardiovascular and other adverse events during a stay at altitude. Based on data from randomized trials, it seems advisable for OSA patients to use continuous positive airway pressure treatment with computer controlled mask pressure adjustment (autoCPAP) in combination with acetazolamide during an altitude sojourn. If CPAP therapy is not feasible, acetazolamide alone is better than no treatment at all, as it improves oxygenation and sleep apnea and prevents excessive blood pressure rises of OSA patients at altitude.
引用
收藏
页码:110 / 116
页数:7
相关论文
共 31 条
[1]   Tissue oxygen index - Thresholds for cerebral ischemia using near-infrared spectroscopy [J].
Al-Rawi, Pippa G. ;
Kirkpatrick, Peter J. .
STROKE, 2006, 37 (11) :2720-2725
[2]   IMPAIRMENT OF CEREBRAL PERFUSION DURING OBSTRUCTIVE SLEEP APNEAS [J].
BALFORS, EM ;
FRANKLIN, KA .
AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE, 1994, 150 (06) :1587-1591
[3]   Continuous positive airway pressure for obstructive sleep apnea [J].
Basner, Robert C. .
NEW ENGLAND JOURNAL OF MEDICINE, 2007, 356 (17) :1751-1758
[4]   Nocturnal Periodic Breathing during Acclimatization at Very High Altitude at Mount Muztagh Ata (7,546 m) [J].
Bloch, Konrad E. ;
Latshang, Tsogyal D. ;
Turk, Alexander J. ;
Hess, Thomas ;
Hefti, Urs ;
Merz, Tobias M. ;
Bosch, Martina M. ;
Barthelmes, Daniel ;
Hefti, Jacqueline Pichler ;
Maggiorini, Marco ;
Schoch, Otto D. .
AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE, 2010, 182 (04) :562-568
[5]   Effect of simulated altitude during sleep on moderate-severity OSA [J].
Burgess, KR ;
Cooper, J ;
Rice, A ;
Wong, K ;
Kinsman, T ;
Hahn, A .
RESPIROLOGY, 2006, 11 (01) :62-69
[6]   Obstructive Sleep Apnea: Brain Structural Changes and Neurocognitive Function before and after Treatment [J].
Canessa, Nicola ;
Castronovo, Vincenza ;
Cappa, Stefano F. ;
Aloia, Mark S. ;
Marelli, Sara ;
Falini, Andrea ;
Alemanno, Federica ;
Ferini-Strambi, Luigi .
AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE, 2011, 183 (10) :1419-1426
[7]   Pulmonary extravascular fluid accumulation in recreational climbers: a prospective study [J].
Cremona, G ;
Asnaghi, R ;
Baderna, P ;
Brunetto, A ;
Brutsaert, T ;
Cavallaro, C ;
Clark, TM ;
Cogo, A ;
Donis, R ;
Lanfranchi, P ;
Luks, A ;
Novello, N ;
Panzetta, S ;
Perini, L ;
Putnam, M ;
Spagnolatti, L ;
Wagner, H ;
Wagner, PD .
LANCET, 2002, 359 (9303) :303-309
[8]   Nocturnal Rostral Fluid Shift A Unifying Concept for the Pathogenesis of Obstructive and Central Sleep Apnea in Men With Heart Failure [J].
Dai Yumino ;
Redolfi, Stefania ;
Ruttanaumpawan, Pimon ;
Su, Mao-Chang ;
Smith, Stephanie ;
Newton, Gary E. ;
Mak, Susanna ;
Bradley, T. Douglas .
CIRCULATION, 2010, 121 (14) :1598-1605
[9]   The ventilatory responsiveness to CO2 below eupnoea as a determinant of ventilatory stability in sleep [J].
Dempsey, JA ;
Smith, CA ;
Przybylowski, T ;
Chenuel, B ;
Xie, AL ;
Nakayama, H ;
Skatrud, JB .
JOURNAL OF PHYSIOLOGY-LONDON, 2004, 560 (01) :1-11
[10]  
Epstein LJ, 2009, J CLIN SLEEP MED, V5, P263