Burgess Keith R, Johnson Pamela, Edwards Natalie, Cooper Jackie
Peninsula Private Sleep Laboratory, Manly, New South Wales, Australia.
Respirology. 2004 Nov;9(4):485-92. doi: 10.1111/j.1440-1843.2004.00625.x.
This study was intended to demonstrate a biologically important association between acute mountain sickness (AMS) and sleep disordered breathing.
A total of 14 subjects (eight males, six females aged 36 +/- 10 years) were studied at six different altitudes from sea level to 5050 m over 12 days on a trekking route in the Nepal Himalaya. AMS was quantified by Lake Louise (LL) score. At each altitude, sleep was studied by 13 channel polysomnography (PSG). Resting arterial blood gases (ABG) and exercise SaO2 were measured. Ventilatory responses (VR) were measured at sea level. Individual data were analysed for association at several altitudes and mean data were analysed for association over all altitudes.
ABG showed partial acclimatization. For the mean data, there were strong positive correlations between LL score and altitude, and periodic breathing, as expected. Strong negative correlations existed between LL score and PaO2, PaCO2, sleep SaO2 and exercise SaO2, but there was no correlation with sea level VR. There were equally tight correlations between LLs/PaO2 and LL score/sleep SaO2. The individual data showed no significant correlations with LL score at any altitude, probably reflecting the non-steady state nature of the experiment. In addition, mean SaO2 during sleep was similar to minimum exercise SaO2 at each altitude and minimum sleep SaO2 was lower, suggesting that the hypoxic insult during sleep was equivalent to or greater than walking at high altitude.
It is concluded that desaturation during sleep has a biologically important association with AMS, and it is speculated that under similar conditions (trekking) it is an important cause of AMS.
本研究旨在证明急性高原病（AMS）与睡眠呼吸障碍之间存在生物学上的重要关联。
在尼泊尔喜马拉雅山脉的一条徒步路线上，对14名受试者（8名男性，6名女性，年龄36±10岁）进行了为期12天的研究，研究地点为从海平面到5050米的六个不同海拔高度。通过路易斯湖（LL）评分对AMS进行量化。在每个海拔高度，通过13通道多导睡眠图（PSG）研究睡眠情况。测量静息动脉血气（ABG）和运动时的血氧饱和度（SaO2）。在海平面测量通气反应（VR）。对几个海拔高度的个体数据进行关联性分析，并对所有海拔高度的平均数据进行关联性分析。
ABG显示出部分适应性变化。对于平均数据，正如预期的那样，LL评分与海拔高度以及周期性呼吸之间存在强正相关。LL评分与动脉血氧分压（PaO2）、动脉血二氧化碳分压（PaCO2）、睡眠时的SaO2和运动时的SaO2之间存在强负相关，但与海平面VR无关。LLs/PaO2与LL评分/睡眠时的SaO2之间存在同样紧密的相关性。个体数据在任何海拔高度与LL评分均无显著相关性，这可能反映了实验的非稳态性质。此外，每个海拔高度睡眠期间的平均SaO2与运动时的最低SaO2相似，而睡眠时的最低SaO2更低，这表明睡眠期间的低氧损伤等同于或大于在高海拔行走时的损伤。
得出的结论是，睡眠期间的血氧饱和度降低与AMS存在生物学上的重要关联，并且推测在类似条件下（徒步旅行），它是AMS的一个重要原因。
