Lebret Marius, Wuyam Bernard, Bertrand Dominique, Chaudot Christiane, Pépin Jean-Louis, Borel Jean-Christian
Inserm U1042, HP2 laboratory - Grenoble - Isère - França.
Agir a dom., Agir a dom. - Meylan - Isère - França.
Sleep Sci. 2018 Mar-Apr;11(2):123-126. doi: 10.5935/1984-0063.20180023.
Sleep-related breathing disturbances are exacerbated at altitude in patients with Obstructive Sleep Apnea (OSA). The objective of this case report was to determine if a portable auto-CPAP device effectively treated sleep apnea across different altitudes. We report the severity of sleep apnea from 60 to 12,000 feet high in a man with severe OSA (Apnea Hypopnea Index at diagnosis = 60 events/hour) during the 2017 Dakar rally over the Andes mountains. The man was equipped with a lightweight portable auto-CPAP device with a narrow window [6-8 cmHO]. Pressures delivered and corresponding residual events were assessed at different altitudes. The 95 percentile pressure reached the maximal set pressure at the highest altitudes, and residual AHI increased from 5 events/hour to 45 events/hour at the highest altitudes. Potential mechanisms behind the development of central apnea, and optimal clinical management at altitude are discussed in the light of the findings.
阻塞性睡眠呼吸暂停（OSA）患者在高原地区睡眠相关呼吸障碍会加剧。本病例报告的目的是确定便携式自动持续气道正压通气（auto-CPAP）设备是否能有效治疗不同海拔高度的睡眠呼吸暂停。我们报告了一名重度OSA男性（诊断时呼吸暂停低通气指数 = 60次/小时）在2017年穿越安第斯山脉的达喀尔拉力赛期间，海拔从60英尺到12000英尺时的睡眠呼吸暂停严重程度。该男子配备了一台窗口较窄[6 - 8厘米水柱]的轻型便携式auto-CPAP设备。在不同海拔高度评估了输送的压力和相应的残余事件。在最高海拔时，第95百分位数压力达到了最大设定压力，并且在最高海拔时残余呼吸暂停低通气指数从5次/小时增加到了45次/小时。根据研究结果讨论了中枢性呼吸暂停发生的潜在机制以及高原地区的最佳临床管理。
