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轻度阻塞性睡眠呼吸暂停对攀登阿空加瓜山的登山者的影响。

Effect of mild obstructive sleep apnea in mountaineers during the climb to Mount Aconcagua.

作者信息

Ortiz-Naretto Alvaro Emilio, Pereiro Miriam Patricia, Ernst Glenda, Aramburo Juan Manuel, Tovo Ana María, Vázquez-Fernández Andres, Borsini Eduardo

机构信息

Hospital Britanico de Buenos Aires, Medicine Respiratory Unit - Buenos Aires - CABA - Argentina.

Hospital Francisco Muñiz, Medicine Respiratory Unit - Buenos Aires - CABA - Argentina.

出版信息

Sleep Sci. 2020 Apr-Jun;13(2):138-144. doi: 10.5935/1984-0063.20190146.

DOI:10.5935/1984-0063.20190146
PMID:32742585
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7384527/
Abstract

OBJECTIVE

to compare mountaineers with and without asymptomatic sleep apnea (OSA) before the ascent and to study high altitude-related sleep disorders, its interaction with metabolic, neuroendocrine and immunological components.

MATERIAL AND METHODS

During an expedition to Mount Aconcagua, researchers assessed the respiratory polygraphy (RP), clinical condition and inflammatory parameters, and rhythm of cortisol secretion in mountaineers sleeping at different altitude camps.

RESULTS

8 athletes (4 women), 36 years old (25-51) participated. Baseline and final BMI were; 23.6 (20.9-28.7) and 22.77 (20.9-27.7), respectively: p<0.01. 40 valid RP recordings were analyzed. At 746 m.a.s.l. (baseline), only 2 mountaineers presented mild asymptomatic OSA. The OSA group presented baseline apnea-hypopnea index (AHI) values between 5-15 events per hour, which evidence a mild respiratory sleep disorder with AHI increased by altitude depending of central apneas and hypopneas (p<0.05) as high altitude periodic breathing pattern but no increase in obstructive apneas (p<0.01). The circadian rhythm of cortisol was maintained in all cases in which they had not received treatment with dexamethasone and their values increased with the altitude reached. Increased systolic blood pressure was observed in the OSA group.

CONCLUSION

In a context of hypobaric hypoxia, individuals with pre-existing asymptomatic OSA are prone to experiencing lower oxygen saturations and clinical deterioration.

摘要

目的

比较登山者在登山前有无无症状睡眠呼吸暂停(OSA)的情况,并研究与高海拔相关的睡眠障碍,及其与代谢、神经内分泌和免疫成分的相互作用。

材料与方法

在阿空加瓜山探险期间,研究人员评估了在不同海拔营地睡眠的登山者的呼吸多导记录仪(RP)、临床状况和炎症参数,以及皮质醇分泌节律。

结果

8名运动员(4名女性)参与,年龄36岁(25 - 51岁)。基线和最终体重指数分别为23.6(20.9 - 28.7)和22.77(20.9 - 27.7):p<0.01。分析了40份有效的RP记录。在海拔746米(基线)时,只有2名登山者出现轻度无症状OSA。OSA组的基线呼吸暂停低通气指数(AHI)值为每小时5 - 15次事件,这表明存在轻度呼吸睡眠障碍,AHI随海拔升高而增加,这取决于中枢性呼吸暂停和低通气(p<0.05),呈现高海拔周期性呼吸模式,但阻塞性呼吸暂停无增加(p<0.01)。在所有未接受地塞米松治疗的病例中,皮质醇的昼夜节律得以维持,其值随到达的海拔升高而增加。OSA组观察到收缩压升高。

结论

在低压缺氧的情况下,先前存在无症状OSA的个体容易出现较低的血氧饱和度和临床恶化。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c960/7384527/a16b5de21c64/ssci-13-02-0138-g03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c960/7384527/16c5967523e7/ssci-13-02-0138-g01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c960/7384527/4b338c66fd2f/ssci-13-02-0138-g02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c960/7384527/a16b5de21c64/ssci-13-02-0138-g03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c960/7384527/16c5967523e7/ssci-13-02-0138-g01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c960/7384527/4b338c66fd2f/ssci-13-02-0138-g02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c960/7384527/a16b5de21c64/ssci-13-02-0138-g03.jpg

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