Grimm M, Seglias A, Ziegler L, Mademilov M, Isaeva E, Tynybekov K, Tilebalieva A, Osmonbaeva N, Furian M, Sooronbaev T M, Ulrich S, Bloch K E
Department of Respiratory Medicine, University Hospital Zurich, Zurich, Switzerland; Swiss-Kyrgyz High Altitude Medicine and Research Initiative, Zurich, Switzerland; Swiss-Kyrgyz High Altitude Medicine and Research Initiative, Bishkek, Kyrgyz Republic.
Department of Respiratory Medicine, National Center of Cardiology and Internal Medicine, Bishkek, Kyrgyz Republic; Swiss-Kyrgyz High Altitude Medicine and Research Initiative, Zurich, Switzerland; Swiss-Kyrgyz High Altitude Medicine and Research Initiative, Bishkek, Kyrgyz Republic.
Pulmonology. 2023 Sep-Oct;29(5):385-391. doi: 10.1016/j.pulmoe.2023.02.008. Epub 2023 Mar 22.
Among adults, sleep apnea is more common in highlanders than in lowlanders. We evaluated the sleep apnea prevalence in children living at high altitude compared to age-matched low-altitude controls.
Healthy children, 7-14 y of age, living at 2500-3800m in the Tien Shan mountains, Kyrgyzstan, were prospectively studied in a health post at 3250m. Healthy controls of similar age living at 700-800m were studied in a University Hospital at 760m in Bishkek. Assessments included respiratory sleep studies scored according to pediatric standards, clinical examination, medical history, and the pediatric sleep questionnaire (PSQ, range 0 to 1 with increasing symptoms).
In children living at high altitude (n = 37, 17 girls, median [quartiles] age 10.8y [9.6;13.0]), sleep studies revealed: mean nocturnal pulse oximetry 90% (89;91), oxygen desaturation index (ODI, >3% dips in pulse oximetry) 4.3/h (2.5;6.7), apnea/hypopnea index (AHI) total 1.7/h (1.0;3.6), central 1.6/h (1.0;3.3), PSQ 0.27 (0.18;0.45). In low-altitude controls (n=41, 17 girls, age 11.6y [9.5;13.0], between-groups comparison of age P=0.69) sleep studies revealed: pulse oximetry 97% (96;97), ODI 0.7/h (0.2;1.2), AHI total 0.4/h (0.1;1.0), central 0.3/h (0.1;0.7), PSQ 0.18 (0.14;0.31); P<0.05, all corresponding between-group comparisons.
In school-age children living at high altitude, nocturnal oxygen saturation was lower, and the total and central AHI were higher compared to children living at low altitude. The greater score of sleep symptoms in children residing at high altitude suggests a potential clinical relevance of the nocturnal hypoxemia and subtle sleep-related breathing disturbances.
在成年人中，高原地区居民的睡眠呼吸暂停比低地地区居民更为常见。我们评估了与年龄匹配的低海拔对照儿童相比，高海拔地区儿童的睡眠呼吸暂停患病率。
对吉尔吉斯斯坦天山地区海拔2500 - 3800米生活的7 - 14岁健康儿童，在海拔3250米的健康站进行前瞻性研究。对生活在海拔700 - 800米的年龄相仿的健康对照儿童，在比什凯克海拔760米的大学医院进行研究。评估包括根据儿科标准进行评分的呼吸睡眠研究、临床检查、病史以及儿科睡眠问卷（PSQ，范围为0至1，症状越严重分数越高）。
在高海拔地区儿童（n = 37，17名女孩，年龄中位数[四分位数间距]10.8岁[9.6；13.0]）中，睡眠研究显示：夜间平均脉搏血氧饱和度90%（89；91），氧饱和度下降指数（ODI，脉搏血氧饱和度下降>3%）4.3次/小时（2.5；6.7），呼吸暂停/低通气指数（AHI）总计1.7次/小时（1.0；3.6），中枢性1.6次/小时（1.0；3.3），PSQ为0.27（0.18；0.45）。在低海拔对照儿童（n = 41，17名女孩，年龄11.6岁[9.5；13.0]，两组年龄比较P = 0.69）中，睡眠研究显示：脉搏血氧饱和度97%（96；97），ODI 0.7次/小时（0.2；1.2），AHI总计0.4次/小时（0.1；1.0），中枢性0.3次/小时（0.1；0.7），PSQ为0.18（0.14；0.31）；所有相应的组间比较P<0.05。
与低海拔地区儿童相比，高海拔地区学龄儿童夜间氧饱和度较低，AHI总计及中枢性AHI较高。高海拔地区儿童睡眠症状得分更高，提示夜间低氧血症及轻微的睡眠相关呼吸障碍可能具有临床意义。
