Obstructive sleep apnea at high altitude


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Abstract

Obstructive sleep apnea (OSA) is an important and socially relevant problem of modern medicine, which is referred to as a most common pathological condition. The problem of OSA is especially urgent for inhabitants of high mountainous regions, as a combination of climatic, social, and cultural factors can significantly affect the course of the disease in both indigenous highlanders and people temporarily residing at high altitude. The paper reviews the current literature covering the problem of OSA at high altitude. It gives the data of Russian and foreign literature on the pathogenesis and clinical presentation of OSA. The author also analyzes an update on the impact of high altitude on the course of OSA in indigenous highlanders and people temporarily living at high altitude. She emphasizes the role of hypobaric hypocapnia as the most important factor for the development of central sleep apnea in the presence of conditions that are obstructive and aggravating the course of the disease.

About the authors

A K Myrzaakhmatova

Национальный центр кардиологии и терапии им. акад. М. Миррахимова

Бишкек, Киргизская Республика

References

  1. Бреслав И.С. Дыхательные рефлексы хеморецепторов. Физиология дыхания. Л.: Наука; 1973.
  2. Lahiri S, Delancy RB, Brody JS, Simpser M, Velasquez T, Motoyama EK, Polgar C. Relative role of environmental and genetic factors in respiratory adaptation to high altitude. Nature. 1976;216:133-135. doi: 10.1038/261133a0
  3. Beall CM, Strohl KP, Blangero J Sarah Williams-Blangero S, Almasy LA, Decker MJ et al. Ventilation and hypoxic ventilatory response of Tibetan and Aymara high altitude native. Am J Phys Anthropol. 1997;104:427-447. doi: 10.1002/(SICI)1096-8644(199712)104:4<427::AID-AJPA1>3.0.CO;2-P
  4. Normand H, Vargas E, Bordachar J et al. Sleep apneas in high altitude residents (3,800 m). Int J SportsMed. 1992;13(1):40-42. doi: 10.1055/s-2007-1024588
  5. Yang SY, Luo XH, Feng EZ, Qi YS, Liu RN, Yin H, Zhang AJ, Zhao LH. Analysis of prognostic risk factors in the patients with acute exacerbation of chronic cor pulmonale and obstructive sleep apnea-hypopnea syndrome in high altitude area. Zhongguo Wei Zhong Bing Ji Jiu Yi Xue 2010;22(5):271-274. doi: 10.3760/cma.j.issn.1003.0603.2010.05.005
  6. Weil JV, Byrne-Quinn E, Sodal IE et al. Hypoxic ventilatory drive in normal man. Journal of Clinical Investigation. 1970;49:1061-1072. doi: 10.1172/JCI106322
  7. Kondo T, Ishii H, Tazaki G, Toda M. Exacerbation of obstructive sleep apnea syndrome at altitude 3,850 m. Nichon Kokyuki Gakkai Zasshi 2008;46(12):1034-1038. Accessed 17.08.2016. Available at:http://www.pubmed.com
  8. Fischer R, Lang S.M, Leitl M, Thiere M, Steiner U, Huber RM. Theophylline and acetazolamide reduce sleep-disordered breathing at high altitude. Eur Respir J. 2004;23(1):47-52. doi: 10.1183/09031936.03.00113102
  9. Nussbaumer-Ochsner Y, Latshang T.D, UlrichS, Kohler M, Thurnheer R, Bloch K.E. Patients with obstructive sleep apnea syndrome benefit from acetazolamide during an altitude sojourn: a randomized, placebo-controlled, double-blind trial. Chest. 2012;141(1):131-138. doi: 10.1378/chest.11-0375
  10. Latshang TD, Nussbaumer-Ochsner Y, Henn RM, Ulrich S, Lo Cascio CM, Ledergerber B, Kohler M, Bloch KE. Effect of acetazolamide and autoCPAP therapy on breathing disturbances among patients with obstructive sleep apnea syndrome who travel to altitude: a randomized controlled trial. JAMA. 2012;308(22):2390-2398. doi: 10.1001/jama.2012.94847
  11. Latshang TD, Bloch KE. How to treat patients with obstructive sleep apnea syndrome during an altitude sojourn. High Alt Med Biol. 2011;(4):303-307. doi: 10.1089/ham.2011.1055
  12. Ng A, Gotsopoulos H, Darendeliler AM, Cistulli PA. Oral appliance therapy for obstructive sleep apnea. Treat Respir Med. 2005;4(6):409-422. doi: 10.2165/00151829-200504060-00005
  13. White DP, Zwillich CW, Pickett CK, Douglas NJ, Findley LJ, Weil JV. Central sleep apnea. Improvement with acetazolamide therapy. Arch Intern Med. 1982;142(10):1816-1819. doi: 10.1001/archinte.142.10.1816
  14. DeBacker WA, Verbraecken J, Willemen M, Wittesaele W, DeCook W, Van deHeyning P. Central apnea index decreases after prolonged treatment with acetazolamide. Am J Respir Crit Care Med. 1995;151:87-91. doi: 10.1164/ajrccm.151.1.7812578
  15. Patz D, Spoon M, Corbin R et al. The effect of altitude descent on obstructive sleep apnea. Chest. 2006;130(6):1744-1750. doi: 10.1378/chest.130.6.1744
  16. Kessler R, Chaouat A, Weitzenblum E, Oswald M, Ehrhart M, Apprill M, Krieger J. Pulmonary hypertension in the obstructive sleep apnoea syndrome:prevalence, causes and therapeutic consequences. Eur Respir J. 1996;9(4):787-794. doi: 10.1183/09031936.96.09040787
  17. Авдеев С.Н. Легочная гипертензия при хронических респираторных заболеваниях. Атмосфера. Пульмонология и аллергология 2010;2:2-10. Ссылка активна на 17.08.2016. Доступно по: http://www.atmosphere-ph.ru/) and CyberLeninka (http://cyberleninka.ru)
  18. Bady E, Achkar A, Pascal S, Orvoen-Frija E, Laaban J. Pulmonary arterial hypertension in patients with sleep apnea syndrome. Thorax. 2000;55(11):934-939. doi: 10.1136/thorax.55.11.934
  19. Hultgren HN. High Altitude Pulmonary Edema: Hemodynamic Aspects. International Journal of Sports Medicine. 1997;18:20-25. doi: 10.1055/s-2007-972589
  20. Миррахимов М.М, Мейманалиев Т.С. Высокогорная кардиология. М.: Кыргызстан; 1984.
  21. Ward MP, Milledge JS, West J. High altitude Medicine and Physiology. 3rd ed. Oxford University Press Inc. New York; 2000.
  22. . Болезни легких и высокогорье. Руководство «Респираторная медицина». Под ред. Чучалина А.Г. М.: Изд-во: ГЭОТАР-Медиа; 2007:382-399.
  23. Güvenç TS, Hüseyinoğlu N, Özben S, Kul Ş, Çetin R, Özen K, Doğan C, Balci B. Right ventricular geometry and mechanics in patients with obstructive sleep apnea living at high altitude. Sleep and Breathing. 2015;1-9. doi: 10.1007/s11325-015-1175-1
  24. Furian M, Latshang T, Aeschbacher S, Ulrich S, Myrzaakmatova A, Sooronbaev T, Aldashev A, Bloch KЕ. Cerebral oxygenation in highlanders with high altitude pulmonary hypertension. Eur Respir J. 2014;44(58). doi: 10.1113/EP085200
  25. Minic M, Ryan CM. Significance of obstructive sleep apnea in the patient with pulmonary hypertension. Curr Opin Pulm Med. 2015;21(6):569-578.
  26. doi:0.1097/0000000000000206 doi: 10.17116/terarkh2017891103-106

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