Adaptation to Life in the High Andes: Nocturnal Oxyhemoglobin Saturation in Early Development

C.M. M. Hill, A Baya, J Gavlak, A Carroll, K Heathcote, D Dimitriou, V L'Esperance, Rebecca J. Webster, J Holloway, J Virues-Ortega, F.J. J. Kirkham, Romola S. Bucks, A.M. M. Hogan

Research output: Contribution to journalArticle

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Abstract

Study Objectives: Physiological adaptation to high altitude hypoxia may be impaired in Andeans with significant European ancestry. The respiratory eburden f of sleep may challenge adaptation, leading to relative nocturnal hypoxia. Developmental aspects of sleep-related breathing in high-altitude native children have not previously been reported. We aimed to determine the influence of development on diurnal-nocturnal oxyhemoglobin differences in children living at high altitude. Methods: This was a cross-sectional, observational study. Seventy-five healthy Bolivian children aged 6 mo to 17 y, native to low altitude (500 m), moderate high altitude (2,500 m), and high altitude (3,700 m) were recruited. Daytime resting pulse oximetry was compared to overnight recordings using Masimo radical oximeters. Genetic ancestry was determined from DNA samples. Results: Children had mixed European/Amerindian ancestry, with no significant differences between altitudes. Sixty-two participants had . 5 h of nocturnal, artifact-free data. As predicted, diurnal mean oxyhemoglobin saturation decreased across altitudes (infants and children, both P < 0.001), with lowest diurnal values at high altitude in infants. At high altitude, there was a greater drop in nocturnal mean oxyhemoglobin saturation (infants, P < 0.001; children, P = 0.039) and an increase in variability (all P . 0.001) compared to low altitude. Importantly, diurnal to nocturnal altitude differences diminished (P = 0.036), from infancy to childhood, with no further change during adolescence. Conclusions: Physiological adaptation to high-altitude living in native Andeans is unlikely to compensate for the significant differences we observed between diurnal and nocturnal oxyhemoglobin saturation, most marked in infancy. This vulnerability to sleep-related hypoxia in early childhood has potential lifespan implications. Future studies should characterize the sleep- related respiratory physiology underpinning our observations.
Original languageEnglish
Pages (from-to)1001-1008
Number of pages8
JournalSLEEP
Volume39
Issue number5
DOIs
Publication statusPublished - 2016

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Oxyhemoglobins
Sleep
Physiological Adaptation
Respiratory Physiological Phenomena
Altitude Sickness
Oximetry
Population Groups
Artifacts
Observational Studies
Respiration
Cross-Sectional Studies

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Hill, C. M. M., Baya, A., Gavlak, J., Carroll, A., Heathcote, K., Dimitriou, D., ... Hogan, A. M. M. (2016). Adaptation to Life in the High Andes: Nocturnal Oxyhemoglobin Saturation in Early Development. SLEEP, 39(5), 1001-1008. https://doi.org/10.5665/sleep.5740
Hill, C.M. M. ; Baya, A ; Gavlak, J ; Carroll, A ; Heathcote, K ; Dimitriou, D ; L'Esperance, V ; Webster, Rebecca J. ; Holloway, J ; Virues-Ortega, J ; Kirkham, F.J. J. ; Bucks, Romola S. ; Hogan, A.M. M. / Adaptation to Life in the High Andes: Nocturnal Oxyhemoglobin Saturation in Early Development. In: SLEEP. 2016 ; Vol. 39, No. 5. pp. 1001-1008.
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title = "Adaptation to Life in the High Andes: Nocturnal Oxyhemoglobin Saturation in Early Development",
abstract = "Study Objectives: Physiological adaptation to high altitude hypoxia may be impaired in Andeans with significant European ancestry. The respiratory eburden f of sleep may challenge adaptation, leading to relative nocturnal hypoxia. Developmental aspects of sleep-related breathing in high-altitude native children have not previously been reported. We aimed to determine the influence of development on diurnal-nocturnal oxyhemoglobin differences in children living at high altitude. Methods: This was a cross-sectional, observational study. Seventy-five healthy Bolivian children aged 6 mo to 17 y, native to low altitude (500 m), moderate high altitude (2,500 m), and high altitude (3,700 m) were recruited. Daytime resting pulse oximetry was compared to overnight recordings using Masimo radical oximeters. Genetic ancestry was determined from DNA samples. Results: Children had mixed European/Amerindian ancestry, with no significant differences between altitudes. Sixty-two participants had . 5 h of nocturnal, artifact-free data. As predicted, diurnal mean oxyhemoglobin saturation decreased across altitudes (infants and children, both P < 0.001), with lowest diurnal values at high altitude in infants. At high altitude, there was a greater drop in nocturnal mean oxyhemoglobin saturation (infants, P < 0.001; children, P = 0.039) and an increase in variability (all P . 0.001) compared to low altitude. Importantly, diurnal to nocturnal altitude differences diminished (P = 0.036), from infancy to childhood, with no further change during adolescence. Conclusions: Physiological adaptation to high-altitude living in native Andeans is unlikely to compensate for the significant differences we observed between diurnal and nocturnal oxyhemoglobin saturation, most marked in infancy. This vulnerability to sleep-related hypoxia in early childhood has potential lifespan implications. Future studies should characterize the sleep- related respiratory physiology underpinning our observations.",
author = "Hill, {C.M. M.} and A Baya and J Gavlak and A Carroll and K Heathcote and D Dimitriou and V L'Esperance and Webster, {Rebecca J.} and J Holloway and J Virues-Ortega and Kirkham, {F.J. J.} and Bucks, {Romola S.} and Hogan, {A.M. M.}",
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Hill, CMM, Baya, A, Gavlak, J, Carroll, A, Heathcote, K, Dimitriou, D, L'Esperance, V, Webster, RJ, Holloway, J, Virues-Ortega, J, Kirkham, FJJ, Bucks, RS & Hogan, AMM 2016, 'Adaptation to Life in the High Andes: Nocturnal Oxyhemoglobin Saturation in Early Development' SLEEP, vol. 39, no. 5, pp. 1001-1008. https://doi.org/10.5665/sleep.5740

Adaptation to Life in the High Andes: Nocturnal Oxyhemoglobin Saturation in Early Development. / Hill, C.M. M.; Baya, A; Gavlak, J; Carroll, A; Heathcote, K; Dimitriou, D; L'Esperance, V; Webster, Rebecca J.; Holloway, J; Virues-Ortega, J; Kirkham, F.J. J.; Bucks, Romola S.; Hogan, A.M. M.

In: SLEEP, Vol. 39, No. 5, 2016, p. 1001-1008.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Adaptation to Life in the High Andes: Nocturnal Oxyhemoglobin Saturation in Early Development

AU - Hill, C.M. M.

AU - Baya, A

AU - Gavlak, J

AU - Carroll, A

AU - Heathcote, K

AU - Dimitriou, D

AU - L'Esperance, V

AU - Webster, Rebecca J.

AU - Holloway, J

AU - Virues-Ortega, J

AU - Kirkham, F.J. J.

AU - Bucks, Romola S.

AU - Hogan, A.M. M.

PY - 2016

Y1 - 2016

N2 - Study Objectives: Physiological adaptation to high altitude hypoxia may be impaired in Andeans with significant European ancestry. The respiratory eburden f of sleep may challenge adaptation, leading to relative nocturnal hypoxia. Developmental aspects of sleep-related breathing in high-altitude native children have not previously been reported. We aimed to determine the influence of development on diurnal-nocturnal oxyhemoglobin differences in children living at high altitude. Methods: This was a cross-sectional, observational study. Seventy-five healthy Bolivian children aged 6 mo to 17 y, native to low altitude (500 m), moderate high altitude (2,500 m), and high altitude (3,700 m) were recruited. Daytime resting pulse oximetry was compared to overnight recordings using Masimo radical oximeters. Genetic ancestry was determined from DNA samples. Results: Children had mixed European/Amerindian ancestry, with no significant differences between altitudes. Sixty-two participants had . 5 h of nocturnal, artifact-free data. As predicted, diurnal mean oxyhemoglobin saturation decreased across altitudes (infants and children, both P < 0.001), with lowest diurnal values at high altitude in infants. At high altitude, there was a greater drop in nocturnal mean oxyhemoglobin saturation (infants, P < 0.001; children, P = 0.039) and an increase in variability (all P . 0.001) compared to low altitude. Importantly, diurnal to nocturnal altitude differences diminished (P = 0.036), from infancy to childhood, with no further change during adolescence. Conclusions: Physiological adaptation to high-altitude living in native Andeans is unlikely to compensate for the significant differences we observed between diurnal and nocturnal oxyhemoglobin saturation, most marked in infancy. This vulnerability to sleep-related hypoxia in early childhood has potential lifespan implications. Future studies should characterize the sleep- related respiratory physiology underpinning our observations.

AB - Study Objectives: Physiological adaptation to high altitude hypoxia may be impaired in Andeans with significant European ancestry. The respiratory eburden f of sleep may challenge adaptation, leading to relative nocturnal hypoxia. Developmental aspects of sleep-related breathing in high-altitude native children have not previously been reported. We aimed to determine the influence of development on diurnal-nocturnal oxyhemoglobin differences in children living at high altitude. Methods: This was a cross-sectional, observational study. Seventy-five healthy Bolivian children aged 6 mo to 17 y, native to low altitude (500 m), moderate high altitude (2,500 m), and high altitude (3,700 m) were recruited. Daytime resting pulse oximetry was compared to overnight recordings using Masimo radical oximeters. Genetic ancestry was determined from DNA samples. Results: Children had mixed European/Amerindian ancestry, with no significant differences between altitudes. Sixty-two participants had . 5 h of nocturnal, artifact-free data. As predicted, diurnal mean oxyhemoglobin saturation decreased across altitudes (infants and children, both P < 0.001), with lowest diurnal values at high altitude in infants. At high altitude, there was a greater drop in nocturnal mean oxyhemoglobin saturation (infants, P < 0.001; children, P = 0.039) and an increase in variability (all P . 0.001) compared to low altitude. Importantly, diurnal to nocturnal altitude differences diminished (P = 0.036), from infancy to childhood, with no further change during adolescence. Conclusions: Physiological adaptation to high-altitude living in native Andeans is unlikely to compensate for the significant differences we observed between diurnal and nocturnal oxyhemoglobin saturation, most marked in infancy. This vulnerability to sleep-related hypoxia in early childhood has potential lifespan implications. Future studies should characterize the sleep- related respiratory physiology underpinning our observations.

U2 - 10.5665/sleep.5740

DO - 10.5665/sleep.5740

M3 - Article

VL - 39

SP - 1001

EP - 1008

JO - SLEEP

JF - SLEEP

SN - 1179-1608

IS - 5

ER -

Hill CMM, Baya A, Gavlak J, Carroll A, Heathcote K, Dimitriou D et al. Adaptation to Life in the High Andes: Nocturnal Oxyhemoglobin Saturation in Early Development. SLEEP. 2016;39(5):1001-1008. https://doi.org/10.5665/sleep.5740