Polysomnography in bolivian children native to high altitude compared to children native to low altitude

Catherine Mary Hill, Annette Carroll, Dagmara Dimitriou, Johanna Gavlak, Kate Heathcote, Veline L'Esperance, Ana Baya, Rebecca Webster, Maria Pushpanathan, Romola Starr Bucks

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

Study Objectives: To compare polysomnographic parameters in high altitude (HA) native Andean children with low altitude (LA) native peers in order to explain the nocturnal oxyhemoglobin saturation (SpO2) instability reported in HA native children and to study the effect on sleep quality. Methods: Ninety-eight healthy children aged 7-10 y and 13-16 y were recruited at LA (500 m) or HA (3,650 m) above sea level. Physical examination was undertaken and genetic ancestry determined from salivary DNA to determine proportion of European ancestry, a risk factor for poor HA adaptation. Attended polysomnography was carried out over 1 night for 58 children at their resident location. Results: Of 98 children recruited, 85 met inclusion criteria, 58 of 85 (68.2%) completed polysomnography, of which 56 were adequate for analysis: 30 at LA (17 male) and 26 at HA (16 male). There were no altitude differences in genetic ancestry, but a high proportion of European admixture (median 50.6% LA; 44.0% HA). SpO2 was less stable at HA with mean 3% and 4% oxygen desaturation indices greater (both P <0.001) than at LA. This was not explained by periodic breathing. However, more obstructive hypopnea was observed at HA (P <0.001), along with a trend toward more central apnea (P = 0.053); neither was explained by clinical findings. There was no difference in sleep quality between altitudes. Conclusions: HA native Andean children have more respiratory events when scoring relies on SpO2 desaturation due to inherent SpO2 instability. Use of American Academy of Sleep Medicine scoring criteria may yield false-positive results for obstructive sleep-disordered breathing at HA.

Original languageEnglish
Pages (from-to)2149-2155
Number of pages7
JournalSLEEP
Volume39
Issue number12
DOIs
Publication statusPublished - 1 Dec 2016

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Polysomnography
Sleep
Central Sleep Apnea
Oxyhemoglobins
Sleep Apnea Syndromes

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Hill, C. M., Carroll, A., Dimitriou, D., Gavlak, J., Heathcote, K., L'Esperance, V., ... Bucks, R. S. (2016). Polysomnography in bolivian children native to high altitude compared to children native to low altitude. SLEEP, 39(12), 2149-2155. https://doi.org/10.5665/sleep.6316
Hill, Catherine Mary ; Carroll, Annette ; Dimitriou, Dagmara ; Gavlak, Johanna ; Heathcote, Kate ; L'Esperance, Veline ; Baya, Ana ; Webster, Rebecca ; Pushpanathan, Maria ; Bucks, Romola Starr. / Polysomnography in bolivian children native to high altitude compared to children native to low altitude. In: SLEEP. 2016 ; Vol. 39, No. 12. pp. 2149-2155.
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Hill, CM, Carroll, A, Dimitriou, D, Gavlak, J, Heathcote, K, L'Esperance, V, Baya, A, Webster, R, Pushpanathan, M & Bucks, RS 2016, 'Polysomnography in bolivian children native to high altitude compared to children native to low altitude' SLEEP, vol. 39, no. 12, pp. 2149-2155. https://doi.org/10.5665/sleep.6316

Polysomnography in bolivian children native to high altitude compared to children native to low altitude. / Hill, Catherine Mary; Carroll, Annette; Dimitriou, Dagmara; Gavlak, Johanna; Heathcote, Kate; L'Esperance, Veline; Baya, Ana; Webster, Rebecca; Pushpanathan, Maria; Bucks, Romola Starr.

In: SLEEP, Vol. 39, No. 12, 01.12.2016, p. 2149-2155.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Polysomnography in bolivian children native to high altitude compared to children native to low altitude

AU - Hill, Catherine Mary

AU - Carroll, Annette

AU - Dimitriou, Dagmara

AU - Gavlak, Johanna

AU - Heathcote, Kate

AU - L'Esperance, Veline

AU - Baya, Ana

AU - Webster, Rebecca

AU - Pushpanathan, Maria

AU - Bucks, Romola Starr

PY - 2016/12/1

Y1 - 2016/12/1

N2 - Study Objectives: To compare polysomnographic parameters in high altitude (HA) native Andean children with low altitude (LA) native peers in order to explain the nocturnal oxyhemoglobin saturation (SpO2) instability reported in HA native children and to study the effect on sleep quality. Methods: Ninety-eight healthy children aged 7-10 y and 13-16 y were recruited at LA (500 m) or HA (3,650 m) above sea level. Physical examination was undertaken and genetic ancestry determined from salivary DNA to determine proportion of European ancestry, a risk factor for poor HA adaptation. Attended polysomnography was carried out over 1 night for 58 children at their resident location. Results: Of 98 children recruited, 85 met inclusion criteria, 58 of 85 (68.2%) completed polysomnography, of which 56 were adequate for analysis: 30 at LA (17 male) and 26 at HA (16 male). There were no altitude differences in genetic ancestry, but a high proportion of European admixture (median 50.6% LA; 44.0% HA). SpO2 was less stable at HA with mean 3% and 4% oxygen desaturation indices greater (both P <0.001) than at LA. This was not explained by periodic breathing. However, more obstructive hypopnea was observed at HA (P <0.001), along with a trend toward more central apnea (P = 0.053); neither was explained by clinical findings. There was no difference in sleep quality between altitudes. Conclusions: HA native Andean children have more respiratory events when scoring relies on SpO2 desaturation due to inherent SpO2 instability. Use of American Academy of Sleep Medicine scoring criteria may yield false-positive results for obstructive sleep-disordered breathing at HA.

AB - Study Objectives: To compare polysomnographic parameters in high altitude (HA) native Andean children with low altitude (LA) native peers in order to explain the nocturnal oxyhemoglobin saturation (SpO2) instability reported in HA native children and to study the effect on sleep quality. Methods: Ninety-eight healthy children aged 7-10 y and 13-16 y were recruited at LA (500 m) or HA (3,650 m) above sea level. Physical examination was undertaken and genetic ancestry determined from salivary DNA to determine proportion of European ancestry, a risk factor for poor HA adaptation. Attended polysomnography was carried out over 1 night for 58 children at their resident location. Results: Of 98 children recruited, 85 met inclusion criteria, 58 of 85 (68.2%) completed polysomnography, of which 56 were adequate for analysis: 30 at LA (17 male) and 26 at HA (16 male). There were no altitude differences in genetic ancestry, but a high proportion of European admixture (median 50.6% LA; 44.0% HA). SpO2 was less stable at HA with mean 3% and 4% oxygen desaturation indices greater (both P <0.001) than at LA. This was not explained by periodic breathing. However, more obstructive hypopnea was observed at HA (P <0.001), along with a trend toward more central apnea (P = 0.053); neither was explained by clinical findings. There was no difference in sleep quality between altitudes. Conclusions: HA native Andean children have more respiratory events when scoring relies on SpO2 desaturation due to inherent SpO2 instability. Use of American Academy of Sleep Medicine scoring criteria may yield false-positive results for obstructive sleep-disordered breathing at HA.

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KW - Hypoxia

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Hill CM, Carroll A, Dimitriou D, Gavlak J, Heathcote K, L'Esperance V et al. Polysomnography in bolivian children native to high altitude compared to children native to low altitude. SLEEP. 2016 Dec 1;39(12):2149-2155. https://doi.org/10.5665/sleep.6316