BACKGROUND & AIMS:
:Steier, Joerg, Nic Cade, Ben Walker, John Moxham, and Caroline Jolley. Observational study of neural respiratory drive during sleep at high altitude. High Alt Med Biol. 18:242-248, 2017.
AIMS:Ventilation at altitude changes due to altered levels of pO2, pCO2 and the effect on blood pH. Nocturnal ventilation is particularly exposed to these changes. We hypothesized that an increasing neural respiratory drive (NRD) is associated with the severity of sleep-disordered breathing at altitude.
METHODS:Mountaineers were studied at sea level (London, United Kingdom), and at altitude at the Aconcagua (Andes, Argentina). NRD was measured as electromyogram of the diaphragm (EMGdi) overnight by a transesophageal multi-electrode catheter; results were reported for sea level, 3,380 m, 4,370 m, and 5,570 m.
RESULTS:Four healthy subjects (3 men, age 31(3)years, body mass index 23.6(0.9)kg/m2, neck circumference 37.0(2.7)cm, forced expiratory volume in 1 second 111.8(5.1)%predicted, and forced vital capacity 115.5(6.3)%predicted) were studied. No subject had significant sleep abnormalities at sea level. Time to ascent to 3,380 m was 1 day, to 4,370 m was 5 days, and the total nights at altitude were 21 days. The oxygen desaturation index (4% oxygen desaturation index [ODI] 0.8(0.4), 22.0 (7.2), 61.4 (26.9), 144.9/hour, respectively) and the EMGdi (5.2 (1.9), 12.8 (5.1), 14.1 (3.4), 18.5%, respectively) increased with the development of periodic breathing at altitude, whereas the average SpO2 declined (97.5 (1.3), 84.8 (0.5), 81.0 (4.1), 68.5%, respectively). The average EMGdi correlated well with the 4%ODI (r = 0.968, p = 0.032).
CONCLUSION:NRD sleep increases at altitude in relation to the severity of periodic breathing.
背景与目标:
:斯蒂尔,约尔格,尼克·凯德,本·沃克,约翰·莫克瑟姆和卡罗琳·乔利。高原睡眠中神经呼吸驱动的观察性研究。高Alt Med生物学。 18:242-248,2017。
目的:由于pO2,pCO2水平的改变以及对血液pH值的影响,海拔高度的通风情况发生变化。夜间通气尤其容易受到这些变化的影响。我们假设增加的神经呼吸驱动(NRD)与海拔高度的睡眠呼吸障碍的严重程度有关。
方法:在海平面(英国伦敦)和阿空加瓜的海拔高度(阿根廷安第斯山脉)对登山者进行了研究。通过经食管的多电极导管将NRD测量为隔夜肌膜(EMGdi)的肌电图;报告了海平面3380 m,4370 m和5570 m的结果。
结果:四名健康受试者(3名男性,年龄31(3)岁,体重指数23.6(0.9)kg / m2,颈围37.0(2.7)cm,1秒内被测出的呼气量为111.8(5.1)%,被测出肺活量115.5(6.3)%预计)。没有受试者在海平面上有明显的睡眠异常。上升到3,380 m的时间是1天,到达4,370 m的时间是5天,海拔高度的总夜晚数是21天。氧饱和度指数(4%氧饱和度指数[ODI] 0.8(0.4),22.0(7.2),61.4(26.9),144.9 /小时)和EMGdi(5.2(1.9),12.8(5.1),14.1( 3.4),18.5%)随高海拔周期性呼吸的发展而增加,而平均SpO2下降(分别为97.5(1.3),84.8(0.5),81.0(4.1)和68.5%)。平均EMGdi与4%ODI密切相关(r = 0.968,p = 0.032)。
结论:与定期呼吸的严重程度相比,高海拔地区的NRD睡眠增加。