The Impact of Altitude on Sleep-Related Breathing Disorders in Infants and Children

• Published in: Current sleep medicine reports Vol. 5; no. 2; pp. 41 - 48
• Main Author: Hughes, Benjamin H.
• Format: Journal Article
• Language: English
• Published: Cham Springer International Publishing 01.06.2019; Springer Nature B.V
• Subjects: Altitude; Cardiology; Family Medicine; General Practice; Hyperventilation; Hypoxia; Internal Medicine; Medicine; Medicine & Public Health; Neurology; Otorhinolaryngology; Pediatrics; Physiology; Psychiatry; Sea level; Section Editor; Sleep and Sleep Apnea at the Extremes (D Gozal; Sleep apnea; Topical Collection on Sleep and Sleep Apnea at the Extremes; Central sleep apnea; Children; Sleep-related breathing disorder; Obstructive sleep apnea; Sleep-disordered breathing; Altitude
• ISSN: 2198-6401; 2198-6401
• DOI: 10.1007/s40675-019-00137-y

Purpose of Review Millions of children worldwide reside at or sojourn to high-altitude locales and are therefore subjected to hypobaric hypoxic conditions. Such exposure is known to impact respiratory physiology including determinants of sleep-related breathing disorders (SRBDs). This review aims to summarize emerging data on the effects of high altitude on SRBDs in infants and children, to highlight possible pathophysiologic consequences of these effects, and to outline specific topics requiring further investigation. Recent Findings Recent findings demonstrate that intermediate and high-altitude conditions increase central and obstructive respiratory event frequency both in healthy infants and children and in those with symptoms of sleep-disordered breathing. These changes are most pronounced in infancy and in symptomatic children. Exposure to high altitude degrades cognitive performance and increases cardiovascular morbidity. Genetic factors which vary between specific populations modulate the high-altitude response and therefore limit the generalizability of these findings. Summary High-altitude exposure worsens SRBD prevalence and severity when implementing scoring rules and diagnostic criteria developed at low altitude. Whether these changes in polysomnographic parameters contribute to the adverse cardiovascular and neurocognitive outcomes observed in high-altitude residents is of critical importance and requires further study.