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Cross-Sectional Comparison of Sleep-Disordered Breathing in Native Peruvian Highlanders and Lowlanders

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dc.contributor.author Pham, Luu V.
dc.contributor.author Meinzen, Christopher
dc.contributor.author Arias, Rafael S.
dc.contributor.author Schwartz, Noah G.
dc.contributor.author Rattner, Adi
dc.contributor.author Miele, Catherine H.
dc.contributor.author Smith, Philip L.
dc.contributor.author Schneider, Hartmut
dc.contributor.author Miranda, J. Jaime
dc.contributor.author Gilman, Robert Hugh
dc.contributor.author Polotsky, Vsevolod Y.
dc.contributor.author Checkley, William
dc.contributor.author Schwartz, Alan R.
dc.date.accessioned 2019-01-25T15:02:22Z
dc.date.available 2019-01-25T15:02:22Z
dc.date.issued 2017
dc.identifier.uri https://hdl.handle.net/20.500.12866/4628
dc.description.abstract BACKGROUND: Altitude can accentuate sleep disordered breathing (SDB), which has been linked to cardiovascular and metabolic diseases. SDB in highlanders has not been characterized in large controlled studies. The purpose of this study was to compare SDB prevalence and severity in highlanders and lowlanders. METHODS: 170 age-, body-mass-index- (BMI), and sex-matched pairs (age 58.2 +/- 12.4 years, BMI 27.2 +/- 3.5 kg/m(2), and 86 men and 84 women) of the CRONICAS Cohort Study were recruited at a sea-level (Lima) and a high-altitude (Puno, 3825 m) setting in Peru. Participants underwent simultaneous nocturnal polygraphy and actigraphy to characterize breathing patterns, movement arousals, and sleep/wake state. We compared SDB prevalence, type, and severity between highlanders and lowlanders as measured by apnea-hypopnea index (AHI) and pulse oximetry (SPO2) during sleep. RESULTS: Sleep apnea prevalence was greater in highlanders than in lowlanders (77% vs. 54%, p < 0.001). Compared with lowlanders, highlanders had twofold elevations in AHI due to increases in central rather than obstructive apneas. In highlanders compared with lowlanders, SPO2 was lower during wakefulness and decreased further during sleep (p < 0.001). Hypoxemia during wakefulness predicted sleep apnea in highlanders, and it appears to mediate the effects of altitude on sleep apnea prevalence. Surprisingly, hypoxemia was also quite prevalent in lowlanders, and it was also associated with increased odds of sleep apnea. CONCLUSIONS: High altitude and hypoxemia at both high and low altitude were associated with increased SDB prevalence and severity. Our findings suggest that a large proportion of highlanders remain at risk for SDB sequelae. en_US
dc.language.iso eng
dc.publisher Mary Ann Liebert
dc.relation.ispartofseries High Altitude Medicine and Biology
dc.rights info:eu-repo/semantics/restrictedAccess
dc.rights.uri https://creativecommons.org/licenses/by-nc-nd/4.0/deed.es
dc.subject Female en_US
dc.subject Humans en_US
dc.subject Male en_US
dc.subject epidemiology en_US
dc.subject Aged en_US
dc.subject Middle Aged en_US
dc.subject hypoxia en_US
dc.subject Prospective Studies en_US
dc.subject Risk Factors en_US
dc.subject Cross-Sectional Studies en_US
dc.subject altitude en_US
dc.subject Prevalence en_US
dc.subject Body Mass Index en_US
dc.subject Altitude en_US
dc.subject Respiration en_US
dc.subject Severity of Illness Index en_US
dc.subject Andean en_US
dc.subject apnea en_US
dc.subject Oximetry en_US
dc.subject Peru/epidemiology/ethnology en_US
dc.subject Sleep Apnea Syndromes/epidemiology/etiology/physiopathology en_US
dc.title Cross-Sectional Comparison of Sleep-Disordered Breathing in Native Peruvian Highlanders and Lowlanders en_US
dc.type info:eu-repo/semantics/article
dc.identifier.doi https://doi.org/10.1089/ham.2016.0102
dc.subject.ocde https://purl.org/pe-repo/ocde/ford#3.01.08
dc.subject.ocde https://purl.org/pe-repo/ocde/ford#3.03.11
dc.subject.ocde https://purl.org/pe-repo/ocde/ford#3.03.05
dc.relation.issn 1557-8682


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