Breathing patterns and oxygenation saturation during sleep in children habitually living at high altitude in the Andes: A systematic review
Breathing patterns and oxygenation saturation during sleep in children habitually living at high altitude in the Andes: A systematic review
Background: Human respiratory physiology changes significantly in high altitude settings and these changes are particularly marked during sleep. It is estimated that 170 million people live above 2,500 m in environments where normal sleep parameters differ from those established at sea level or low altitude.
Methods: We conducted a systematic review of publications reporting sleep studies in healthy children living at high altitude. For this purpose, data from PubMed, EMBASE, SciELO and Epistemomikos bases were retrieved up to August 2021.
Results: Six articles met specified inclusion criteria; all reporting data were from South America involving 245 children (404 sleep studies) in children aged 0.6 months to 18 years, at altitudes between 2,560 to 3,775 m. The main results were: (1) Central apnea index decreased as the age increased. (2) The obstructive apnea/hypopnea index showed a bimodal profile with an increase in young infants up to age of 4 months, decreasing to 15 months of age, and then a second peak in children aged 4 to 9 years of age, dropping in older schoolchildren and adolescents. (3) Periodic breathing in the first months of life is more marked with increasing altitude and decreases with age.
Conclusions: There are few studies of sleep physiology in children living at high altitude. The international parameters defining normal apnea indices currently used at low altitude cannot be applied to high altitude settings. The interpretation of sleep studies in children living at high altitude is complex because there are important developmental changes across childhood and a wide range of altitude locations. More normative data are required to determine thresholds for respiratory pathology at a variety of high altitude settings.
apnea—hypopnea index, children, high altitude, polysomnography, sleep
798310
Ucrós, Santiago
1dd2b278-6ceb-4e59-b24e-69125e31e677
Castro-Guevara, Javier A
9501b913-7204-4c31-ab35-cfc2cc18bd1b
Hill, Catherine M
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Castro-Rodriguez, Jose A
b4b17a58-d7ad-4cfd-afbb-7edc0e3cbbb7
28 February 2022
Ucrós, Santiago
1dd2b278-6ceb-4e59-b24e-69125e31e677
Castro-Guevara, Javier A
9501b913-7204-4c31-ab35-cfc2cc18bd1b
Hill, Catherine M
867cd0a0-dabc-4152-b4bf-8e9fbc0edf8d
Castro-Rodriguez, Jose A
b4b17a58-d7ad-4cfd-afbb-7edc0e3cbbb7
Ucrós, Santiago, Castro-Guevara, Javier A, Hill, Catherine M and Castro-Rodriguez, Jose A
(2022)
Breathing patterns and oxygenation saturation during sleep in children habitually living at high altitude in the Andes: A systematic review.
Frontiers in Pediatrics, 9, , [798310].
(doi:10.3389/fped.2021.798310).
Abstract
Background: Human respiratory physiology changes significantly in high altitude settings and these changes are particularly marked during sleep. It is estimated that 170 million people live above 2,500 m in environments where normal sleep parameters differ from those established at sea level or low altitude.
Methods: We conducted a systematic review of publications reporting sleep studies in healthy children living at high altitude. For this purpose, data from PubMed, EMBASE, SciELO and Epistemomikos bases were retrieved up to August 2021.
Results: Six articles met specified inclusion criteria; all reporting data were from South America involving 245 children (404 sleep studies) in children aged 0.6 months to 18 years, at altitudes between 2,560 to 3,775 m. The main results were: (1) Central apnea index decreased as the age increased. (2) The obstructive apnea/hypopnea index showed a bimodal profile with an increase in young infants up to age of 4 months, decreasing to 15 months of age, and then a second peak in children aged 4 to 9 years of age, dropping in older schoolchildren and adolescents. (3) Periodic breathing in the first months of life is more marked with increasing altitude and decreases with age.
Conclusions: There are few studies of sleep physiology in children living at high altitude. The international parameters defining normal apnea indices currently used at low altitude cannot be applied to high altitude settings. The interpretation of sleep studies in children living at high altitude is complex because there are important developmental changes across childhood and a wide range of altitude locations. More normative data are required to determine thresholds for respiratory pathology at a variety of high altitude settings.
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fped-09-798310
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Accepted/In Press date: 30 December 2021
Published date: 28 February 2022
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Copyright © 2022 Ucrós, Castro-Guevara, Hill and Castro-Rodriguez.
Keywords:
apnea—hypopnea index, children, high altitude, polysomnography, sleep
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Local EPrints ID: 468094
URI: http://eprints.soton.ac.uk/id/eprint/468094
ISSN: 2296-2360
PURE UUID: 7d42a82e-b235-4723-a563-5dff1baac90f
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Date deposited: 02 Aug 2022 17:02
Last modified: 17 Mar 2024 02:48
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Author:
Santiago Ucrós
Author:
Javier A Castro-Guevara
Author:
Jose A Castro-Rodriguez
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