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The Young Everest Study: preliminary report of changes in sleep and cerebral blood flow velocity during slow ascent to altitude in unacclimatised children
BACKGROUND: Cerebral blood flow velocity (CBFV) and sleep physiology in healthy children exposed to hypoxia and hypocarbia are under-researched. AIM: To investigate associations between sleep variables, daytime end-tidal carbon dioxide (EtCO(2)) and CBFV in children during high-altitude ascent. METH...
Autores principales: | , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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BMJ Publishing Group
2013
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3625826/ https://www.ncbi.nlm.nih.gov/pubmed/23471157 http://dx.doi.org/10.1136/archdischild-2012-302512 |
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author | Gavlak, Johanna C Stocks, Janet Laverty, Aidan Fettes, Emma Bucks, Romola Sonnappa, Samatha Cooper, Janine Grocott, Michael P Levett, Denny Z Martin, Daniel S Imray, Christopher H Kirkham, Fenella J |
author_facet | Gavlak, Johanna C Stocks, Janet Laverty, Aidan Fettes, Emma Bucks, Romola Sonnappa, Samatha Cooper, Janine Grocott, Michael P Levett, Denny Z Martin, Daniel S Imray, Christopher H Kirkham, Fenella J |
author_sort | Gavlak, Johanna C |
collection | PubMed |
description | BACKGROUND: Cerebral blood flow velocity (CBFV) and sleep physiology in healthy children exposed to hypoxia and hypocarbia are under-researched. AIM: To investigate associations between sleep variables, daytime end-tidal carbon dioxide (EtCO(2)) and CBFV in children during high-altitude ascent. METHODS: Vital signs, overnight cardiorespiratory sleep studies and transcranial Doppler were undertaken in nine children (aged 6–13 years) at low altitude (130 m), and then at moderate (1300 m) and high (3500 m) altitude during a 5-day ascent. RESULTS: Daytime (130 m: 98%; 3500 m: 90%, p=0.004) and mean (130 m: 97%, 1300 m: 94%, 3500: 87%, p=0.0005) and minimum (130 m: 92%, 1300 m: 84%, 3500 m: 79%, p=0.0005) overnight pulse oximetry oxyhaemoglobin saturation decreased, and the number of central apnoeas increased at altitude (130 m: 0.2/h, 1300 m: 1.2/h, 3500 m: 3.5/h, p=0.2), correlating inversely with EtCO(2) (R(2) 130 m: 0.78; 3500 m: 0.45). Periodic breathing occurred for median (IQR) 0.0 (0; 0.3)% (130 m) and 0.2 (0; 1.2)% (3500 m) of total sleep time. At 3500 m compared with 130 m, there were increases in middle (MCA) (mean (SD) left 29.2 (42.3)%, p=0.053; right 9.9 (12)%, p=0.037) and anterior cerebral (ACA) (left 65.2 (69)%, p=0.024; right 109 (179)%; p=0.025) but not posterior or basilar CBFV. The right MCA CBFV increase at 3500 m was predicted by baseline CBFV and change in daytime SpO(2) and EtCO(2) at 3500 m (R(2) 0.92); these associations were not seen on the left. CONCLUSIONS: This preliminary report suggests that sleep physiology is disturbed in children even with slow ascent to altitude. The regional variations in CBFV and their association with hypoxia and hypocapnia require further investigation. |
format | Online Article Text |
id | pubmed-3625826 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2013 |
publisher | BMJ Publishing Group |
record_format | MEDLINE/PubMed |
spelling | pubmed-36258262013-04-15 The Young Everest Study: preliminary report of changes in sleep and cerebral blood flow velocity during slow ascent to altitude in unacclimatised children Gavlak, Johanna C Stocks, Janet Laverty, Aidan Fettes, Emma Bucks, Romola Sonnappa, Samatha Cooper, Janine Grocott, Michael P Levett, Denny Z Martin, Daniel S Imray, Christopher H Kirkham, Fenella J Arch Dis Child Original Article BACKGROUND: Cerebral blood flow velocity (CBFV) and sleep physiology in healthy children exposed to hypoxia and hypocarbia are under-researched. AIM: To investigate associations between sleep variables, daytime end-tidal carbon dioxide (EtCO(2)) and CBFV in children during high-altitude ascent. METHODS: Vital signs, overnight cardiorespiratory sleep studies and transcranial Doppler were undertaken in nine children (aged 6–13 years) at low altitude (130 m), and then at moderate (1300 m) and high (3500 m) altitude during a 5-day ascent. RESULTS: Daytime (130 m: 98%; 3500 m: 90%, p=0.004) and mean (130 m: 97%, 1300 m: 94%, 3500: 87%, p=0.0005) and minimum (130 m: 92%, 1300 m: 84%, 3500 m: 79%, p=0.0005) overnight pulse oximetry oxyhaemoglobin saturation decreased, and the number of central apnoeas increased at altitude (130 m: 0.2/h, 1300 m: 1.2/h, 3500 m: 3.5/h, p=0.2), correlating inversely with EtCO(2) (R(2) 130 m: 0.78; 3500 m: 0.45). Periodic breathing occurred for median (IQR) 0.0 (0; 0.3)% (130 m) and 0.2 (0; 1.2)% (3500 m) of total sleep time. At 3500 m compared with 130 m, there were increases in middle (MCA) (mean (SD) left 29.2 (42.3)%, p=0.053; right 9.9 (12)%, p=0.037) and anterior cerebral (ACA) (left 65.2 (69)%, p=0.024; right 109 (179)%; p=0.025) but not posterior or basilar CBFV. The right MCA CBFV increase at 3500 m was predicted by baseline CBFV and change in daytime SpO(2) and EtCO(2) at 3500 m (R(2) 0.92); these associations were not seen on the left. CONCLUSIONS: This preliminary report suggests that sleep physiology is disturbed in children even with slow ascent to altitude. The regional variations in CBFV and their association with hypoxia and hypocapnia require further investigation. BMJ Publishing Group 2013-05 2013-03-07 /pmc/articles/PMC3625826/ /pubmed/23471157 http://dx.doi.org/10.1136/archdischild-2012-302512 Text en Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions This is an open-access article distributed under the terms of the Creative Commons Attribution Non-commercial License, which permits use, distribution, and reproduction in any medium, provided the original work is properly cited, the use is non commercial and is otherwise in compliance with the license. See: http://creativecommons.org/licenses/by-nc/3.0/ and http://creativecommons.org/licenses/by-nc/3.0/legalcode |
spellingShingle | Original Article Gavlak, Johanna C Stocks, Janet Laverty, Aidan Fettes, Emma Bucks, Romola Sonnappa, Samatha Cooper, Janine Grocott, Michael P Levett, Denny Z Martin, Daniel S Imray, Christopher H Kirkham, Fenella J The Young Everest Study: preliminary report of changes in sleep and cerebral blood flow velocity during slow ascent to altitude in unacclimatised children |
title | The Young Everest Study: preliminary report of changes in sleep and cerebral blood flow velocity during slow ascent to altitude in unacclimatised children |
title_full | The Young Everest Study: preliminary report of changes in sleep and cerebral blood flow velocity during slow ascent to altitude in unacclimatised children |
title_fullStr | The Young Everest Study: preliminary report of changes in sleep and cerebral blood flow velocity during slow ascent to altitude in unacclimatised children |
title_full_unstemmed | The Young Everest Study: preliminary report of changes in sleep and cerebral blood flow velocity during slow ascent to altitude in unacclimatised children |
title_short | The Young Everest Study: preliminary report of changes in sleep and cerebral blood flow velocity during slow ascent to altitude in unacclimatised children |
title_sort | young everest study: preliminary report of changes in sleep and cerebral blood flow velocity during slow ascent to altitude in unacclimatised children |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3625826/ https://www.ncbi.nlm.nih.gov/pubmed/23471157 http://dx.doi.org/10.1136/archdischild-2012-302512 |
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