Alvaro Emilio Ortiz-Naretto

Objective: to compare mountaineers with and without asymptomatic sleep apnea (OSA) before the ascent and to study high altitude-related sleep disorders, its interaction with metabolic, neuroendocrine and immunological components. Material and Methods: During an expedition to Mount Aconcagua, researchers assessed the respiratory polygraphy (RP), clinical condition and inflammatory parameters, and rhythm of cortisol secretion in mountaineers sleeping at different altitude camps. Results: 8 athletes (4 women), 36 years old (25-51) participated. Baseline and final BMI were; 23.6 (20.9-28.7) and 22.77 (20.9-27.7), respectively: p<0.01. 40 valid RP recordings were analyzed. At 746 m.a.s.l. (baseline), only 2 mountaineers presented mild asymptomatic OSA. The OSA group presented baseline apnea-hypopnea index (AHI) values between 5-15 events per hour, which evidence a mild respiratory sleep disorder with AHI increased by altitude depending of central apneas and hypopneas (p<0.05) as high altitude periodic breathing pattern but no increase in obstructive apneas (p<0.01). The circadian rhythm of cortisol was maintained in all cases in which they had not received treatment with dexamethasone and their values increased with the altitude reached. Increased systolic blood pressure was observed in the OSA group. Conclusion: In a context of hypobaric hypoxia, individuals with pre-existing asymptomatic OSA are prone to experiencing lower oxygen saturations and clinical deterioration.

Introduction: Mountaineers exposed to hypobaric hypoxia (HH) show high-altitude periodic breathing (PB). Objective: To analyze high-altitude PB during the ascent of Mount Aconcagua (Argentina). Materials and Methods: Descriptive study in healthy volunteers using respiratory polygraphy (RP) at different altitudes. Results: We studied 8 andinist, mean age: 36 years old (25-51), body mass index (BMI) of 23.6 (20.9-28.7) and 22.77 (20.9-27.7) upon return, p<0.01. RP without PB showed a lower Oxygen Desaturation Index (ODI) and a lower Apnea-Hypopnea-Index (AHI); 5.43 (0 - 20) versus 45.95 (2-122) p<0.001 and 3.9 (0-15.5) versus 44.35 (4-115) p<0.001. AHI increased with altitude at the expense of central apneas and hypopneas: p<0.05. Conclusion: High-altitude PB is frequent above 2,581m.a.s.l. And it is characterized by short cycles. None of the mountaineers showed PB at baseline; however, high-altitude PB occurred in all subjects above 4,900 m.a.s.l