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Comparative Study
. 2010 Feb;15(2):277-82.
doi: 10.1111/j.1440-1843.2009.01678.x. Epub 2009 Dec 27.

Non-invasive positive pressure ventilation during sleep at 3800 m: Relationship to acute mountain sickness and sleeping oxyhaemoglobin saturation

Pamela L Johnson  1 , Daniel A Popa, G Kim Prisk, Natalie Edwards, Colin E Sullivan
Affiliations
Comparative Study

Non-invasive positive pressure ventilation during sleep at 3800 m: Relationship to acute mountain sickness and sleeping oxyhaemoglobin saturation

Pamela L Johnson et al. Respirology. 2010 Feb.

Abstract

Overnight oxyhaemoglobin desaturation is related to AMS. AMS can be debilitating and may require descent. Positive pressure ventilation during sleep at high altitude may prevent AMS and therefore be useful in people travelling to high altitude, who are known to suffer from AMS.

Background and objective: Ascent to high altitude results in hypobaric hypoxia and some individuals will develop acute mountain sickness (AMS), which has been shown to be associated with low oxyhaemoglobin saturation during sleep. Previous research has shown that positive end-expiratory pressure by use of expiratory valves in a face mask while awake results in a reduction in AMS symptoms and higher oxyhaemoglobin saturation. We aimed to determine whether positive pressure ventilation would prevent AMS by increasing oxygenation during sleep.

Methods: We compared sleeping oxyhaemoglobin saturation and the incidence and severity of AMS in seven subjects sleeping for two consecutive nights at 3800 m above sea level using either non-invasive positive pressure ventilation that delivered positive inspiratory and expiratory airway pressure via a face mask, or sleeping without assisted ventilation. The presence and severity of AMS were assessed by administration of the Lake Louise questionnaire.

Results: We found significant increases in the mean and minimum sleeping oxyhaemoglobin saturation and decreases in AMS symptoms in subjects who used positive pressure ventilation during sleep. Mean and minimum sleeping SaO2 was lower in subjects who developed AMS after the night spent without positive pressure ventilation.

Conclusions: The use of positive pressure ventilation during sleep at 3800 m significantly increased the sleeping oxygen saturation; we suggest that the marked reduction in symptoms of AMS is due to this higher sleeping SaO2. We agree with the findings from previous studies that the development of AMS is associated with a lower sleeping oxygen saturation.

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Conflict of interest statement

I, Pamela Johnson, received support from the Faculty of Medicine at the University of Sydney to partially finance one of the three treks undertaken in Nepal. I have no financial interest in any aspect of the research undertaken and have no conflict of interest issues nor relationships with any organizations involved in this work.

I, Dan Popa, have no financial interest in any aspect of the research undertaken and have no conflict of interest issues nor relationships with any organizations involved in this work.

I, Kim Prisk, have no financial interest in any aspect of the research undertaken and have no conflict of interest issues nor relationships with any organization involved in this work.

I, Colin Sullivan, have no financial interest in any aspect of the research undertaken and have no conflict of interest issues nor relationships with any organization involved in this work.

I, Natalie Edwards, have no financial interest in any aspect of the research undertaken and have no conflict of interest issues nor relationships with any organizations involved in this work.

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