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Non‐invasive positive pressure ventilation during sleep at 3800 m: Relationship to acute mountain sickness and sleeping oxyhaemoglobin saturation
Author(s) -
JOHNSON Pamela L.,
POPA Daniel A.,
PRISK G. Kim,
EDWARDS Natalie,
SULLIVAN Colin E.
Publication year - 2010
Publication title -
respirology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.857
H-Index - 85
eISSN - 1440-1843
pISSN - 1323-7799
DOI - 10.1111/j.1440-1843.2009.01678.x
Subject(s) - medicine , anesthesia , positive pressure , ventilation (architecture) , oxygenation , oxygen saturation , continuous positive airway pressure , positive airway pressure , oxygen , obstructive sleep apnea , mechanical engineering , chemistry , organic chemistry , engineering
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 SaO 2 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 SaO 2 . We agree with the findings from previous studies that the development of AMS is associated with a lower sleeping oxygen saturation.