Influence of cerebral blood flow on central sleep apnea at high altitude

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Influence of cerebral blood flow on central sleep apnea at high altitude. / Burgess, Keith R; Lucas, Samuel; Shepherd, Kelly; Dawson, Andrew; Swart, Marianne; Thomas, Kate N; Lucas, Rebekah A I; Donnelly, Joseph; Peebles, Karen C; Basnyat, Rishi; Ainslie, Philip N; Lucas, Samuel.

In: Sleep, Vol. 37, No. 10, 2014, p. 1679-87.

Research output: Contribution to journalArticlepeer-review

Harvard

Burgess, KR, Lucas, S, Shepherd, K, Dawson, A, Swart, M, Thomas, KN, Lucas, RAI, Donnelly, J, Peebles, KC, Basnyat, R, Ainslie, PN & Lucas, S 2014, 'Influence of cerebral blood flow on central sleep apnea at high altitude', Sleep, vol. 37, no. 10, pp. 1679-87. https://doi.org/10.5665/sleep.4080

APA

Burgess, K. R., Lucas, S., Shepherd, K., Dawson, A., Swart, M., Thomas, K. N., Lucas, R. A. I., Donnelly, J., Peebles, K. C., Basnyat, R., Ainslie, P. N., & Lucas, S. (2014). Influence of cerebral blood flow on central sleep apnea at high altitude. Sleep, 37(10), 1679-87. https://doi.org/10.5665/sleep.4080

Vancouver

Burgess KR, Lucas S, Shepherd K, Dawson A, Swart M, Thomas KN et al. Influence of cerebral blood flow on central sleep apnea at high altitude. Sleep. 2014;37(10):1679-87. https://doi.org/10.5665/sleep.4080

Author

Burgess, Keith R ; Lucas, Samuel ; Shepherd, Kelly ; Dawson, Andrew ; Swart, Marianne ; Thomas, Kate N ; Lucas, Rebekah A I ; Donnelly, Joseph ; Peebles, Karen C ; Basnyat, Rishi ; Ainslie, Philip N ; Lucas, Samuel. / Influence of cerebral blood flow on central sleep apnea at high altitude. In: Sleep. 2014 ; Vol. 37, No. 10. pp. 1679-87.

Bibtex

@article{391eb271b38948bb8db04ea36a44c87e,
title = "Influence of cerebral blood flow on central sleep apnea at high altitude",
abstract = "STUDY OBJECTIVES: To further our understanding of central sleep apnea (CSA) at high altitude during acclimatization, we tested the hypothesis that pharmacologically altering cerebral blood flow (CBF) would alter the severity of CSA at high altitude.DESIGN: The study was a randomized, placebo-controlled single-blind study.SETTING: A field study at 5,050 m in Nepal.PATIENTS OR PARTICIPANTS: We studied 12 normal volunteers.INTERVENTIONS: Between days 5 to10 at high altitude, CBF velocity (CBFv) was increased by intravenous (IV) acetazolamide (10 mg/kg) and reduced by oral indomethacin (100 mg).MEASUREMENTS AND RESULTS: Arterial blood gases, hypoxic and hypercapnic ventilatory responses, and CBFv and its reactivity to carbon dioxide were measured awake. Overnight polysomnography was performed. The central apnea-hypopnea index was elevated following administration of indomethacin (89.2 ± 43.7 to 112.5 ± 32.9 events/h; mean ± standard deviation; P < 0.05) and was reduced following IV acetazolamide (89.2 ± 43.7 to 47.1 ± 48.1 events/h; P < 0.001). Intravenous acetazolamide elevated CBFv at high altitude by 28% (95% confidence interval [CI]: 22-34%) but did not affect ventilatory responses. The elevation in CBFv was partly mediated via a selective rise in partial pressure of arterial carbon dioxide (PaCO2) (28 ± 4 to 31 ± 3 mm Hg) and an associated fall in pH (P < 0.01). Oral indomethacin reduced CBFv by 23% (95% CI: 16-30%), blunted CBFv reactivity, and increased the hypercapnic ventilatory response by 66% (95% CI: 30-102%) but had no effect on PaCO2 or pH.CONCLUSION: Our findings indicate an important role for cerebral blood flow regulation in the pathophysiology of central sleep apnea at high altitude.",
author = "Burgess, {Keith R} and Samuel Lucas and Kelly Shepherd and Andrew Dawson and Marianne Swart and Thomas, {Kate N} and Lucas, {Rebekah A I} and Joseph Donnelly and Peebles, {Karen C} and Rishi Basnyat and Ainslie, {Philip N} and Samuel Lucas",
note = "{\textcopyright} 2014 Associated Professional Sleep Societies, LLC.",
year = "2014",
doi = "10.5665/sleep.4080",
language = "English",
volume = "37",
pages = "1679--87",
journal = "Sleep",
issn = "0161-8105",
publisher = "American Academy of Sleep Medicine",
number = "10",

}

RIS

TY - JOUR

T1 - Influence of cerebral blood flow on central sleep apnea at high altitude

AU - Burgess, Keith R

AU - Lucas, Samuel

AU - Shepherd, Kelly

AU - Dawson, Andrew

AU - Swart, Marianne

AU - Thomas, Kate N

AU - Lucas, Rebekah A I

AU - Donnelly, Joseph

AU - Peebles, Karen C

AU - Basnyat, Rishi

AU - Ainslie, Philip N

AU - Lucas, Samuel

N1 - © 2014 Associated Professional Sleep Societies, LLC.

PY - 2014

Y1 - 2014

N2 - STUDY OBJECTIVES: To further our understanding of central sleep apnea (CSA) at high altitude during acclimatization, we tested the hypothesis that pharmacologically altering cerebral blood flow (CBF) would alter the severity of CSA at high altitude.DESIGN: The study was a randomized, placebo-controlled single-blind study.SETTING: A field study at 5,050 m in Nepal.PATIENTS OR PARTICIPANTS: We studied 12 normal volunteers.INTERVENTIONS: Between days 5 to10 at high altitude, CBF velocity (CBFv) was increased by intravenous (IV) acetazolamide (10 mg/kg) and reduced by oral indomethacin (100 mg).MEASUREMENTS AND RESULTS: Arterial blood gases, hypoxic and hypercapnic ventilatory responses, and CBFv and its reactivity to carbon dioxide were measured awake. Overnight polysomnography was performed. The central apnea-hypopnea index was elevated following administration of indomethacin (89.2 ± 43.7 to 112.5 ± 32.9 events/h; mean ± standard deviation; P < 0.05) and was reduced following IV acetazolamide (89.2 ± 43.7 to 47.1 ± 48.1 events/h; P < 0.001). Intravenous acetazolamide elevated CBFv at high altitude by 28% (95% confidence interval [CI]: 22-34%) but did not affect ventilatory responses. The elevation in CBFv was partly mediated via a selective rise in partial pressure of arterial carbon dioxide (PaCO2) (28 ± 4 to 31 ± 3 mm Hg) and an associated fall in pH (P < 0.01). Oral indomethacin reduced CBFv by 23% (95% CI: 16-30%), blunted CBFv reactivity, and increased the hypercapnic ventilatory response by 66% (95% CI: 30-102%) but had no effect on PaCO2 or pH.CONCLUSION: Our findings indicate an important role for cerebral blood flow regulation in the pathophysiology of central sleep apnea at high altitude.

AB - STUDY OBJECTIVES: To further our understanding of central sleep apnea (CSA) at high altitude during acclimatization, we tested the hypothesis that pharmacologically altering cerebral blood flow (CBF) would alter the severity of CSA at high altitude.DESIGN: The study was a randomized, placebo-controlled single-blind study.SETTING: A field study at 5,050 m in Nepal.PATIENTS OR PARTICIPANTS: We studied 12 normal volunteers.INTERVENTIONS: Between days 5 to10 at high altitude, CBF velocity (CBFv) was increased by intravenous (IV) acetazolamide (10 mg/kg) and reduced by oral indomethacin (100 mg).MEASUREMENTS AND RESULTS: Arterial blood gases, hypoxic and hypercapnic ventilatory responses, and CBFv and its reactivity to carbon dioxide were measured awake. Overnight polysomnography was performed. The central apnea-hypopnea index was elevated following administration of indomethacin (89.2 ± 43.7 to 112.5 ± 32.9 events/h; mean ± standard deviation; P < 0.05) and was reduced following IV acetazolamide (89.2 ± 43.7 to 47.1 ± 48.1 events/h; P < 0.001). Intravenous acetazolamide elevated CBFv at high altitude by 28% (95% confidence interval [CI]: 22-34%) but did not affect ventilatory responses. The elevation in CBFv was partly mediated via a selective rise in partial pressure of arterial carbon dioxide (PaCO2) (28 ± 4 to 31 ± 3 mm Hg) and an associated fall in pH (P < 0.01). Oral indomethacin reduced CBFv by 23% (95% CI: 16-30%), blunted CBFv reactivity, and increased the hypercapnic ventilatory response by 66% (95% CI: 30-102%) but had no effect on PaCO2 or pH.CONCLUSION: Our findings indicate an important role for cerebral blood flow regulation in the pathophysiology of central sleep apnea at high altitude.

U2 - 10.5665/sleep.4080

DO - 10.5665/sleep.4080

M3 - Article

C2 - 25197804

VL - 37

SP - 1679

EP - 1687

JO - Sleep

JF - Sleep

SN - 0161-8105

IS - 10

ER -