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  • Updated 01.23.2024
  • Released 03.17.1999
  • Expires For CME 01.23.2027

Central sleep apnea due to high-altitude periodic breathing



In this article, the authors explain the basics of central sleep apnea due to high-altitude periodic breathing. Included are updates related to sleep timing, oxygen saturation and pulse oximetry measurements at high-altitude.

Key points

• Central sleep apnea due to high-altitude periodic breathing affects about a quarter of people who ascend to 2500 meters and almost 100% of those who ascend to 4000 meters or higher.

• It is characterized by central apneas, periodic breathing, insomnia, and sleep fragmentation.

• There are a variety of medications that may be beneficial, including sedative hypnotics, acetazolamide, steroids, and nonsteroidal anti-inflammatory drugs (NSAIDs).

• There are ethnic and gender differences in resistance to the effects of high altitude.

• Pregnant women at high altitudes tend to have increased neonatal complications and high risk of low birthweight in newborns.

Historical note and terminology

High-altitude insomnia and high-altitude periodic breathing are no longer diagnostic categories in the 2014 International Classification of Sleep Disorders, 3rd edition (01). The current nomenclature is central sleep apnea due to high-altitude periodic breathing, which is characterized by cyclic periods of central apnea and hypopnea, usually accompanied by frequent awakenings, poor quality sleep, sense of suffocation, and fatigue at high altitudes.

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