Sleep advances : a journal of the Sleep Research Society · 2025
Sleep and nocturnal breathing of individuals working over 1-week periods at high altitude: a cross-sectional polysomnographic study.
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Pun Matiram, Sanzana Francisco, Faundez Manuel, Mancilla Mauricio, Jara Marcelo, Gomez Gerardo, Moraga Fernando A, Barrientos Claudio A, Hansen Bradley, Rawling Jean M, Lopez Ivan, Poulin Marc
Аннотация
STUDY OBJECTIVES: To investigate objective sleep architectures, sleep fragmentation, and sleep-disordered breathing (SDB) indices in high-altitude workers rotating a week of altitude followed by a week of rest schedules from the Atacama Large Millimeter Array (ALMA) Observatory, Atacama, Chile.
METHODS: A total of 122 high-altitude workers (males/females: 70/52) completed a polysomnographic sleep study at the Operation Support Facility (OSF, 2950 m). The majority of the participants (78 [63.9%]) were low-altitude residents. Most of the workers (74 [60.7%]) worked at the Array Operation Site (AOS) at 5050 m (work high) during the day and returned to the OSF to sleep (sleep lower).
RESULTS: The ALMA workers had a sleep efficiency of 83.2 ± 10.3%, with a total sleep time of 352.2 ± 84.8 minutes. Sleep latency was 16.5 ± 19.3 minutes, and wake after sleep onset was 62.6 ± 56.5 minutes. The odds ratio product (ORP) showed that a quarter of altitude workers (n = 31) were in the severe sleep fragmentation category (ORP type 1,1 and 1,2), with deep sleep of 15.6 ± 11.4% of the total recorded time. The total Sleep Fragmentation Index (SFI) was 34.6 ± 13.5 numbers per hour, with the number of awakenings overnight being 31.3 ± 15.9. The Apnea-Hypopnea Index (AHI) was 27.4 ± 25.5 events per hour (central apneas: 2.4 ± 6.7 events per hour; obstructive apneas: 7.7 ± 14.6 events per hour). The average blood oxygen saturation (SpO2) was 88.6 ± 2.2%, with the nadir of 77.3 ± 11.8%, and the Oxygen Desaturation Index (ODI) was 17.2 ± 20.8 events per hour. Males had a higher number of arousals (26.5 ± 13.3 vs 20.4 ± 9.1 events per hour, p = .005), lighter sleep (15.4 ± 9.9 vs 9.7 ± 4.6% total sleep time, p < .001), and higher AHI (36.6 ± 28.7 vs 15.1 ± 12.9 events per hour, p < .001) and ODI (23.8 ± 24.2 vs 8.5 ± 10.0 events per hour, p < .001) compared to females. The number of sleep nights spent within the work week at altitude was negatively associated with sleep fragmentation (p = .0119) and arousal (p = .0092) indices and positively associated with ORP deep sleep (p = .0422), controlling for age. However, the number of years working at altitude was positively associated with the Respiratory Disturbance Index (p = .0014), AHI (p = .0026), and ODI (p = .0328), controlling for age. Older age, male sex, and higher body mass index played contributory roles in increasing AHI and ODI (p < .05).
CONCLUSIONS: High-altitude workers had less deep sleep and high fragmented sleep. Further, they had high sleep apnea and oxygen desaturation indices. The workers who had sleep studies in the latter part of the work week had better sleep indices compared to the workers who had sleep studies on the first and second nights at altitude. The SDB indices were positively associated with the years of working at altitude.
METHODS: A total of 122 high-altitude workers (males/females: 70/52) completed a polysomnographic sleep study at the Operation Support Facility (OSF, 2950 m). The majority of the participants (78 [63.9%]) were low-altitude residents. Most of the workers (74 [60.7%]) worked at the Array Operation Site (AOS) at 5050 m (work high) during the day and returned to the OSF to sleep (sleep lower).
RESULTS: The ALMA workers had a sleep efficiency of 83.2 ± 10.3%, with a total sleep time of 352.2 ± 84.8 minutes. Sleep latency was 16.5 ± 19.3 minutes, and wake after sleep onset was 62.6 ± 56.5 minutes. The odds ratio product (ORP) showed that a quarter of altitude workers (n = 31) were in the severe sleep fragmentation category (ORP type 1,1 and 1,2), with deep sleep of 15.6 ± 11.4% of the total recorded time. The total Sleep Fragmentation Index (SFI) was 34.6 ± 13.5 numbers per hour, with the number of awakenings overnight being 31.3 ± 15.9. The Apnea-Hypopnea Index (AHI) was 27.4 ± 25.5 events per hour (central apneas: 2.4 ± 6.7 events per hour; obstructive apneas: 7.7 ± 14.6 events per hour). The average blood oxygen saturation (SpO2) was 88.6 ± 2.2%, with the nadir of 77.3 ± 11.8%, and the Oxygen Desaturation Index (ODI) was 17.2 ± 20.8 events per hour. Males had a higher number of arousals (26.5 ± 13.3 vs 20.4 ± 9.1 events per hour, p = .005), lighter sleep (15.4 ± 9.9 vs 9.7 ± 4.6% total sleep time, p < .001), and higher AHI (36.6 ± 28.7 vs 15.1 ± 12.9 events per hour, p < .001) and ODI (23.8 ± 24.2 vs 8.5 ± 10.0 events per hour, p < .001) compared to females. The number of sleep nights spent within the work week at altitude was negatively associated with sleep fragmentation (p = .0119) and arousal (p = .0092) indices and positively associated with ORP deep sleep (p = .0422), controlling for age. However, the number of years working at altitude was positively associated with the Respiratory Disturbance Index (p = .0014), AHI (p = .0026), and ODI (p = .0328), controlling for age. Older age, male sex, and higher body mass index played contributory roles in increasing AHI and ODI (p < .05).
CONCLUSIONS: High-altitude workers had less deep sleep and high fragmented sleep. Further, they had high sleep apnea and oxygen desaturation indices. The workers who had sleep studies in the latter part of the work week had better sleep indices compared to the workers who had sleep studies on the first and second nights at altitude. The SDB indices were positively associated with the years of working at altitude.