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Children at high altitude have less nocturnal periodic breathing than adults

¹ Pulmonary Division, Dept of Internal Medicine, University Hospital of Zurich, ⁵ Zurich Center for Integrative Human Physiology, ⁴ Institute of Exercise Physiology, University of Zurich, Zurich, ² Institute of Sport and Health Sciences, and ³ Division of Cardiology, University Hospital of Basel, Basel, Switzerland.

CORRESPONDENCE: K. E. Bloch, Pulmonary Division, Dept of Internal Medicine, University Hospital of Zurich, Ramistrasse 100, CH-8091 Zurich, Switzerland. Fax: 41 442554451. E-mail: konrad.bloch{at}usz.ch

Keywords: Acute mountain sickness, apnoea, high altitude, hypoxia, periodic breathing

Received: September 10, 2007
Accepted February 4, 2008

Although children commonly travel to high altitudes, their respiratory adaptation to hypoxia remains elusive. Therefore, in the present study respiratory inductive plethysmography, pulse oximetry (S_p,O2) and end-tidal CO₂ tension (P_ET,CO2) were recorded in 20 pre-pubertal children (aged 9–12 yrs) and their fathers during 1 night in Zurich (490 m) and 2 nights at the Swiss Jungfrau-Joch research station (3,450 m) following ascent by train within <3 h.

In children, mean±SD nocturnal S_p,O2 fell from 98±1% at 490 m to 85±4 and 86±4% at 3,450 m (nights 1 and 2, respectively); P_ET,CO2 decreased significantly from 37±6 to 32±3 and 33±4 mmHg (3,450 versus 490 m). In adults, changes in nocturnal S_p,O2 and P_ET,CO2 at 3,450 m were similar to those in children.

Children spent less time in periodic breathing at 3,450 m during night 1 and 2 (8±11 and 9±13%, respectively) than adults (34±24 and 22±17%, respectively), and their apnoea threshold for CO₂ was lower compared with adults (27±2 and 30±2 mmHg, respectively, both nights). S_p,O2, P_ET,CO2 and time in periodic breathing at altitude were not correlated between children and their fathers.

In conclusion, children revealed a similarly reduced nocturnal O₂ saturation and associated hyperventilation at high altitude as adults but their breathing pattern was more stable, possibly related to a lower apnoea threshold for CO₂.