Study Looking at End Expiratory Pressure for Altitude Illness Decrease (SLEEP-AID)
Autor: | Kristin Fontes, Becky Higbee, Sean Wentworth, Dave Pomeranz, Carolyn Meyer, Patrick Cain, Diane Walsh, Nicholas C. Kanaan, Michael Shaheen, Caleb Phillips, Grant S. Lipman |
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Rok vydání: | 2015 |
Předmět: |
Adult
Male medicine.medical_specialty Time Factors Physiology Polysomnography Placebo-controlled study Pressure support ventilation Altitude Sickness Placebo Severity of Illness Index Double blind Positive-Pressure Respiration Altitude Double-Blind Method Nepal Surveys and Questionnaires medicine Humans business.industry Pulmonary Gas Exchange Incidence Public Health Environmental and Occupational Health General Medicine Hypoxia (medical) Effects of high altitude on humans Surgery Oxygen Expiratory positive airway pressure Acute Disease Physical therapy Female medicine.symptom business Sleep |
Zdroj: | High altitude medicinebiology. 16(2) |
ISSN: | 1557-8682 |
Popis: | Lipman, Grant S., Nicholas C. Kanaan, Caleb Phillips, Dave Pomeranz, Patrick Cain, Kristin Fontes, Becky Higbee, Carolyn Meyer, Michael Shaheen, Sean Wentworth, and Diane Walsh. Study Looking at End Expiratory Pressure for Altitude Illness Decrease (SLEEP-AID). High Alt Med Biol 16:154-161, 2015.--Acute mountain sickness (AMS) affects 25%-70% of the tens of millions of high altitude travelers annually, with hypoxia and nocturnal desaturations as major contributing factors. This is the first double blind randomized placebo controlled trial to assess expiratory positive airway pressure (EPAP) for AMS prevention and nocturnal hypoxic events. Healthy adult participants trekking in the Khumbu region of the Himalayas were randomized to a single-use EPAP nasal strip, or a visually identical sham device (placebo) prior to first night sleeping between 4371-4530 m (14,340-14,800 ft). The primary outcome was AMS incidence, measured by Lake Louise Questionnaire (LLQ), with secondary outcomes of AMS severity (by LLQ) and physiologic sleep indices measured by continuous sleep monitor. Intent-to-treat analysis included 219 participants with comparable demographic characteristics, of which 115 received EPAP and 104 placebo. There was no decrease in AMS with EPAP intervention (14% EPAP vs. 17% placebo; p=0.65; risk difference (-)3.15%, 95% CI (-)12.85%-6.56%). While overall AMS severity was not different between groups, EPAP reported decreased incidence of headache (64% vs. 76%; p0.05, OR 0.51, 95% CI 0.27-0.95) and dizziness (81% vs. 98%; p0.03, OR 0.29, 95% CI 0.09-0.78). During sleep, EPAP resulted in significant improvements in average peripheral oxygenation (Spo(2)) (80% versus 78%; p0.01, mean difference=2, 95% CI 0.58-3.63) and a reduced percentage of time below 80% Spo(2) (31% vs. 46%; p0.03, median difference=16, 95% CI 2.22-28.18). This lightweight and inexpensive EPAP device did not prevent acute mountain sickness, but did reduce the subgroup incidence of headache and dizziness while improving average nighttime peripheral oxygenation. |
Databáze: | OpenAIRE |
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