Journal Article Ahead of print
PubMed: 42086484 DOI: 10.1111/jsr.70346
Impact of Tibetan Ancestry on Respiratory Control and Central Sleep Apnea in Hypoxia.
J Sleep Res
Authors: Grégory Heiniger, Lise Piquilloud, Geoffroy Solelhac, Théo Imler, Adrien Waeber, Brian Bradley, Gianpaolo Lecciso, Francis Degache, Alban Lovis, Karma Lambercy, Bengt Kayser, Scott Sands, Andrew Wellman, Raphael Heinzer
Affiliations
- Center for Investigation and Research in Sleep, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.
- Adult Intensive Care Unit, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.
- Institute of Sport Sciences University of Lausanne (ISSUL), University of Lausanne, Lausanne, Switzerland.
- Division of Pulmonary Medicine, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.
- Head and Neck Surgery Department, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.
- Division of Sleep and Circadian Disorders, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, USA.
Abstract
The onset of altitude-induced central sleep apnea (CSA) varies among individuals and may be influenced by genetic factors affecting respiratory control. Tibetans, who have undergone high-altitude adaptation over generations, may exhibit physiologic traits that protect against CSA. This study investigated the impact of Tibetan ancestry on respiratory control and hypoxia-induced CSA. Nine healthy unacclimatized Tibetans living in Switzerland for at least 5 years and 20 Caucasians (all males; median[IQR] age: 28 [27-32] vs. 24 [23.5-26] years; median[IQR] BMI: 23.8 [23.1-28] vs. 22.1[21.2-23.1]kg/m 2) underwent two full polysomnographies, one at low altitude and one in a hypoxic chamber simulating 3500 m. The apnea-hypopnea index (AHI) and the percentage of sleep spent in periodic breathing (PB) were calculated. A hyperoxic hypercapnic ventilatory response (HCVR) test and hypoxic ventilatory response tests at rest (HVRr) and during exercise (HVRe) were performed. Parameters were compared between groups using non-parametric tests. At simulated altitude, Tibetans exhibited a significantly lower AHI (51.2 [12.7-72.1]/h vs. 107.0 [36.7-140.3]/h; p = 0.0231) and spent less sleep time in PB (27.6 [2.6-44.5]% vs. 58.8 [14.0-89.0]%; p = 0.0334) compared to Caucasians. HCVR did not differ significantly between groups (Tibetans: 1.983 [1.349-2.224] L/min/mmHg; Caucasians: 2.227 [1.698-3.071] L/min/mmHg; p = 0.2167). Tibetans showed a significantly lower HVRr (Tibetans: 0.001 [-0.211-0.074] L/min/%/kg; Caucasians: 0.384 [0.160-0.637] L/min/%/kg; p = 0.0112) and a blunted HVRe (Tibetans: 0.311 [0.225-0.789] L/min/%/kg; Caucasians: 0.806 [0.518-1.196] L/min/%/kg; p = 0.0448). These results indicate that Tibetan ancestry is associated with a partial protection from hypoxia-induced central sleep apnea, likely related to a blunted hypoxic ventilatory response. These findings suggest that inherited differences in ventilatory control may modulate breathing stability during sleep at high altitude.
MeSH
Respiration, Sleep, Wakefulness, Apnea, Altitude, Hypoxia, Sleep Apnea, Central, Sleep Apnea Syndromes