{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T02:49:43Z","timestamp":1788922183618,"version":"build-2803163510"},"reference-count":45,"publisher":"SAGE Publications","issue":"1","license":[{"start":{"date-parts":[[2025,3,1]],"date-time":"2025-03-01T00:00:00Z","timestamp":1740787200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["High Altitude Medicine &amp; Biology"],"published-print":{"date-parts":[[2025,3,1]]},"abstract":"<jats:p>\n                    Foster, Katharine, James D. Anholm, Gary Foster, Suman Thapamagar, and Prajan Subedi. Effects of naltrexone on sleep quality and periodic breathing at high altitude.\n                    <jats:italic toggle=\"yes\">High Alt Med Biol.<\/jats:italic>\n                    26:13\u201319, 2025.\n                  <\/jats:p>\n                  <jats:sec>\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>This study examined the effects of naltrexone on breathing and sleep at high altitude. Mu-opioid receptor (MOR) agonists have a depressive effect on respiration. Naltrexone is known to block the MOR. We hypothesized that MOR blockade with naltrexone would result in higher nocturnal oxygen saturations, fewer apneas, and improved sleep at high altitude.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>This double-blind, placebo-controlled, crossover study included nine healthy volunteers (four females, five males) aged 27.9 (4.6) (mean [standard deviation]) years. Two overnight trips spaced at least 2 weeks apart took participants from Loma Linda, CA (355 m) to the Barcroft Laboratory, CA (3,810 m) for each arm. Participants ingested either 50 mg naltrexone or matching placebo at bedtime. Sleep metrics were recorded using an ambulatory physiological sleep monitor (APSM). Subjective data were measured with the Groningen Sleep Quality Scale, Stanford Sleepiness Scale, and the 2018 Lake Louise Score (LLS) for acute mountain sickness (AMS).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Mean overnight SpO\n                      <jats:sub>2<\/jats:sub>\n                      was lower after taking naltrexone, 81% (6) versus 83% (4) (mean difference 1.9% [2.1, 95% confidence interval or CI = 0.1\u20133.6,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      = 0.040]). The lowest overnight SpO\n                      <jats:sub>2<\/jats:sub>\n                      (nadir) was lower on naltrexone 70% (6) versus 74% (4) (dif. 4.6% [4.3], CI = 1.0\u20138.2,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      = 0.020). Total sleep time and total apnea\u2013hypopnea index were unchanged. Subjective sleep quality was significantly worse on naltrexone measured via the Groningen Sleep Quality Scale (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      = 0.033) and Stanford Sleepiness Scale (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      = 0.038). AMS measured via LLS was significantly worse while taking naltrexone (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      = 0.025).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Contrary to our hypothesis, this study demonstrated a significant decrease in nocturnal oxygen saturation, worse sleep quality, and AMS scores. Further characterization of the MOR\u2019s effects on sleep and AMS is needed to evaluate potential exacerbating mechanisms for AMS and poor sleep quality at altitude.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1089\/ham.2024.0023","type":"journal-article","created":{"date-parts":[[2024,7,5]],"date-time":"2024-07-05T04:48:12Z","timestamp":1720154892000},"page":"13-19","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":2,"title":["Effects of Naltrexone on Sleep Quality and Periodic Breathing at High Altitude"],"prefix":"10.1177","volume":"26","author":[{"given":"Katharine","family":"Foster","sequence":"first","affiliation":[{"name":"Department of Emergency Medicine, Loma Linda University School of Medicine, Loma Linda, California, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5699-3481","authenticated-orcid":false,"given":"James D.","family":"Anholm","sequence":"additional","affiliation":[{"name":"Pulmonary &amp; Critical Care, VA Loma Linda Healthcare System, Loma Linda, California, USA."},{"name":"Department of Medicine, Loma Linda University School of Medicine, Loma Linda, California, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gary","family":"Foster","sequence":"additional","affiliation":[{"name":"Cardiology, St. Charles Health System, Bend, Oregon, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4158-8085","authenticated-orcid":false,"given":"Suman","family":"Thapamagar","sequence":"additional","affiliation":[{"name":"Department of Medicine, Loma Linda University School of Medicine, Loma Linda, California, USA."},{"name":"Riverside University Healthcare System Medical Center, Moreno Valley, California, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3574-9949","authenticated-orcid":false,"given":"Prajan","family":"Subedi","sequence":"additional","affiliation":[{"name":"Pulmonary &amp; Critical Care, VA Loma Linda Healthcare System, Loma Linda, California, USA."},{"name":"Department of Medicine, Loma Linda University School of Medicine, Loma Linda, California, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,3,3]]},"reference":[{"key":"e_1_3_5_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.resp.2013.05.020"},{"issue":"4","key":"e_1_3_5_3_1","doi-asserted-by":"crossref","first-page":"817","DOI":"10.1164\/ajrccm\/145.4_Pt_1.817","article-title":"Operation Everest II: Arterial oxygen saturation and sleep at extreme simulated altitude","volume":"145","author":"Anholm JD","year":"1992","unstructured":"Anholm JD, , Powles AC, , Downey R, et al. 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