{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,27]],"date-time":"2026-09-27T17:27:19Z","timestamp":1790530039431,"version":"4.1.0"},"reference-count":36,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2013,1,7]],"date-time":"2013-01-07T00:00:00Z","timestamp":1357516800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Journal of Sleep Research"],"published-print":{"date-parts":[[2013,6]]},"abstract":"<jats:title>SUMMARY<\/jats:title><jats:p>High\u2010altitude exposure is characterized by the appearance of periodic breathing during sleep. Only limited evidence is available, however, on the presence of gender\u2010related differences in this breathing pattern. In 37 healthy subjects, 23 male and 14 female, we performed nocturnal cardio\u2010respiratory monitoring in the following conditions: (1) sea level; (2) first\/second night at an altitude of 3400\u00a0m; (3) first\/second night at an altitude of 5400\u00a0m and after a 10\u00a0day sojourn at 5400\u00a0m. At sea level, a normal breathing pattern was observed in all subjects throughout the night. At 3400\u00a0m the apnea\u2013hypopnea index was 40.3\u00a0\u00b1\u00a033.0 in males (central apneas 77.6%, central hypopneas 22.4%) and 2.4\u00a0\u00b1\u00a02.8 in females (central apneas 58.2%, central hypopneas 41.8%; <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.01). During the first recording at 5400\u00a0m, the apnea\u2013hypopnea index was 87.5\u00a0\u00b1\u00a035.7 in males (central apneas 60.0%, central hypopneas 40.0%) and 41.1\u00a0\u00b1\u00a044.0 in females (central apneas 73.2%, central hypopneas 26.8%; <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.01), again with a higher frequency of central events in males as seen at lower altitude. Similar results were observed after 10\u00a0days. With increasing altitude, there was also a progressive reduction in respiratory cycle length during central apneas in males (26.9\u00a0\u00b1\u00a03.4\u00a0s at 3400\u00a0m and 22.6\u00a0\u00b1\u00a03.7\u00a0s at 5400\u00a0m). Females, who displayed a significant number of central apneas only at the highest reached altitude, were characterized by longer cycle length than males at similar altitude (30.1\u00a0\u00b1\u00a05.8\u00a0s at 5400\u00a0m). In conclusion, at high altitude, nocturnal periodic breathing affects males more than females. Females started to present a significant number of central sleep apneas only at the highest reached altitude. After 10\u00a0days at 5400\u00a0m gender differences in the apnea\u2013hypopnea index similar to those observed after acute exposure were still observed, accompanied by differences in respiratory cycle length.<\/jats:p>","DOI":"10.1111\/jsr.12012","type":"journal-article","created":{"date-parts":[[2013,1,7]],"date-time":"2013-01-07T09:42:47Z","timestamp":1357551767000},"page":"322-330","source":"Crossref","is-referenced-by-count":106,"title":["High\u2010altitude hypoxia and periodic breathing during sleep: gender\u2010related differences"],"prefix":"10.1111","volume":"22","author":[{"given":"Carolina","family":"Lombardi","sequence":"first","affiliation":[{"name":"Department of Cardiology S.Luca Hospital, Istituto Auxologico Italiano IRCCS Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paolo","family":"Meriggi","sequence":"additional","affiliation":[{"name":"Polo Tecnologico Biomedical Technology Department Fondazione Don Carlo Gnocchi Onlus Milano Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Piergiuseppe","family":"Agostoni","sequence":"additional","affiliation":[{"name":"Centro Cardiologico Monzino IRCCS Milan Italy"},{"name":"Department of Cardiovascular Sciences University of Milan Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Faini","sequence":"additional","affiliation":[{"name":"Department of Cardiology S.Luca Hospital, Istituto Auxologico Italiano IRCCS Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Grzegorz","family":"Bilo","sequence":"additional","affiliation":[{"name":"Department of Cardiology S.Luca Hospital, Istituto Auxologico Italiano IRCCS Milan Italy"},{"name":"Department of Health Sciences University Milano\u2010Bicocca Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miriam","family":"Revera","sequence":"additional","affiliation":[{"name":"Department of Cardiology S.Luca Hospital, Istituto Auxologico Italiano IRCCS Milan Italy"},{"name":"Department of Health Sciences University Milano\u2010Bicocca Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gianluca","family":"Caldara","sequence":"additional","affiliation":[{"name":"Department of Cardiology S.Luca Hospital, Istituto Auxologico Italiano IRCCS Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco","family":"Di Rienzo","sequence":"additional","affiliation":[{"name":"Polo Tecnologico Biomedical Technology Department Fondazione Don Carlo Gnocchi Onlus Milano Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paolo","family":"Castiglioni","sequence":"additional","affiliation":[{"name":"Polo Tecnologico Biomedical Technology Department Fondazione Don Carlo Gnocchi Onlus Milano Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bussotti","family":"Maurizio","sequence":"additional","affiliation":[{"name":"Cardiologia Riabilitativa Istituto di Riabilitazione, Fondazione Salvatore Maugeri IRCCS Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesca","family":"Gregorini","sequence":"additional","affiliation":[{"name":"Department of Cardiology S.Luca Hospital, Istituto Auxologico Italiano IRCCS Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giuseppe","family":"Mancia","sequence":"additional","affiliation":[{"name":"Department of Cardiology S.Luca Hospital, Istituto Auxologico Italiano IRCCS Milan Italy"},{"name":"Department of Health Sciences University Milano\u2010Bicocca Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gianfranco","family":"Parati","sequence":"additional","affiliation":[{"name":"Department of Cardiology S.Luca Hospital, Istituto Auxologico Italiano IRCCS Milan Italy"},{"name":"Department of Health Sciences University Milano\u2010Bicocca Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"The Highcare Investigators","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2013,1,7]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehp472"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1152\/ajpregu.91008.2008"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1152\/japplphysiol.00911.2006"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1164\/arrd.1986.133.1.42"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1152\/jappl.1992.73.2.393"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.resp.2008.06.006"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.200911-1694OC"},{"key":"e_1_2_6_9_1","first-page":"217","article-title":"Clinical and physiologic heterogeneity of the central sleep apnea syndrome","volume":"134","author":"Bradley T. 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