{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T00:10:09Z","timestamp":1791245409408,"version":"4.1.0"},"reference-count":47,"publisher":"American Physiological Society","issue":"8","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Journal of Applied Physiology"],"published-print":{"date-parts":[[2013,4,15]]},"abstract":"<jats:p> Although periodic breathing during sleep at high altitude occurs almost universally, the likely mechanisms and independent effects of altitude and acclimatization have not been clearly reported. Data from 2005 demonstrated a significant relationship between decline in cerebral blood flow (CBF) at sleep onset and subsequent severity of central sleep apnea that night. We suspected that CBF would decline during partial acclimatization. We hypothesized therefore that reductions in CBF and its reactivity would worsen periodic breathing during sleep following partial acclimatization. Repeated measures of awake ventilatory and CBF responsiveness, arterial blood gases during wakefulness. and overnight polysomnography at sea level, upon arrival (days 2\u20134), and following partial acclimatization (days 12\u201315) to 5,050 m were made on 12 subjects. The apnea-hypopnea index (AHI) increased from to 77 \u00b1 49 on days 2\u20134 to 116 \u00b1 21 on days 12\u201315 ( P = 0.01). The AHI upon initial arrival was associated with marked elevations in CBF (+28%, 68 \u00b1 11 to 87 \u00b1 17 cm\/s; P &lt; 0.05) and its reactivity to changes in Pa<jats:sub>CO<jats:sub>2<\/jats:sub><\/jats:sub> [&gt;90%, 2.0 \u00b1 0.6 to 3.8 \u00b1 1.5 cm\u00b7s<jats:sup>\u22121<\/jats:sup>\u00b7mmHg<jats:sup>\u22121<\/jats:sup> hypercapnia and 1.9 \u00b1 0.4 to 4.1 \u00b1 0.9 cm\u00b7s<jats:sup>\u22121<\/jats:sup>\u00b7mmHg<jats:sup>\u22121<\/jats:sup> for hypocapnia ( P &lt; 0.05)]. Over 10 days, the increases resolved and AHI worsened. During sleep at high altitude large oscillations in mean CBF velocity (CBFv) occurred, which were 35% higher initially (peak CBFv = 96 cm\/s vs. peak CBFv = 71 cm\/s) than at days 12\u201315. Our novel findings suggest that elevations in CBF and its reactivity to CO<jats:sub>2<\/jats:sub> upon initial ascent to high altitude may provide a protective effect on the development of periodic breathing during sleep (likely via moderating changes in central Pco<jats:sub>2<\/jats:sub>). <\/jats:p>","DOI":"10.1152\/japplphysiol.01462.2012","type":"journal-article","created":{"date-parts":[[2013,2,22]],"date-time":"2013-02-22T04:48:32Z","timestamp":1361508512000},"page":"1021-1028","source":"Crossref","is-referenced-by-count":36,"title":["Worsening of central sleep apnea at high altitude\u2014a role for cerebrovascular function"],"prefix":"10.1152","volume":"114","author":[{"given":"Keith R.","family":"Burgess","sequence":"first","affiliation":[{"name":"Peninsula Sleep Laboratory, Sydney, New South Wales, Australia;"},{"name":"Department of Medicine, University of Sydney, Sydney, New South Wales, Australia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samuel J. 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