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Sleeping with Elevated Upper Body Does Not Attenuate Acute Mountain Sickness: Pragmatic Randomized Clinical Trial

Limper, U. and Fiala, V. and Tank, J. and Elmenhorst, E.-M. and Schaelte, G. and Hew, Y.M. and Gauger, P. and Martus, P. and Jordan, J. (2020) Sleeping with Elevated Upper Body Does Not Attenuate Acute Mountain Sickness: Pragmatic Randomized Clinical Trial. The American Journal of Medicine. Elsevier. DOI: 10.1016/j.amjmed.2020.01.024 ISSN 0002-9343

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Official URL: https://doi.org/10.1016/j.amjmed.2020.01.024

Abstract

PURPOSE: Acute mountain sickness commonly occurs following ascent to high altitude and is aggravated following sleep. Cephalad fluid shifts have been implicated. We hypothesized that sleeping with the upper body elevated by 30º reduces the risk of acute mountain sickness. METHODS: In a pragmatic, randomized, observer-blinded field study at 4554 meters altitude, we investigated 134 adults aged 18-70 years with a Lake Louise score between 3 and 12 points on the evening of their arrival at the altitude. The individuals were exposed to sleeping on an inflatable cushion elevating the upper body by 30º or on a sham pillow in a horizontal position. The primary endpoint was the change in the Acute Mountain Sickness-Cerebral (AMS-C) score in the morning after sleeping at an altitude of 4554 meters compared with the evening before. Sleep efficiency was the secondary endpoint. RESULTS: Among 219 eligible mountaineers, 134 fulfilled the inclusion criteria and were randomized. The AMS-C score increased by 0.250 ± 0.575 in the control group and by 0.121 ± 0.679 in the intervention group (difference 0.105; 95% confidence interval, -0.098-0.308; P = .308). Oxygen saturation in the morning was 79% ± 6% in the intervention group and 78% ± 6% in the control group (P = .863). Sleep efficiency did not differ between groups (P = .115). CONCLUSIONS: Sleeping with the upper body elevated by 30° does not lead to relevant reductions in acute mountain sickness symptoms or hypoxemia at high altitude.

Item URL in elib:https://elib.dlr.de/134754/
Document Type:Article
Title:Sleeping with Elevated Upper Body Does Not Attenuate Acute Mountain Sickness: Pragmatic Randomized Clinical Trial
Authors:
AuthorsInstitution or Email of AuthorsAuthor's ORCID iD
Limper, U.Ulrich.Limper (at) dlr.dehttps://orcid.org/0000-0001-9927-4180
Fiala, V.UNSPECIFIEDUNSPECIFIED
Tank, J.German Aerospace Center, Institute of Aerospace Medicinehttps://orcid.org/0000-0002-5672-1187
Elmenhorst, E.-M.Sleep an Human Factors Research Department, Institute of Aerospace Medicine, German Aerospace Center (DLR), Cologne, Germany; Eva-Maria.Elmenhorst (at) dlr.dehttps://orcid.org/0000-0003-0336-6705
Schaelte, G.Department of Anesthesiology, Medical Faculty, University Hospital RWTH Aachen, Aachen, GermanyUNSPECIFIED
Hew, Y.M.German Aerospace Center (DLR), Institute of Aerospace Medicine, Cologne, GermanyUNSPECIFIED
Gauger, P.Institute of Aerospace Medicine, German Aerospace Center (DLR), Cologne, Germany.UNSPECIFIED
Martus, P.Institute of Medical Biometry, University of Tuebingen, Tuebingen, GermanyUNSPECIFIED
Jordan, J.Institute of Aerospace Medicine, German Aerospace Center (DLR), Cologne, Germany and Lehrstuhl für Luft- und Raumfahrtmedizin, Universität zu Köln; Jens.Jordan (at) dlr.dehttps://orcid.org/0000-0003-4518-0706
Date:17 February 2020
Journal or Publication Title:The American Journal of Medicine
Refereed publication:Yes
Open Access:No
Gold Open Access:No
In SCOPUS:Yes
In ISI Web of Science:Yes
DOI :10.1016/j.amjmed.2020.01.024
Publisher:Elsevier
ISSN:0002-9343
Status:Published
Keywords:Acute mountain sickness; Altitude; Brain edema; Environmental medicine; High altitude; Mountaineering; Pulmonary; Sleep; Travel medicine
HGF - Research field:Aeronautics, Space and Transport
HGF - Program:Space
HGF - Program Themes:Research under Space Conditions
DLR - Research area:Raumfahrt
DLR - Program:R FR - Forschung unter Weltraumbedingungen
DLR - Research theme (Project):R - Vorhaben Systemphysiologie
Location: Köln-Porz
Institutes and Institutions:Institute of Aerospace Medicine
Institute of Aerospace Medicine > Leitungsbereich ME
Institute of Aerospace Medicine > Sleep and Human Factors Research
Institute of Aerospace Medicine > Cardiovascular Medicine in Aerospace
Deposited By: Schrage, Larissa
Deposited On:29 Apr 2020 11:01
Last Modified:29 Apr 2020 11:01

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