Sleeping with Elevated Upper Body Does Not Attenuate Acute Mountain Sickness: Pragmatic Randomized Clinical Trial - 28/09/20
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.
Le texte complet de cet article est disponible en PDF.Keywords : Acute mountain sickness, Altitude, Brain edema, Environmental medicine, High altitude, Mountaineering, Pulmonary, Sleep, Travel medicine
Plan
| Trial registration: German Clinical Trial Register DRKS00012676. |
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| Funding: This study was supported by the programmatic funding of the German Aerospace Center (DLR) and by a grant from the German Society for Mountain- and Expedition Medicine (BExMed). |
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| Conflict of Interest: UL reports grants from the German Society for Mountain and Expedition Medicine (BExMed) during the conduct of the study. All other authors have nothing to disclose. UL affirms that this manuscript is an honest, accurate, and transparent account of the study being reported; that no important aspects of the study have been omitted; and that any discrepancies from the study as planned (and, if relevant, registered) have been explained. |
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| Authorship: UL: Conceptualization, methodology, formal analysis, investigation, writing - original draft, review & editing, funding acquisition; VF: Formal analysis, investigation, writing - review and editing, project administration; JT: Investigation, project administration, provision of study materials; E-ME: Methodology, supervision, writing - review and editing; GS: Methodology, writing - review and editing, supervision; Y-YMH: Investigation, project administration; PG: Provision and design of study materials (wedges), visualization, investigation; PM: Formal analysis, methodology; programming; JJ: Supervision, writing - review and editing, funding acquisition, methodology. |
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| The authors declare that the data supporting the findings of this study are available within the article. Anonymized data will be shared from the corresponding author upon reasonable request from any qualified investigator. |
Vol 133 - N° 10
P. e584-e588 - octobre 2020 Retour au numéro
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