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The most serious symptoms of altitude sickness arise from edema (fluid accumulation in the tissues of the body). At very high altitude, humans can get either high-altitude pulmonary edema (HAPE), or high-altitude cerebral edema (HACE). The physiological cause of altitude-induced edema is not conclusively established.
The conditions of hypoxia and hypercapnia, whether caused by apnea or not, trigger additional effects on the body.The immediate effects of central sleep apnea on the body depend on how long the failure to breathe endures, how short is the interval between failures to breathe, and the presence or absence of independent conditions whose effects amplify those of an apneic episode.
At high altitude, in the short term, the lack of oxygen is sensed by the carotid bodies, which causes an increase in the breathing depth and rate . However, hyperpnea also causes the adverse effect of respiratory alkalosis , inhibiting the respiratory center from enhancing the respiratory rate as much as would be required.
CSA is organized into 6 individual syndromes: Cheyne-Stokes respiration, Complex sleep apnea, Primary CSA, High altitude periodic breathing, CSA from medication, CSA from comorbidity. [11] Like in OSA, nocturnal polysomnography is the mainstay of diagnosis for CSA. [18]
Re-entry HAPE is also an entity that has been described in persons who normally live at high altitude but who develop pulmonary edema after returning from a stay at low altitude. [3] If HAPE is not treated, there is a 50% risk of mortality. [4] Symptoms include crackling sounds when breathing, dyspnea (at rest), and cyanosis. [4]
CMS was first described in 1925 by Carlos Monge Medrano, a Peruvian doctor who specialised in diseases of high altitude. [3] While acute mountain sickness is experienced shortly after ascent to high altitude, chronic mountain sickness may develop only after many years of living at high altitude. In medicine, high altitude is defined as over ...
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Pulmonary hypertension is also common amongst the cardiovascular problems resulting from OSA. [27] Children with obstructive sleep-disordered breathing also show a faster heart rate during wakefulness and during sleep. [72] In adult patients, OSA has been shown to be associated with insulin resistance. [73]