Longevity Project: Altitude and the effects it can have on sleep (2024)

Editor’s note: This is the final installment of the series The Longevity Project, a collaboration between The Aspen Times and the Glenwood Springs Post Independent.

Sleep is important for everybody; sleep deprivation can lead to many problems, such as mental distress and difficulty concentrating. One reason sleep deprivation can occur is from higher altitudes, which is important to know if you live in the mountains.

Dr. Omar McTabi, DO, is the director of Valley View Hospital’s Sleep Lab. He explained some of the general impacts altitude can have on sleep.

“It’s a brain thing, a breathing thing,” he said. “When you’re at a higher altitude — we’re talking altitudes greater than 8,000 feet — the partial pressure of oxygen in the atmosphere (makes it) less available to the lungs. It’s a fine balance in the brain.”

The brain, while asleep, receives and sends messages throughout the body and sensors in the brain measure how much oxygen and carbon dioxide (CO2) are in the body. This sensor is connected to the lungs.

“It’s like a thermostat in a house,” McTabi said. “It senses the temperature and tells the furnace to go higher or lower.” The thermostat is the brain, temperature is oxygen levels and the furnace is the lungs in this scenario.

If the involuntary part of the brain — the part that’s controlling the body while asleep — senses a low oxygen level, it will tell the diaphragm — the muscle controlling the lungs — to move faster, to bring in more oxygen to the body. Unfortunately, there are adverse effects.

“You’re breathing faster for more oxygen, but then too much CO2 is getting out, so the brain brings the level down to stop breathing, even for a moment, to bring that CO2 level back up,” McTabi explained. “Then by that time your oxygen levels are lower, so you have this periodic breathing at high altitude.”

One way to get help if you experience high CO2, McTabi said, is with Diamox, a medication that helps the kidneys and allows you to urinate out extra CO2.

Sleep apnea, or ‘not breathing during sleep’ as defined by McTabi, is a common problem among people. There are two types of sleep apnea: Central Sleep Apnea (CSA) and Obstructive Sleep Apnea (OSA).

CSA, which is what McTabi is describing, can affect anybody. Marty Gaither, the director of respiratory care at Valley View, explained further, differentiating between CSA and OSA.

“Usually people associate big people with OSA, that’s the picture associated with it,” Gaither said. “But anybody can get CSA, even if you’re athletic.”

OSA is when there is an obstruction of any kind in the mouth, nose, top of the lungs or anywhere in the breathing structure except inside the lungs themselves. Sometimes OSA can result in snoring.

“Weight is a factor in OSA,” Gaither confirmed. However, McTabi said that age is the leading cause of OSA.

“The back of the throat is made of muscle and muscle weakens as you get older, leading to that muscle sort of collapsing,” he said.

OSA is not caused by altitude. CSA on the other hand, can be a result of higher altitudes, especially if someone isn’t used to being in a place of high altitude.

“High Altitude Periodic Breathing is a form of CSA,” McTabi said. CSA can be caused by a number of things and can overlap with OSA, a comorbidity.

McTabi said they see problems with sleep apnea interacting with the altitude more so in Glenwood Springs, which is about 6,000 feet above sea level, than in Grand Junction, which is about 4,500.

“Every patient is different,” McTabi said. “Not everyone will experience the same thing.”

Because there’s different ways people can experience sleep apnea, there’s different ways to treat it. Gaither said that sometimes treating sleep apnea can solve other problems.

“When sleep apnea is treated, sometimes people who have heart problems might not need a procedure anymore or they can get a lower dose of medication,” Gaither said.

The heart is directly in accordance with the lungs, due to our need for oxygen, which is carried in the bloodstream. Also, breathing erratically can affect the heart and its beat.

“This is not an evidence-based recommendation, because there’s not a lot of research,” McTabi warned. “But an Adaptive Servo Ventilator can help control your breathing while you sleep.”

An Adaptive Servo Ventilator (ASV) is somewhat similar to a Continuous Positive Airway Pressure (CPAP) machine. ASVs measure your breathing patterns and stabilize it with various levels of pressure. CPAPs are continuous pressure and don’t control your breathing.

“I can look at a machine remotely because the CPAP measures your sleep patterns, and I can access it if it’s not working, and see if you need to adjust it or you need something else,” McTabi said.

The Sleep Lab is another way to get needed help.

“We do sleep studies, ones you can even do at home, and we can simulate a higher altitude in the lab,” Gaither said. “We try to make it as comfortable as possible. We have sleep number beds, you can bring your pillows or blankets from home, because we understand it’s uncomfortable sleeping in a different place and you’ve got all these connections on you that you don’t normally have.”

To help the patient in the sleep lab, usually a sleeping aid is provided, but the lab might only last one night. Doctors recognize that this isn’t sufficient, McTabi said.

“At sleep conferences, you’ll hear that people want to do more than one night to get the sleep pattern,” he said. “But unfortunately, we’re not clinically there yet.”

Sleep Medicine at Valley View lists some symptoms of sleep disorders, including insomnia, which might not actually be insomnia.

“Sometimes people think it’s insomnia. They’ll stop breathing and wake up but have no idea why,” McTabi said. People who experience this don’t realize they’re not breathing while they’re sleeping, so they write it off as insomnia.

Schedule with Valley View’s Sleep Medicine for an In-Lab Test at 970-384-8030 or an At-Home Test at 970-384-7694. For more information, visit vvh.org/sleep-medicine/.