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    • Our selection of oxygen within our gas mixture was informed

    2018-11-07

    Our selection of 10% oxygen within our gas mixture was informed by our prior studies in which we employed indwelling arterial catheters with simultaneous pulse oximetry to measure both partial pressures of arterial oxygen (PaO2) and hemoglobin oxygen saturation (SaO2) in rats exposed to hypobaric as well as hypoxic hypoxia [46]. Those studies revealed that a sustained inspired oxygen content of 10% produced a PaO2 of approximately 40mmHg with a corresponding SaO2 of 75–80%. As Fig. 4 illustrates, an SaO2 near 80% is within the range observed during apneic events in a prematurely born infant at a gestational age of approximately 50 weeks at the time of the recording.
    Conclusions
    Acknowledgements This work was supported by the National Institutes of Health, HL-72722 (Decker). We wish to thank Daniel Miller for his excellent technical assistance with neuroimmunohistochemistry. We dedicate this work to our beloved laboratory colleague, Inez Solomon, deceased. The authors report no conflict of interest.
    Introduction Social and urban developments have resulted in unhealthy lifestyles. Sleep habits have changed significantly, and altered habits can cause sleep disorders [1]. The prevalence of sleep problems is 56% in the US population, 31% in Western Europe, and 23% in Japan [2]. Insomnia is the most common sleep disorder, followed by respiratory sleep disorders and restless legs syndrome [1]. Altitude has been shown to increase central apneas even in healthy people and to be associated with higher apnea-hypopnea index in those with obstructive sleep mitoxantrone [3,4] Even more, in those with obstructive apnea, some of the episodes convert to central [5]. Due to Colombia’s rugged geography, it is important to understand the impact of various disorders at different altitudes. The aim of this study was to establish the prevalence of sleep complaints in adults in three Colombian cities located between 15 mitoxantrone and 2640 meters above sea level.
    Materials and methods
    Results Most of subjects were female (53.8%) between 18 and 44 years of age (66.1%) (Table 1). The weighted average age of the population was 40.1 years. Only 41.5% had a body mass index (BMI) in the normal weight category, and women had a higher prevalence of obesity (17.3 versus 11.1%) (Fig. 1). Additionally, women required more sleep medication and had worse sleep quality. Distribution by sex and age groups was similar for the three cities. The subjects had regular sleep schedules (93.5%), with an average duration of 7.9±3.1h of sleep. With respect to sleep habits, went to bed early and got up early (38.4%) than those who stayed up late and got up late (18.2%) (Table 2). According to the Pittsburgh scale, 45.3% (95% CI: 43.0, 47.5%) of the population requires medical care due to sleep problems (Fig. 2). The overall prevalence of high risk for sleep apnea, according to the Berlin questionnaire, was 19.0% (95% CI: 17.3; 20.8%). However, with the STOP-Bang questionnaire, the overall prevalence of high risk for OSA (26.9%; 95% CI: 24.9; 29.0%) was higher than that reported by this questionnaire. It was identified that 13.7% (95% CI: 12.3; 15.3%) of the population has EDS, and 37.7% (95% CI: 35.5; 39.8%) reported restless legs syndrome. In the analysis by city, the population of Santa Marta had a high prevalence of sleep complaints (72.4%). In that city, high-risk percentages were found for severe sleep apnea (by STOP-Bang (28.9%)), OSA (by the Berlin questionnaire (21.2%)), restless legs (54.5%), and propensity for EDS (29.9%). Bogota had the second-highest frequency of sleep disturbances (59.7%), attributable in part to a high-risk-weighted prevalence for OSA in the STOP-Bang (27.2%) questionnaire. When comparing cities with respect to the frequency of sleep problems, there were statistically significant differences in the overall frequency of patients who require medical care in Santa Marta (higher frequency) versus the other two cities. The frequencies of sleep problems according to the Epworth scale and the restless legs syndrome questionnaire were statistically significant in the comparison between Santa Marta (higher frequency) and the other cities. There were also differences in the frequency of sleep problems (Pittsburgh) not only between Bogota (higher frequency) and Bucaramanga but also between Santa Marta (higher frequency) and the other two cities. With respect to the frequency of high OSA risk (STOP-Bang) requiring medical care, statistically significant differences were found not only between the cities of Bogota (higher frequency) and Bucaramanga but also between Santa Marta (higher frequency) and Bucaramanga (Table 3).