Wirkungen von Alkohol und hypobarer Hypoxie auf Schlaf, SpO_₂ und Herzfrequenz

Zusammenfassung

Untersucht wurde der kombinierte Einfluss von Alkohol und hypobarer Hypoxie auf Schlaf, Sauerstoffsättigung (SpO₂) und Herzfrequenz. Zwei Gruppen verbrachten 2 4-stündige Nächte im Schlaflabor (n = 23; 53 m über dem Meeresspiegel) oder in der Druckkammer (n = 17; 753 hPa entsprechend 2438 m über dem Meeresspiegel, hypobare Bedingung). Vor einer der beiden Nächte konsumierten die Teilnehmer*innen Alkohol, wobei die Reihenfolge der Nächte randomisiert war. Zwischen den beiden Nächten lagen 2 8-stündige Erholungsnächte. Während der Nächte wurden Schlaf, SpO₂ und Herzfrequenz aufgezeichnet. Die Kombination aus Alkohol und hypobarer Hypoxie verringerte die SpO₂ (Median 85,32 %) und erhöhte die Herzfrequenz (Median 87,73 S/min) während des Schlafs, verglichen mit 95,88 % und 63,74 S/min unter normobaren Bedingungen und ohne Alkoholkonsum. Unter der kombinierten Exposition lag die SpO₂ für 201,18 min unter dem klinischen Hypoxieschwellenwert von 90 % und der Tiefschlaf (N3) war reduziert.

Abstract

In this study, the combined influence of alcohol and hypobaric hypoxia on sleep, oxygen saturation (SpO₂) and heart rate was investigated. Two groups spent either 2 4-hour nights in the sleep laboratory (n = 23; 53 m above sea level) or in the altitude chamber (n = 17; 753 hPa corresponding to 2438 m above sea level, hypobaric condition). Before one of the 2 nights, participants consumed alcohol. The order of the nights was counterbalanced. 2 8-hour recovery nights were scheduled between the 2 nights. During the nights, sleep, SpO₂ and heart rate were recorded. The combination of alcohol exposure and hypobaric conditions decreased SpO₂ to a median of 85.32 % and increased heart rate to a median of 87.73 bpm during sleep, compared to 95.88 % and 63.74 bpm in the nonalcohol condition of the sleep laboratory group. Under the combined exposure, SpO₂ was 201.18 min below the clinical hypoxia threshold of 90 % and deep sleep (N3) was reduced.

Schlüsselwörter

Polysomnografie - Schlaf - Höhe - Alkohol - Hypoxie

Key words

polysomnography - sleep - altitude - alcohol - hypoxia

Publication History

Article published online:
02 June 2025

• Literatur

• 1 British Thoracic Society Standards of Care Committee. Managing passengers with respiratory disease planning air travel: British Thoracic Society recommendations. Thorax 2002; 57: 289-304
• 2 Martin-Gill C, Doyle TJ, Yealy DM. In-flight medical emergencies: a review. JAMA 2018; 320: 2580-2590
• 3 Coker RK, Armstrong A, Church AC. et al. BTS clinical statement on air travel for passengers with respiratory disease. Thorax 2022; 77: 329-350
• 4 Muhm JM, Rock PB, McMullin DL. et al. Effect of aircraft-cabin altitude on passenger discomfort. N Engl J Med 2007; 357: 18-27
• 5 Seccombe LM, Peters MJ. Physiology in medicine: acute altitude exposure in patients with pulmonary and cardiovascular disease. J Appl Physiol (1985) 2014; 116: 478-485
• 6 Pump S, Stüben U, Graf J. Flug- und Höhenmedizin für Anästhesisten: Teil 1: Physikalische Grundlagen und Pathophysiologie. Anästhesiol Intensivmed Notfallmed Schmerzther 2012; 47: 682-687
• 7 Elmenhorst EM, Rooney D, Benderoth S. et al. Sleep-induced hypoxia under flight conditions: implications and countermeasures for long-haul flight crews and passengers. Nat Sci Sleep 2022; 14: 193-205
• 8 Zieliński J, Koziej M, Mańkowski M. et al. The quality of sleep and periodic breathing in healthy subjects at an altitude of 3,200 m. High Alt Med Biol 2000; 1: 331-336
• 9 Petrassi FA, Hodkinson PD, Walters PL. et al. Hypoxic hypoxia at moderate altitudes: review of the state of the science. Aviat Space Environ Med 2012; 83: 975-984
• 10 Latshang TD, Lo Cascio CM, Stöwhas AC. et al. Breathing, sleep and cognitive performance at moderate altitude: are nocturnal breathing, sleep, and cognitive performance impaired at moderate altitude (1,630–2,590 m)?. Sleep 2013; 36: 1969-1976
• 11 Stadelmann K, Latshang TD, Lo Cascio CM. et al. Quantitative changes in the sleep EEG at moderate altitude (1630 m and 2590 m). PLoS One 2013; 8: e76945
• 12 Wickramasinghe H, Anholm JD. Sleep and breathing at high altitude. Sleep Breath 1999; 3: 89-102
• 13 Skyscanner. Würden Sie lieber einen „trockenen“ Flug buchen, wo kein Alkohol ausgeschenkt wird?. Umfrage 2013 veröffentlicht 26.03.2013 unter https://de.statista.com/statistik/daten/studie/259446/umfrage/umfrage-zum-alkoholverbot-in-flugzeugen
• 14 Thakkar MM, Sharma R, Sahota P. Alcohol disrupts sleep homeostasis. Alcohol 2015; 49: 299-310
• 15 Kido M, Asakawa A, Koyama KIK. et al. Acute effects of traditional Japanese alcohol beverages on blood glucose and polysomnography levels in healthy subjects. PeerJ 2016; 4: e1853
• 16 Elmenhorst EM, Elmenhorst D, Benderoth S. et al. Cognitive impairments by alcohol and sleep deprivation indicate trait characteristics and a potential role for adenosine A1 receptors. Proc Natl Acad Sci U S A 2018; 115: 8009-8014
• 17 Ebrahim IO, Shapiro CM, Williams AJ. et al. Alcohol and sleep I: effects on normal sleep. Alcohol Clin Exp Res 2013; 37: 539-549
• 18 Taasan VC, Block AJ, Boysen PG. et al. Alcohol increases sleep apnea and oxygen desaturation in asymptomatic men. Am J Med 1981; 71: 240-245
• 19 Brown RE, Basheer R, McKenna JT. et al. Control of sleep and wakefulness. Physiol Rev 2012; 92: 1087-1187
• 20 Izumi I, Nasermoaddeli A, Sekine M. et al. Effect of moderate alcohol intake on nocturnal sleep respiratory parameters in healthy middle-aged men. Environ Health Prev Med 2005; 10: 16-20
• 21 Hoshikawa M, Uchida S, Sugo T. et al. Changes in sleep quality of athletes under normobaric hypoxia equivalent to 2,000-m altitude: a polysomnographic study. J Appl Physiol (1985) 2007; 103: 2005-2011
• 22 Benderoth S, Hörmann HJ, Schießl C. et al. Reliability and validity of a 3-min psychomotor vigilance task in assessing sensitivity to sleep loss and alcohol: fitness for duty in aviation and transportation. Sleep 2021; 44: zsab151
• 23 Watson PE, Watson ID, Batt RD. Prediction of blood alcohol concentrations in human subjects updating the Widmark equation. J Stud Alcohol 1981; 42: 547-556
• 24 Pavlic M, Grubwieser P, Brandstätter A. et al. A study concerning the blood/breath alcohol conversion factor Q: concentration dependency and its applicability in daily routine. Forensic Sci Int 2006; 158: 149-156
• 25 Iber C, Ancoli-Israel S, Chesson AL. et al. The AASM manual for the scoring of sleep and associated events: rules, terminology and technical specifications. Westchester, IL: 2007
• 26 O’Driscoll BR, Howard LS, Earis J. et al. BTS guideline for oxygen use in adults in healthcare and emergency settings. Thorax 2017; 72: ii1-ii90
• 27 Hu JS, Smith JK. In-flight Medical Emergencies. Am Fam Physician 2021; 103: 547-552
• 28 Pastori D, Cormaci VM, Marucci S. et al. A comprehensive review of risk factors for venous thromboembolism: from epidemiology to pathophysiology. Int J Mol Sci 2023; 24: 3169
• 29 Rostin P, Teja BJ, Friedrich S. et al. The association of early postoperative desaturation in the operating theatre with hospital discharge to a skilled nursing or long-term care facility. Anaesthesia 2019; 74: 457-467
• 30 Goodacre S, Turner J, Nicholl J. Prediction of mortality among emergency medical admissions. Emerg Med J 2006; 23: 372-375
• 31 Tsutsumi W, Miyazaki S, Itasaka Y. et al. Sleep breathing disorders: influence of alcohol on respiratory disturbance during sleep. Psychiatry Clin Neurosci 2000; 54: 332-333
• 32 Muhm JM, Signal TL, Rock PB. et al. Sleep at simulated 2438 m: effects on oxygenation, sleep quality, and postsleep performance. Aviat Space Environ Med 2009; 80: 691-697
• 33 Mizuno K, Asano K, Okudaira N. Sleep and respiration under acute hypobaric hypoxia. Jpn J Physiol 1993; 43: 161-175
• 34 Arnedt JT, Rohsenow DJ, Almeida AB. et al. Sleep following alcohol intoxication in healthy, young adults: effects of sex and family history of alcoholism. Alcohol Clin Exp Res 2011; 35: 870-878
• 35 Gries RE, Brooks LJ. Normal oxyhemoglobin saturation during sleep: how low does it go?. Chest 1996; 110: 1489-1492
• 36 Kolla BP, Foroughi M, Saeidifard F. et al. The impact of alcohol on breathing parameters during sleep: a systematic review and meta-analysis. Sleep Med Rev 2018; 42: 59-67
• 37 de Zambotti M, Forouzanfar M, Javitz H. et al. Impact of evening alcohol consumption on nocturnal autonomic and cardiovascular function in adult men and women: a dose-response laboratory investigation. Sleep 2021; 44: zsaa135
• 38 Aeschbach D, Cajochen C, Tobler I. et al. Sleep in a sitting position: effect of triazolam on sleep stages and EEG power spectra. Psychopharmacology (Berl) 1994; 114: 209-214
• 39 Rooney D, Herkenrath S, Priegnitz C. et al. Choosing an adequate test to determine fitness for air travel in obese individuals. Chest 2019; 156: 926-932
• 40 Trammer RA, Rooney D, Benderoth S. et al. Effects of moderate alcohol consumption and hypobaric hypoxia: implications for passengers’ sleep, oxygen saturation and heart rate on long-haul flights. Thorax 2024; 79: 970-978