Sueño en ALTurA (SALTA)
Sleep disordered breathing (SDB) is a prevalent disease that is linked to cardiovascular disease. The prevalence and severity of SDB are amplified at high altitudes, in which an estimated 150 million people live worldwide. In Puno, Peru (3825m above sea level), we documented an ~80% prevalence of SDB in a population-based community sample, indicating that highlanders are exposed to significant reductions in oxyhemoglobin saturation and recurrent apneic episodes during sleep. We demonstrated that (1) sleep greatly amplifies daytime hypoxemia and exposes subjects to recurrent apneic episodes, (2) oxygenation improves markedly when highlanders sleep on an incline rather than in the horizontal plane, and (3) SDB in highlanders is closely linked to markers of cardiometabolic stress.
The SALTA trial will investigate if a simple, readily deployed nocturnal postural maneuver will effectively treat SDB and reduce cardiometabolic stress. SALTA is a 12-week Phase II randomized controlled clinical trial in 60 adults with BMI ≥25 kg/m2 living in urban Puno. The trial aims to assess the therapeutic efficacy of inclined sleep posture on SDB. Secondary aims include documenting adherence to sleeping on an inclined plane and to what degree postural therapy decreases markers of cardiometabolic stress, including metabolic dysfunction, cardiovascular stress, and markers of hypoxemia.