Altered blood chemistry, acid-base and electrolyte are suggested determinants of sleep disturbance, with frequent arousal at high altitude even in well and long-trained altitude marathon runners. In this sample of experienced altitude marathon runners with maximal aerobic power at sea level of 61.4 ± 2.7 ml/kg-1·min-1 we found that pO2 and percent of oxygen saturation (%SO2) were lower at2050 mand3480 mthan at sea level; pO2 was higher after 38 - 41 hours than after 30 - 31 hours of acclimatization at3480 m(P < 0.05). After ascentto3480 m%SO2 decreased (P < 0.003). Com- pared to sea level values, pH increased at high altitude (P < 0.05) consistent with changes in pCO2 and (P < 0.05). Nocturnal %SpaO2 at a sleeping altitude of3480 mwas lower (P < 0.05) than at sea level. At high altitude, the percent of wake (W) time and delay falling asleep (DFA) increased, whereas non-rapid eye movement sleep (N-REM), REM sleep and total sleep time (TST) decreased (P < 0.05). Simple regression analysis disclosed a significant correlation between the changes in TST and the percent of REM sleep and the changes in %SpaO2 recorded during sleep (P < 0.05). Simple regression analysis showed a positive correlation between the changes in pO2 at higher altitude and the percent of W and of TST (P < 0.05). The changes in pO2, tCO2 and [HCO3-] correlated negatively and significantly with the percent of REM sleep changes at high altitude (P < 0.05). The TST changes at high altitude correlated positively with the changes in pO2 and pH and correlated negatively with the changes in %SO2, pCO2, tCO2, and [HCO3-] (P < 0.05). The changes in the percent of W at high altitude correlated significantly and positively with the changes in bases excess [BE] at high altitude (P < 0.05). The changes in the percent of REM sleep correlated significantly and positively with the changes in [iCa++] and [BE] and negatively with the changes in buffered bases [BB] and [BEeffective] (P < 0.05). The change in the percent of NREM + REM sleep at high altitude correlated significantly and positively with the changes in [BE] and [BB] concentration (P < 0.05). The increase in DFA at high altitude correlated significantly and negatively with the changes in pCO2 and significantly and negatively with the changes in [K+] (P < 0.05). Simple regression analysis demonstrated that the changes in pH at high altitude correlated positively and significantly with the percent of W and the DFA and negatively with the percent of changes in NREM sleep, REM sleep, NREM + REM sleep (P < 0.05). The decrease in the TST at high altitude correlated significantly and negatively with the changes in pCO2, tCO2, [HCO3-] and [K+] (P < 0.05). Our data demonstrate that the arterialized ear lobe techniques we used for evaluating most of the changes in blood chemistry, acid-base, electrolyte and blood lactate metabolism aresuitable for clinical and laboratory assessment and are important predictors of the quality and quantity of acclimatization and sleep at high altitude.
Cite this paper
I. Gritti, C. Mauri, S. Defendi, D. Cesana, F. Consonni, A. Dolci and S. Luoni, "Blood Chemistry, Acid-Base, Electrolyte, Blood Lactate Metabolism and Sleep at 3480 m in Mountain Marathon Runners," Journal of Behavioral and Brain Science, Vol. 3 No. 1, 2013, pp. 13-25. doi: 10.4236/jbbs.2013.31003.
 J. H. Coote, “Medicine and Mechanisms in Altitude Sickness. Recommendations,” Sports of Medicine, Vol. 20, No. 3, 1995, pp. 148-159.
 P. H. Hackett and R. C. Roach, “High-Altitude Illness,” New England Journal of Medicine, Vol. 25, No. 17, 2001, pp. 1279-1280.
 M. Samaja, “Blood Gas Transport at High Altitude,” Respiration, Vol. 64, 1997, pp. 422-428.
 M. Samaja, C. Mariani, A. Prestini and P. Ceretelli, “Acid Base Balance and O2 Transport at High Altitude,” Acta Physiological Scandinavica, Vol. 159, No. 3, 1997, pp. 249-256. doi:10.1046/j.1365-201X.1997.574342000.x
 M. Samaja, T. Crespi, M. Guazzi and K. D. Vandergriff, “Oxygen Transport in Blood in Altitude: Role of the Hemoglobin-Oxygen Affinity and Impact of the Phenomena Related to Hemoglobinallosterism and Red Cell Function,” European Journal Applied Physiology, Vol. 90, No. 3-4, 2003, pp. 351-359. doi:10.1007/s00421-003-0954-8
 G. S. Roi, M. Giacometti, G. Banfi, M. Zaccaria, I. Gritti and S. P. Von Duvillard, “Competitive Running at High Altitude, Is It Safe?” Medicine Science Sports Exercise, Vol. 3, No. 5, 1999, p. S861.
 G. Banfi, M. Marinelli, G. S. Roi, A. Colombini, M. Pontillo, M. Giacometti and S. Wade “Growth Hormone and Insulin-Like Growth Factor I in Athletes Performing a Marathon at 4000 m of Altitude,” Growth Regulation, Vol. 4, No. 2, 1994, pp. 82-86.
 G. Banfi, M. Marinelli, G. S. Roi and M. Giacometti, “Platelet Indices in Athletes Performing a Race in Altitude Environment,” Journal of Clinical Laboratory Analysis, Vol. 9, No. 1, 1995, pp. 34-36.
 G. Banfi, M. Marinelli, P. Bonini, I. Gritti and G. S. Roi, “Pepsinogens and Gastrointestinal Symptoms in Mountain Marathon Runners,” International Journal Sports Medicine, Vol. 17, No. 8, 1996, pp. 554-558.
 G. Banfi, M. Pontillo, M. Marinelli, A. Dolci and G. S. Roi, “Thyrotropin and Free Thyroid Hormones in Athletes during and after Ultra Endurance Sport Performances,” Journal Clinical Ligand Assay, Vol. 21, No. 3, 1998, pp. 331-334.
 G. Banfi, G. S. Roi and A. Dolci, “Erythrocytes, Haemoglobin and Packed Cell Volume in Athletes Performing Races in Altitude Environment,” Haematologica, Vol. 85, 2000, p. E12.
 G. Banfi and A. Dolci, “Preanalytical Phase of Sport Biochemistry and Haematology,” The Journal of Sports Medicine and Physical Fitness, Vol. 43, No. 2, 2003, pp. 223-230.
 G. Banfi, G. S. Roi, A. Dolci and D. Susta, “Behaviour of Haematological Parameters in Athletes Performing Marathon and Ultramarathon in Altitude (‘skyrunners’),” Clinical Laboratory Haematologica, Vol. 26, No. 6, 2004, pp. 1-5. doi:10.1111/j.1365-2257.2004.00642.x
 G. Fragasso, A. Palloshi, S. Roi, E. Rossetti, G. Monaco, A. Dolci, A. Margonato and S. Chierchia, “Transient Left Ventricular Diastolic Dysfunction Following Strenuous Exercise,” Sport Science Health, Vol. 1, No. 1, 2004, pp. 31-35. doi:10.1007/s11332-004-0007-7
 M. Marinelli, G. S. Roi, M. Giacometti, P. Bovini and G. Banfi, “Cortisol, Testosterone and Free Testosterone in Athletes Performing a Marathon at 4000 m of Altitude,” Hormon Research, Vol. 41, No. 5-6, 1994, pp. 225-229.
 G. Pelamatti, M. Pascotto and C. Semenza, “Verbal Free Recall in High Altitude: Proper Names vs Common Names,” Cortex, Vol. 39, No. 1, 2003, pp. 97-103.
 C. Murrell, L. Wilson, J. D. Cotter, S. Lucas, S. Ogoh, G. Keith and N. Ainslie, “Alteration in Autonomic Function and Cerebral Hemodynamics to Orthostatic Challenge Following a Mountain Marathon,” Journal Applied Physiology, Vol. 103, No. 1, 2007, pp. 88-96.
 J. V. Weil, “Sleep at High Altitude,” In: M. H. Kryger, T. Roth, W. C. Dement, Eds., Principle and Practice of Sleep Medicine, W. B. Sauders Company, Toronto, 1989, pp. 269-276.
 T. P. Finnegan, P. Abraham and T. B. Docherty, “Ambulatory Monitoring of the Electroencephalogram in High Altitude Mountaineers,” Electroencephalography & Clinical Neurophysiology, Vol. 60, No. 3, 1985, pp. 220-224.
 B. Kayser, “Nutrition and Energetics of Exercise at Altitude,” Sports Medicine, Vol. 17, No. 5, 1994, pp. 309-323.
 A. Sauty, L. F. Uldry, P. Debetaz, P. Leuenberger and J. W. Fitting, “Differences in PO2 and PCO2 between Arterial and Arterialized Earlobe Samples,” European Respiratory Journal, Vol. 9, No. 2, 1996, pp. 186-189.
 J. E. Hansen, G. P. Stelter and J. A. Vogel, “Arterial Pyruvate, Lactate, pH and pCO2 during Work at Sea Level and High Altitude,” Journal Applied Physiology, Vol. 23, No. 4, 1967, pp. 523-530.
 H. Normand, M. Barragan, O. Benoit, O. Bailliart and J. Raynaud, “Periodic Breathing and O2 Saturation in Relation to Sleep Stages at High Altitude,” Aviation Space Environ Medicine, Vol. 61, No. 3, 1990, pp. 229-235.
 B. Kayser, G. Ferretti, B. Grassi, T. Binzoni, P. Ceretelli, “Maximal Lactic Capacity at Altitude: Effect of Bicarbonate Loading,” Journal Applied Physiology, Vol. 75, No. 3, 1995, pp. 1070-1074