The Effects of High Altitude on Children’s Sleep: A Community-Based Study on Preschoolers in the Tibetan Plateau

Su, Ping, Masako Taniike, Yuko Ohno, and Ikuko Mohri. The effects of high altitude on children's sleep: a community-based study on preschoolers in the Tibetan Plateau. <i>High Alt Med Biol.</i> 26:187-194, 2025. <b><i>Objective/Background:</i></b> It has been reported that high altitude affects breathing during sleep in children. To evaluate the symptoms suspected sleep-disordered breathing (SDB) and sleep quality of preschool children living in high altitude of 2,261-3,800 m above sea level (masl) in the Tibetan Plateau, we conducted the community-based survey using a questionnaire. <b><i>Patients/Methods:</i></b> Sleep problems were assessed in 3,113 children aged 3-6 years in Qinghai province using the Chinese version of the Japanese Sleep Questionnaire for Preschoolers (JSQ-P-C), focusing on obstructive sleep apnea (OSA) and OSA-related symptoms. The effect of altitude on these scores was analyzed. <b><i>Results:</i></b> The subscale scores of OSA, morning symptoms, and daytime excessive sleepiness in the JSQ-P-C were higher in children living in areas above 3,000 masl than in those living below 3,000 masl and in Japanese children. Altitude, but not family income or maternal education level, significantly affected the scores of OSA, morning symptoms, and daytime excessive sleepiness. <b><i>Conclusions:</i></b> Living at altitudes higher than 3,000 masl may adversely affect children's sleep quality.