Why Your Brain "Forgets" to Breathe at High Altitude

If you have ever felt like you were suffocating in a high-altitude mountain cabin, you aren't just reacting to a cold room or a loud bunkmate. At elevations above 2,500 metres, your body enters a chaotic internal battle known as periodic breathing.

In this episode of The 24.18 Hour Podcast, we go into the "engine room" of the respiratory system to explain why sleep disturbance at altitude is almost always an internal, physiological problem rather than an environmental one. We explore the mechanics of Central Sleep Apnea (CSA)—a temporary neurological "glitch" where the brain stops sending the signal to breathe, resulting in cycles of intense gasping followed by 5-to-15-second pauses. This disruption is driven by a chemical tug-of-war: while low oxygen screams at your body to breathe harder, the resulting drop in CO2 tells your brain to stop breathing entirely.

We also challenge the common belief that sleep improves as you adjust to the mountains. Our sources reveal an "Acclimatisation Paradox," where breathing instability and "twitchy" sensors actually cause sleep quality to worsen for the first 12 to 15 days at a fixed altitude. Furthermore, we discuss why Obstructive Sleep Apnea (OSA) often paradoxically resolves at altitude and why Acetazolamide remains the gold-standard prevention, reducing CSA events by 50% to 80%.

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— Sleep2DreamAnalytics Education-first sleep science. Not medical advice.