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DOI: 10.1055/s-0043-1770219
Sleep Quality in Upper Airway Resistance Syndrome Indicated by Cyclic Alternating Pattern Analysis
Authors
Introduction: Upper Airway Resistance Syndrome (UARS) is suspected in individuals with excessive daytime sleepiness, fatigue, and sleep fragmentation associated with increased respiratory effort. UARS can negatively impact daytime function. Conventional polysomnography parameters do not demonstrate significant abnormalities in UARS patients but increase in RERAs. Sleep abnormalities may not be indicated by AASM current manual definition in UARS patients. Cyclic alternating pattern (CAP) is a periodic electroencephalogram activity of non-REM sleep that expresses a condition of sleep instability.
Aim: The objective of the study was to compare CAP components between UARS patients and health individuals.
Methods: Fifteen subjects with UARS and 15 age- and sex- matched controls had their sleep study blinded analyzed. UARS criteria were the presence of sleepiness (Epworth Sleepiness Scale–ESS ≥ 10) and/or fatigue (Modified Fatigue Impact Scale ≥ 38) associated with an apnea/hypopnea index (AHI) ≤ 5 and a respiratory disturbance index (RDI) > 5 events/hour of sleep, and/or flow limitation in more than 30% of total sleep time. Control group criteria were AHI < 5 events/hour, RDI ≤ 5 events/hour and < 30% of TST with flow limitation and ESS < 10, without sleep, clinical, neurological, or psychiatric disorder. CAP electroencephalogram of both groups was analyzed.
Results: The number of CAP cycles in NREM 1 stage was significantly higher in UARS patients compared with controls (3.0 ± 1.1 vs 0.5 ± 0.2, respectively). Mean phase B duration in NREM 1 stage was significantly higher in UARS patients compared with control group (31.3 ± 8.1 vs 3.1 ± 1.4). Mean phase B duration in both NREM 2 and 3 were also significantly higher in UARS patients (28.3 ± 1.0 vs 25 ± 0.9, p = 0,02 and 25.3 ± 1.1 vs 21.7 ± 1.0, respectively). There was a significant positive correlation between number of CAP cycles in NREM 1 (r = 0.5) and mean phase B duration in NREM 1 (r = 0.6) and ESS. There was a significant positive correlation between number of CAP cycles in NREM 1 (r = 0.4), mean phase B duration in NREM 3 (r = 0.4) and mean phase B duration in NREM (r = 0.4) and Beck Depression Inventory score (BDI).
Conclusions: We found higher number of CAP cycles in NREM 1 and higher mean phase B duration in NREM 1, 2 and 3 stages in UARS compared with control, suggesting altered sleep regulation leading to sleep instability.
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Publikationsverlauf
Artikel online veröffentlicht:
15. Juni 2023
© 2023. Brazilian Sleep Association. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)
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