Published ahead of print on December 10, 2004, doi:10.1164/rccm.200408-1056OC Am. J. Respir. Crit. Care Med., Volume 171, Number 6, March 2005, 652-658 A more recent version of this article appeared on March 15, 2005
Submitted on August 14, 2004 Electroencephalographic Changes during Respiratory Cycles Predict Sleepiness in Sleep ApneaRonald D Chervin1*,1 Department of Neurology, Sleep Disorders Center, University of Michigan, Ann Arbor, MI, USA, 2 Division of Environmental and Emerging Technology, Altarum Institute, Ann Arbor, MI, USA * To whom correspondence should be addressed. E-mail: chervin{at}umich.edu.
Common polysomnographic measures of sleep-disordered breathing have shown disappointing ability to predict important consequences such as excessive daytime sleepiness. Using novel analytic techniques, this study tested the hypothesis that numerous, brief disruptions in cortical activity could occur on a breath-to-breath basis during non-apneic sleep. Spectral analysis proved the existence of respiratory cycle-related electroencephalographic changes in each of 38 adult patients evaluated by polysomnography for sleep-disordered breathing. Furthermore, the tendency for sigma (13 to 15 Hz) electroencephalographic power to vary with the respiratory cycle predicted next-day sleepiness as measured by the Multiple Sleep Latency Test. The predictive value was enhanced when the analysis was limited to those 27 patients who had sleep-disordered breathing (more than 5 apneas or hypopneas per hour of sleep). In contrast, nocturnal rates of apneas and hypopneas, as well as minimum oxygen saturation, did not predict sleepiness as well. On average, sigma power increased notably during inspiration, whereas delta power showed a simultaneous decrease. We conclude that electroencephalographic activity shows detectable changes during non-apneic respiratory cycles in adults evaluated for sleep-disordered breathing. Quantification of these changes, which may reflect numerous inspiratory microarousals, could prove useful in prediction of excessive daytime sleepiness. Key words: Polysomnography, Sleep Apnea, Obstructive, Disorders of Excessive Somnolence, Signal Processing, Computer-Assisted, Respiratory Cycle-Related EEG Changes
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