Fig. 1. Mean electroencephalography (C4-M1) power spectral densities during 3-second epochs of stable non-rapid eye movement (stage N1, stage N2, stage N3) and rapid eye movement (stage R) during sleep (A) and during respiratory arousals (ArR) in the corresponding stages (B). Source: DOI: 10.1109/TBME.2021.3118229
Obstructive sleep apnea (OSA) is a common breathing disorder that causes excessive daytime sleepiness and increases the risk of cardiovascular disease, high blood pressure and stroke. OSA is characterized by recurrent total (apnea) or partial (hypopnea) upper airway obstructions during sleep, often leading to blood oxygen desaturation and waking from sleep. Excitement constantly disrupts normal sleep patterns, which then leads to inadequate sleep and reduced sleep times.
The sleep quality, e.g. B. sleep stages and awakening from sleep, can be assessed from the electroencephalogram (EEG) signal recorded during a polysomnogram. Although awakening from sleep is identified using overnight recordings to characterize the degree of sleep disruption, this information is rarely used to assess OSA severity. A recent study conducted in the Sleep Technology and Analytics Research (STAR) group at the University of Eastern Finland examined differences between arousal states induced by different respiratory events.
In the study, 867 patients with clinically suspected OSA were examined for differences in the high-frequency content of the EEG signals during respiratory arousal. Differences were measured in the gamma frequency band (30–40 Hz) between arousals caused by different respiratory events (obstructive apneas and hypopneas with and without ≥3% blood oxygen desaturation) and as a function of respiratory event duration (10–20 s, 20–30 s or > 30s). Awakening was also studied at different sleep stages and compared to 3-second epochs of sustained sleep during the respective stages.
In contrast to sustained sleep, where gamma output decreased as sleep deepened, arousal gamma output increased as sleep deepened. In addition, arousal gamma performance was higher in obstructive apneas than in hypopneas, and higher in longer obstructive apneas than shorter ones. In addition, the excitation gamma output was higher in the presence of oxygen desaturation than when no desaturation event was present.
Since increased EEG gamma activity has previously been associated with nocturnal wakefulness, the results show that the intensity of arousal, and thus the extent of sleep disturbance and respiratory instability, can vary depending on the type and severity of the preceding respiratory event.
“These results may provide more insight into sleep fragmentation associated with respiratory events and assessment of OSA severity,” says lead author, early-stage researcher Henna Pitkänen from the University of Eastern Finland.
Intense awakenings during the night can contribute to sleep apnea
Henna Pitkanen et al., Gamma Power of Electroencephalogram Arousal is Modulated by Respiratory Event Type and Severity in Obstructive Sleep Apnea, IEEE Transactions on Biomedical Engineering (2021). DOI: 10.1109/TBME.2021.3118229 Provided by the University of Eastern Finland
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