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Arousal responses to respiratory events during sleep: the role of pulse wave amplitude
Author(s) -
Bosi Marcello,
Milioli Giulia,
Riccardi Silvia,
Melpignano Andrea,
Vaudano Anna E.,
Cortelli Pietro,
Poletti Venerino,
Parrino Liborio
Publication year - 2018
Publication title -
journal of sleep research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.297
H-Index - 117
eISSN - 1365-2869
pISSN - 0962-1105
DOI - 10.1111/jsr.12593
Subject(s) - pulse (music) , anesthesia , rapid eye movement sleep , medicine , non rapid eye movement sleep , obstructive sleep apnea , respiratory system , pulse wave analysis , audiology , slow wave sleep , apnea , pulse wave , electroencephalography , sleep (system call) , cardiology , eye movement , pulse wave velocity , physics , blood pressure , optics , ophthalmology , laser , psychiatry , detector , computer science , operating system
Summary The study aims at assessing the changes in electroencephalography (as measured by the A‐phases of cyclic alternating pattern) and autonomic activity (based on pulse wave amplitude) at the recovery of airway patency in patients with obstructive sleep apnea syndrome. Analysis of polysomnographic recordings from 20 male individuals with obstructive sleep apnea syndrome was carried out in total sleep time, non‐rapid eye movement and rapid eye movement sleep. Scoring quantified the combined occurrence (time range of 4 s before and 4 s after respiratory recovery) or separate occurrence of A‐phases (cortical activation), and pulse wave amplitude drops (below 30%) to apneas, hypopneas or flow limitation events. A dual response (A‐phase associated with a pulse wave amplitude drop) was the most frequent response (71.8% in total sleep time) for all types of respiratory events, with a progressive reduction from apneas to hypopneas and flow limitation events. The highly significant correlation in total sleep time ( r = 0.9351; P < 0.0001) between respiratory events combined with A‐phases and respiratory events combined with pulse wave amplitude drops was confirmed both in non‐rapid eye movement ( r = 0.9622; P < 0.0001) and rapid eye movement sleep ( r = 0.7162; P < 0.0006). In conclusion, a dual cortical and autonomic activation is the most common manifestation at the recovery of airway patency. The significant correlation between A‐phases and relevant pulse wave amplitude drops suggests a possible role of pulse wave amplitude as a marker of cerebral response to respiratory events.