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Microsleep as a marker of sleepiness in obstructive sleep apnea patients
Author(s) -
Morrone Elisa,
D'Artavilla Lupo Nadia,
Trentin Rossella,
Pizza Fabio,
Risi Irene,
Arcovio Simona,
Fanfulla Francesco
Publication year - 2020
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.12882
Subject(s) - multiple sleep latency test , latency (audio) , obstructive sleep apnea , medicine , sleep apnea , sleep (system call) , psychology , anesthesia , sleep disorder , excessive daytime sleepiness , psychiatry , insomnia , computer science , telecommunications , operating system
Summary We hypothesized that: (a) the presence of microsleep ( MS) during a Maintenance Wakefulness Test (MWT) trial may represent a reliable marker of sleepiness in obstructive sleep apnea (OSA) patients; (b) the number of MSs will be higher in sleepy versus non‐sleepy patients with a borderline MWT mean sleep latency; and (c) scoring MS during MWT analysis may help physicians to recognize patients with a higher degree of sleepiness. We analysed the MWT data of 112 treatment‐naïve OSA patients: 20 with short sleep latency ( SL , sleep latency <12.8 min), 43 with borderline latency ( BL , sleep latency between 12.8 and 32.6 min) and 49 with normal latency ( NL , sleep latency >32.6 min). Microsleep was identified in all SL , in 42 BL and in 18 NL patients, with a median latency of 5.6 min. Accordingly, patients were classified into two subgroups: group A ( n = 43) with microsleep latency <5.6 min and group B ( n = 69) with microsleep latency >5.6 min when present. The mean sleep latency in the MWT was 14.5 ± 7.5 min in group A and 34.6 ± 7.4 min in group B ( p < 0.0001). The number of microsleep episodes during each MWT trial was higher in group A than in group B. Sleep latency survival curves demonstrated different patterns of sleep latency in these groups (log‐rank test <0.0001). This finding was confirmed in a Cox proportional hazard analysis: the presence of a mean MS latency <5.6 min is associated with an increasing risk of falling asleep during the MWT ( RR, 1.93; 95 CI 1.04–3.6; p = 0.03). We conclude that the detection of microsleep may help in discriminating OSA patients with and without daytime vigilance impairment.