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RESEARCH PRODUCT
Unique sleep-stage transitions determined by obstructive sleep apnea severity, age and gender
Marcel WächterJan W. KantelhardtMaria R. BonsignoreIzolde BouloukakiPierre EscourrouFietze IngoLudger GroteDamian KorzybskiCarolina LombardiOreste MarroneIvana ParanicovaAthanasia PatakaSilke RyanSophia E. SchizaPawel SliwinskiPaschalis SteiropoulosJohan VerbraeckenThomas PenzelEsada Study Groupsubject
AdultMalesleep-disordered breathing.medicine.medical_specialtysleepdisordered breathing[SDV]Life Sciences [q-bio]Cognitive Neurosciencesleep dynamicsExcessive daytime sleepinessSettore MED/10 - Malattie Dell'Apparato Respiratorio600 Technik Medizin angewandte Wissenschaften::610 Medizin und Gesundheit::616 Krankheitenpower-law distribution03 medical and health sciencesBehavioral Neuroscience0302 clinical medicineInternal medicine616HumansMedicineexponential distributionsleep fragmentationStage (cooking)Retrospective StudiesSleep Apnea Obstructivebusiness.industryConfoundingsleep-disordered breathingAge FactorsGender IdentitySleep apneaGeneral MedicineMiddle AgedAnthropometrymedicine.diseaseSleep in non-human animals[SDV] Life Sciences [q-bio]Obstructive sleep apnea030228 respiratory systemsleep dynamicCohortCardiologyFemaleHuman medicinemedicine.symptomSleepbusiness030217 neurology & neurosurgerydescription
In obstructive sleep apnea, patients' sleep is fragmented leading to excessive daytime sleepiness and co-morbidities like arterial hypertension. However, traditional metrics are not always directly correlated with daytime sleepiness, and the association between traditional sleep quality metrics like sleep duration and arterial hypertension is still ambiguous. In a development cohort, we analysed hypnograms from mild (n = 213), moderate (n = 235) and severe (n = 277) obstructive sleep apnea patients as well as healthy controls (n = 105) from the European Sleep Apnea Database. We assessed sleep by the analysis of two-step transitions depending on obstructive sleep apnea severity and anthropometric factors. Two-step transition patterns were examined for an association to arterial hypertension or daytime sleepiness. We also tested cumulative distributions of wake as well as sleep-states for power-laws (exponent α) and exponential distributions (decay time τ) in dependency on obstructive sleep apnea severity and potential confounders. Independent of obstructive sleep apnea severity and potential confounders, wake-state durations followed a power-law distribution, while sleep-state durations were characterized by an exponential distribution. Sleep-stage transitions are influenced by obstructive sleep apnea severity, age and gender. N2 → N3 → wake transitions were associated with high diastolic blood pressure. We observed higher frequencies of alternating (symmetric) patterns (e.g. N2 → N1 → N2, N2 → wake → N2) in sleepy patients both in the development cohort and in a validation cohort (n = 425). In conclusion, effects of obstructive sleep apnea severity and potential confounders on sleep architecture are small, but transition patterns still link sleep fragmentation directly to obstructive sleep apnea-related clinical outcomes like arterial hypertension and daytime sleepiness.
| year | journal | country | edition | language |
|---|---|---|---|---|
| 2019-03-30 |