Quantitative electroencephalography measures in rapid eye movement and nonrapid eye movement sleep are associated with apnea-hypopnea index and nocturnal hypoxemia in men

Sarah Appleton, Andrew Vakulin, Angela D'Rozario, Andrew Vincent, Alison Teare, Sean Martin, Gary Wittert, R. Doug McEvoy, Peter G. Catcheside, Robert Adams

Research output: Contribution to journalArticle

Abstract

Study Objectives: Quantitative electroencephalography (EEG) measures of sleep may identify vulnerability to obstructive sleep apnea (OSA) sequelae, however, small clinical studies of sleep microarchitecture in OSA show inconsistent alterations. We examined relationships between quantitative EEG measures during rapid eye movement (REM) and non-REM (NREM) sleep and OSA severity among a large population-based sample of men while accounting for insomnia. Methods: All-night EEG (F4-M1) recordings from full in-home polysomnography (Embletta X100) in 664 men with no prior OSA diagnosis (age ≥ 40) were processed following exclusion of artifacts. Power spectral analysis included non-REM and REM sleep computed absolute EEG power for delta, theta, alpha, sigma, and beta frequency ranges, total power (0.5-32 Hz) and EEG slowing ratio. Results: Apnea-hypopnea index (AHI) ≥10/h was present in 51.2% (severe OSA [AHI ≥ 30/h] 11.6%). In mixed effects regressions, AHI was positively associated with EEG slowing ratio and EEG power across all frequency bands in REM sleep (all p < 0.05); and with beta power during NREM sleep (p = 0.06). Similar associations were observed with oxygen desaturation index (3%). Percentage total sleep time with oxygen saturation <90% was only significantly associated with increased delta, theta, and alpha EEG power in REM sleep. No associations with subjective sleepiness were observed. Conclusions: In a large sample of community-dwelling men, OSA was significantly associated with increased EEG power and EEG slowing predominantly in REM sleep, independent of insomnia. Further study is required to assess if REM EEG slowing related to nocturnal hypoxemia is more sensitive than standard PSG indices or sleepiness in predicting cognitive decline.

LanguageEnglish
Article numberzsz092
JournalSleep
Volume42
Issue number7
DOIs
Publication statusPublished - 23 Apr 2019

Keywords

  • insomnia
  • obstructive sleep apnea
  • power spectral analysis
  • quantitative EEG analysis
  • sleep disordered breathing

ASJC Scopus subject areas

  • Clinical Neurology
  • Physiology (medical)

Cite this

@article{60e8c110967e4d87901260abe62f090f,
title = "Quantitative electroencephalography measures in rapid eye movement and nonrapid eye movement sleep are associated with apnea-hypopnea index and nocturnal hypoxemia in men",
abstract = "Study Objectives: Quantitative electroencephalography (EEG) measures of sleep may identify vulnerability to obstructive sleep apnea (OSA) sequelae, however, small clinical studies of sleep microarchitecture in OSA show inconsistent alterations. We examined relationships between quantitative EEG measures during rapid eye movement (REM) and non-REM (NREM) sleep and OSA severity among a large population-based sample of men while accounting for insomnia. Methods: All-night EEG (F4-M1) recordings from full in-home polysomnography (Embletta X100) in 664 men with no prior OSA diagnosis (age ≥ 40) were processed following exclusion of artifacts. Power spectral analysis included non-REM and REM sleep computed absolute EEG power for delta, theta, alpha, sigma, and beta frequency ranges, total power (0.5-32 Hz) and EEG slowing ratio. Results: Apnea-hypopnea index (AHI) ≥10/h was present in 51.2{\%} (severe OSA [AHI ≥ 30/h] 11.6{\%}). In mixed effects regressions, AHI was positively associated with EEG slowing ratio and EEG power across all frequency bands in REM sleep (all p < 0.05); and with beta power during NREM sleep (p = 0.06). Similar associations were observed with oxygen desaturation index (3{\%}). Percentage total sleep time with oxygen saturation <90{\%} was only significantly associated with increased delta, theta, and alpha EEG power in REM sleep. No associations with subjective sleepiness were observed. Conclusions: In a large sample of community-dwelling men, OSA was significantly associated with increased EEG power and EEG slowing predominantly in REM sleep, independent of insomnia. Further study is required to assess if REM EEG slowing related to nocturnal hypoxemia is more sensitive than standard PSG indices or sleepiness in predicting cognitive decline.",
keywords = "insomnia, obstructive sleep apnea, power spectral analysis, quantitative EEG analysis, sleep disordered breathing",
author = "Sarah Appleton and Andrew Vakulin and Angela D'Rozario and Andrew Vincent and Alison Teare and Sean Martin and Gary Wittert and McEvoy, {R. Doug} and Catcheside, {Peter G.} and Robert Adams",
year = "2019",
month = "4",
day = "23",
doi = "10.1093/sleep/zsz092",
language = "English",
volume = "42",
journal = "Sleep",
issn = "0161-8105",
publisher = "American Academy of Sleep Medicine",
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Quantitative electroencephalography measures in rapid eye movement and nonrapid eye movement sleep are associated with apnea-hypopnea index and nocturnal hypoxemia in men. / Appleton, Sarah; Vakulin, Andrew; D'Rozario, Angela; Vincent, Andrew; Teare, Alison; Martin, Sean; Wittert, Gary; McEvoy, R. Doug; Catcheside, Peter G.; Adams, Robert.

In: Sleep, Vol. 42, No. 7, zsz092, 23.04.2019.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Quantitative electroencephalography measures in rapid eye movement and nonrapid eye movement sleep are associated with apnea-hypopnea index and nocturnal hypoxemia in men

AU - Appleton, Sarah

AU - Vakulin, Andrew

AU - D'Rozario, Angela

AU - Vincent, Andrew

AU - Teare, Alison

AU - Martin, Sean

AU - Wittert, Gary

AU - McEvoy, R. Doug

AU - Catcheside, Peter G.

AU - Adams, Robert

PY - 2019/4/23

Y1 - 2019/4/23

N2 - Study Objectives: Quantitative electroencephalography (EEG) measures of sleep may identify vulnerability to obstructive sleep apnea (OSA) sequelae, however, small clinical studies of sleep microarchitecture in OSA show inconsistent alterations. We examined relationships between quantitative EEG measures during rapid eye movement (REM) and non-REM (NREM) sleep and OSA severity among a large population-based sample of men while accounting for insomnia. Methods: All-night EEG (F4-M1) recordings from full in-home polysomnography (Embletta X100) in 664 men with no prior OSA diagnosis (age ≥ 40) were processed following exclusion of artifacts. Power spectral analysis included non-REM and REM sleep computed absolute EEG power for delta, theta, alpha, sigma, and beta frequency ranges, total power (0.5-32 Hz) and EEG slowing ratio. Results: Apnea-hypopnea index (AHI) ≥10/h was present in 51.2% (severe OSA [AHI ≥ 30/h] 11.6%). In mixed effects regressions, AHI was positively associated with EEG slowing ratio and EEG power across all frequency bands in REM sleep (all p < 0.05); and with beta power during NREM sleep (p = 0.06). Similar associations were observed with oxygen desaturation index (3%). Percentage total sleep time with oxygen saturation <90% was only significantly associated with increased delta, theta, and alpha EEG power in REM sleep. No associations with subjective sleepiness were observed. Conclusions: In a large sample of community-dwelling men, OSA was significantly associated with increased EEG power and EEG slowing predominantly in REM sleep, independent of insomnia. Further study is required to assess if REM EEG slowing related to nocturnal hypoxemia is more sensitive than standard PSG indices or sleepiness in predicting cognitive decline.

AB - Study Objectives: Quantitative electroencephalography (EEG) measures of sleep may identify vulnerability to obstructive sleep apnea (OSA) sequelae, however, small clinical studies of sleep microarchitecture in OSA show inconsistent alterations. We examined relationships between quantitative EEG measures during rapid eye movement (REM) and non-REM (NREM) sleep and OSA severity among a large population-based sample of men while accounting for insomnia. Methods: All-night EEG (F4-M1) recordings from full in-home polysomnography (Embletta X100) in 664 men with no prior OSA diagnosis (age ≥ 40) were processed following exclusion of artifacts. Power spectral analysis included non-REM and REM sleep computed absolute EEG power for delta, theta, alpha, sigma, and beta frequency ranges, total power (0.5-32 Hz) and EEG slowing ratio. Results: Apnea-hypopnea index (AHI) ≥10/h was present in 51.2% (severe OSA [AHI ≥ 30/h] 11.6%). In mixed effects regressions, AHI was positively associated with EEG slowing ratio and EEG power across all frequency bands in REM sleep (all p < 0.05); and with beta power during NREM sleep (p = 0.06). Similar associations were observed with oxygen desaturation index (3%). Percentage total sleep time with oxygen saturation <90% was only significantly associated with increased delta, theta, and alpha EEG power in REM sleep. No associations with subjective sleepiness were observed. Conclusions: In a large sample of community-dwelling men, OSA was significantly associated with increased EEG power and EEG slowing predominantly in REM sleep, independent of insomnia. Further study is required to assess if REM EEG slowing related to nocturnal hypoxemia is more sensitive than standard PSG indices or sleepiness in predicting cognitive decline.

KW - insomnia

KW - obstructive sleep apnea

KW - power spectral analysis

KW - quantitative EEG analysis

KW - sleep disordered breathing

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U2 - 10.1093/sleep/zsz092

DO - 10.1093/sleep/zsz092

M3 - Article

VL - 42

JO - Sleep

T2 - Sleep

JF - Sleep

SN - 0161-8105

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