ERP Evidence of Enhanced Excitatory and Reduced Inhibitory Processes of Auditory Stimuli During Sleep in Patients With Primary Insomnia

Yang, Chien‐Ming; Lo, Hsiao-Sui

doi:10.1093/sleep/30.5.585

Cited by 61 publications

(38 citation statements)

References 38 publications

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“…This is similar to a previous study in adults with OSAS, in which the main AEP outcome was N550 (17). In the current study we documented the presence of a P900 as well, which has been reported to increase with the deepening of sleep, and has been associated with maintenance of sleep (33,34). Therefore, the presence of this peak in children with OSAS is consistent with one of the main differences between adult and pediatric OSAS: the conserved sleep architecture in children with OSAS (35).…”

Section: Aep During Sleepsupporting

confidence: 92%

Respiratory and Auditory Cortical Processing in Children with Obstructive Sleep Apnea Syndrome

Huang¹,

Marcus²,

Davenport³

et al. 2013

Am J Respir Crit Care Med

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Rationale: Children with obstructive sleep apnea syndrome (OSAS) have impaired cortical processing of respiratory afferent stimuli, manifested by blunted sleep respiratory-related evoked potentials (RREP). However, whether this impairment is limited to respiratory stimuli, or reversible after successful treatment, is unknown. We hypothesized that, during sleep, children with OSAS have (1) abnormal RREP, (2) normal cortical processing of nonrespiratory stimuli, and (3) persistence of abnormal RREP after treatment. Objectives: To measure sleep RREP and auditory evoked potentials in normal control subjects and children with OSAS before and after treatment. Methods: Twenty-four children with OSAS and 24 control subjects were tested during N3 sleep. Thirteen children with OSAS repeated testing 4-6 months after adenotonsillectomy. Measurements and Main Results: RREP were blunted in OSAS compared with control subjects (N350 at Cz 227 6 15.5 vs. 247.4 6 28.5 mV; P ¼ 0.019), and did not improve after OSAS treatment (N350 at Cz pretreatment 225.1 6 7.4 vs. 229.8 6 8.1 posttreatment). Auditory evoked potentials were similar in OSAS and control subjects at baseline (N350 at Cz 258 6 33.1 vs. 266 6 31.1 mV), and did not change after treatment (N350 at Cz 267.5 6 36.8 vs. 6 20.3).Conclusions: Children with OSAS have persistent primary or irreversible respiratory afferent cortical processing deficits during sleep that could put them at risk of OSAS recurrence. OSAS does not seem to affect the cortical processing of nonrespiratory (auditory) afferent stimuli during sleep.Keywords: evoked potentials; children; auditory; respiratory; obstructive sleep apnea syndromeThe pathophysiology of the childhood obstructive sleep apnea syndrome (OSAS) is not clear. In most children, OSAS is related to adenotonsillar hypertrophy or obesity. However, these structural factors cannot fully explain the degree of upper airway collapsibility (1, 2). Studies have shown that upper airway neuromotor tone and reflexes during sleep play an important role in maintaining airway patency during sleep in the pediatric population (3, 4). Recently, it has been shown that central nervous system processing of upper airway respiratory stimuli is abnormal during sleep in children with OSAS (5). However, it is not known whether this abnormal afferent processing is limited to respiratory stimuli, or whether it is an indicator of broader abnormalities in stimulus processing, secondary to the hypoxemia, hypercapnia, and sleep fragmentation of OSAS. Furthermore, it is not known whether this deficit resolves after treatment of OSAS. Determining reversibility would help elucidate whether the blunted responses were a primary and perhaps predisposing abnormality, or were secondary to the OSAS.Respiratory-related evoked potentials (RREP) have been used to study the central nervous system processing of upper airway stimuli (6, 7). Auditory evoked potentials (AEP) are a useful tool to investigate cortical responses to nonrespiratory stimuli and produce the same set of longer...

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Section: Aep During Sleepsupporting

confidence: 92%

Respiratory and Auditory Cortical Processing in Children with Obstructive Sleep Apnea Syndrome

Huang¹,

Marcus²,

Davenport³

et al. 2013

Am J Respir Crit Care Med

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“…The authors did not observe any between group differences, from evening to morning, when insomnia individuals were compared to GS. On the other hand, Yang and Lo (2007) observed a larger N1 and a smaller P2 in individuals with insomnia than in GS during the first 5 min of continuous stage 2 sleep, supporting the hyperarousal hypothesis. Recently, our research group recorded ERPs over multiple nights during wakefulness and sleep onset as an oddball paradigm was delivered to Psy-I and GS during the 3rd and 4th nights in the sleep laboratory (in the evening and upon awakening), with the addition of sleep-onset recordings on the 4th night.…”

Section: Introductionmentioning

confidence: 53%

“…If individuals with insomnia are unable to inhibit information processing, it would be expected that the changes from the waking ERPs to the sleeping one would be different from what is generally observed among GS. Although hyperarousal has already been investigated using the ERPs technique with insomnia individuals Devoto et al, 2005;Kertesz and Cote, 2011;Sforza and Haba-Rubio, 2006;Yang and Lo, 2007), the inability to inhibit information processing during sleep onset as well as during sleep itself remains to be clarified. The poor sleep experienced by insomnia individuals may be the result of an inability to inhibit external information processing of irrelevant stimulus during sleep onset and sleep and this enhanced information processing may result in hyperarousal.…”

Section: Introductionmentioning

confidence: 99%

Are individuals with paradoxical insomnia more hyperaroused than individuals with psychophysiological insomnia? Event-related potentials measures at the peri-onset of sleep

Turcotte

St-Jean

Bastien

2011

International Journal of Psychophysiology

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“…First, Yang and Lo (2007) reported that insomniacs show larger N1 and smaller P2 to rare tones as well as smaller N350 to standard tones than controls during the first 5 min of continuous stage 2 sleep. However, observed that during the different stages of sleep, and contrary to what Yang and Lo (2007) had reported, insomniacs and good sleepers did not differ on measures of N1 and P2 during the night. Thus the issue of hyperarousal during the night, as measured with ERPs, requires more investigations as contradictory results are reported to this point.…”

Section: Event-related Potentials (Erps)mentioning

confidence: 99%

Insomnia: Neurophysiological and NeuropsychologicalApproaches

Bastien

2011

Neuropsychol Rev

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Insomnia is a symptom, a syndrome and a comorbid disorder. Its diagnosis relies on subjective reports from the afflicted individual and is defined as difficulties in initiating sleep, maintaining sleep, waking up too early or non-restorative sleep. However, insomnia and especially, primary insomnia, has received much attention in insomnia research with the use of objective measures. Insomnia, its peculiarities, most frequent subtypes and two most prominent models will first be briefly introduced. Then, insomnia will be reviewed according to results obtained with the use of neurophysiological measures as basic/traditional as polysomnography to more sophisticated ones such as power spectral analysis, neuroimaging, cyclic alternating patterns and event-related potentials. In addition, a review of the discrepancies between subjective and objective reports of cognitive alterations through neuropsychological testing is offered. The need to combine measures is then highlighted in conclusion.

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ERP Evidence of Enhanced Excitatory and Reduced Inhibitory Processes of Auditory Stimuli During Sleep in Patients With Primary Insomnia

Cited by 61 publications

References 38 publications

Respiratory and Auditory Cortical Processing in Children with Obstructive Sleep Apnea Syndrome

Respiratory and Auditory Cortical Processing in Children with Obstructive Sleep Apnea Syndrome

Are individuals with paradoxical insomnia more hyperaroused than individuals with psychophysiological insomnia? Event-related potentials measures at the peri-onset of sleep

Insomnia: Neurophysiological and NeuropsychologicalApproaches

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