Interhemispheric sleep depth coherence predicts driving safety in sleep apnea

Azarbarzin, Ali; Younes, Magdy; Sands, Scott A.; Wellman, Andrew; Redline, Susan; Czeisler, Charles A.; Gottlieb, Daniel J.

doi:10.1111/jsr.13092

Cited by 17 publications

(10 citation statements)

References 41 publications

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“…ORP differences could be identified between OSA and insomnia (Younes et al, 2021). ORP measures have been found to predict driving accidents in OSA, suggesting a relationship with alertness and/or cognition (Azarbarzin et al, 2020) coherence", a metric derived from correlation between right and left brain hemisphere ORP across the night (Azarbarzin et al, 2020). The authors posited that interhemispheric sleep depth coherence may be related to altered interhemispheric functional connectivity, and higher interhemispheric sleep depth coherence may confer some protection against OSA-related neurocognitive dysfunction.…”

Section: Orp In Osamentioning

confidence: 99%

Sleep electroencephalography biomarkers of cognition in obstructive sleep apnea

Gagnon

Kamińska

2023

Journal of Sleep Research

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SummaryObstructive sleep apnea has been associated with cognitive impairment and may be linked to disorders of cognitive function. These associations may be a result of intermittent hypoxaemia, sleep fragmentation and changes in sleep microstructure in obstructive sleep apnea. Current clinical metrics of obstructive sleep apnea, such as the apnea–hypopnea index, are poor predictors of cognitive outcomes in obstructive sleep apnea. Sleep microstructure features, which can be identified on sleep electroencephalography of traditional overnight polysomnography, are increasingly being characterized in obstructive sleep apnea and may better predict cognitive outcomes. Here, we summarize the literature on several major sleep electroencephalography features (slow‐wave activity, sleep spindles, K‐complexes, cyclic alternating patterns, rapid eye movement sleep quantitative electroencephalography, odds ratio product) identified in obstructive sleep apnea. We will review the associations between these sleep electroencephalography features and cognition in obstructive sleep apnea, and examine how treatment of obstructive sleep apnea affects these associations. Lastly, evolving technologies in sleep electroencephalography analyses will also be discussed (e.g. high‐density electroencephalography, machine learning) as potential predictors of cognitive function in obstructive sleep apnea.

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Section: Orp In Osamentioning

confidence: 99%

Sleep electroencephalography biomarkers of cognition in obstructive sleep apnea

Gagnon

Kamińska

2023

Journal of Sleep Research

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“…associated health consequences (Younes and Giannouli, 2020;Azarbarzin et al, 2021;Younes et al, 2021). For example, sleep depth coherence between C3 and C4 channels measured using the ORP is associated with risk of motor vehicle crashes (Azarbarzin et al, 2021). A higher ORP during NREM sleep is also associated with the presence of OSA and insomnia, consistent with a more "alert" brain during NREM sleep in people with OSA and insomnia (Younes et al, 2021).…”

Section: The Odds Ratio Productmentioning

confidence: 99%

“…The transition from arousal to N2 sleep is also very specific, with a reduction in high frequency power, a sparse low frequency burst (likely reflecting K-complexes), sometimes followed by a burst of 12-16 Hz activity. associated health consequences (Younes and Giannouli, 2020;Azarbarzin et al, 2021;Younes et al, 2021). For example, sleep depth coherence between C3 and C4 channels measured using the ORP is associated with risk of motor vehicle crashes (Azarbarzin et al, 2021).…”

Section: The Odds Ratio Productmentioning

confidence: 99%

New and Emerging Approaches to Better Define Sleep Disruption and Its Consequences

et al. 2021

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Current approaches to quantify and diagnose sleep disorders and circadian rhythm disruption are imprecise, laborious, and often do not relate well to key clinical and health outcomes. Newer emerging approaches that aim to overcome the practical and technical constraints of current sleep metrics have considerable potential to better explain sleep disorder pathophysiology and thus to more precisely align diagnostic, treatment and management approaches to underlying pathology. These include more fine-grained and continuous EEG signal feature detection and novel oxygenation metrics to better encapsulate hypoxia duration, frequency, and magnitude readily possible via more advanced data acquisition and scoring algorithm approaches. Recent technological advances may also soon facilitate simple assessment of circadian rhythm physiology at home to enable sleep disorder diagnostics even for “non-circadian rhythm” sleep disorders, such as chronic insomnia and sleep apnea, which in many cases also include a circadian disruption component. Bringing these novel approaches into the clinic and the home settings should be a priority for the field. Modern sleep tracking technology can also further facilitate the transition of sleep diagnostics from the laboratory to the home, where environmental factors such as noise and light could usefully inform clinical decision-making. The “endpoint” of these new and emerging assessments will be better targeted therapies that directly address underlying sleep disorder pathophysiology via an individualized, precision medicine approach. This review outlines the current state-of-the-art in sleep and circadian monitoring and diagnostics and covers several new and emerging approaches to better define sleep disruption and its consequences.

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“…There is growing evidence that OSA is associated with regional changes in sleep electroencephalography (EEG) pattern, reduced fMRI-measured brain connectivity or reduced functional interhemispheric connectivity [82,83]. Azabarzin et al, recently explored the functional implications of the reduced interhemispheric sleep depth coherence for motor vehicle crash risk in middle-aged and older individuals with OSA [84]. The OSA patients with the highest degree of sleep depth coherence were those with a lower risk of being in an accident [84].…”

Section: Renewal Of Drivingmentioning

confidence: 99%

“…Azabarzin et al, recently explored the functional implications of the reduced interhemispheric sleep depth coherence for motor vehicle crash risk in middle-aged and older individuals with OSA [84]. The OSA patients with the highest degree of sleep depth coherence were those with a lower risk of being in an accident [84].…”

Section: Renewal Of Drivingmentioning

confidence: 99%

Epidemiology, Physiology and Clinical Approach to Sleepiness at the Wheel in OSA Patients: A Narrative Review

Bonsignore

Lombardi

Lombardo

et al. 2022

JCM

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Sleepiness at the wheel (SW) is recognized as an important factor contributing to road traffic accidents, since up to 30 percent of fatal accidents have been attributed to SW. Sleepiness-related motor vehicle accidents may occur both from falling asleep while driving and from behavior impairment attributable to sleepiness. SW can be caused by various sleep disorders but also by behavioral factors such as sleep deprivation, shift work and non-restorative sleep, as well as chronic disease or the treatment with drugs that negatively affect the level of vigilance. An association between obstructive sleep apnea (OSA) and motor vehicle accidents has been found, with an increasing risk in OSA patients up to sevenfold in comparison to the general population. Regular treatment with continuous positive airway pressure (CPAP) relieves excessive daytime sleepiness and reduces the crash risk. Open questions still remain about the physiological and clinical determinants of SW in OSA patients: the severity of OSA in terms of the frequency of respiratory events (apnea hypopnea index, AHI) or hypoxic load, the severity of daytime sleepiness, concomitant chronic sleep deprivation, comorbidities, the presence of depressive symptoms or chronic fatigue. Herein, we provide a review addressing the epidemiological, physiological and clinical aspects of SW, with a particular focus on the methods to recognize those patients at risk of SW.

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Interhemispheric sleep depth coherence predicts driving safety in sleep apnea

Abstract: Obstructive sleep apnea (OSA) is a common disorder(Young et al., 1993) associated with adverse cardiometabolic (Nieto

Cited by 17 publications

References 41 publications

Sleep electroencephalography biomarkers of cognition in obstructive sleep apnea

Sleep electroencephalography biomarkers of cognition in obstructive sleep apnea

New and Emerging Approaches to Better Define Sleep Disruption and Its Consequences

Epidemiology, Physiology and Clinical Approach to Sleepiness at the Wheel in OSA Patients: A Narrative Review

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