Prolonged partial obstruction during sleep is a NREM phenomenon

Himanen, Sari-Leena; Martikkala, Lauri; Sulkamo, Saramia; Rutanen, Antti; Huupponen, Eero; Tenhunen, Mirja; Saunamäki, Tiia

doi:10.1016/j.resp.2018.05.009

Cited by 2 publications

(1 citation statement)

References 54 publications

(63 reference statements)

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“…Arousals induce less ventilatory instability in females, thereby protecting them from OSA. Prolonged episodes of partial upper airway obstruction [25][26][27][28] typically appear in slow-wave sleep and are associated with increased carbon dioxide (CO 2 ) levels [29][30][31]. Importantly, prolonged partial upper airway obstruction is far more common than "conventional" sleep apnoea in females [32].…”

Section: Clinical Presentationmentioning

confidence: 99%

Sex differences in obstructive sleep apnoea

2019

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Obstructive sleep apnoea (OSA) and obstructive sleep apnoea/hypopnoea syndrome (OSAHS) have long been considered predominantly male-related conditions. The clinical presentation of sleep disordered breathing in females differs from males and can vary with age and physiological status,e.g.menopause and pregnancy. Overall, females appear to be more symptomatic, with lower apnoea–hypopnoea index scores compared to males. Furthermore, they appear to have more prolonged partial upper airway obstruction, and may report insomnia as a symptom of OSAHS more frequently. As a consequence of these differences in clinical presentation, females with sleep disordered breathing are often underdiagnosed and undertreated compared to males. This review is aimed at discussing the epidemiology, clinical presentation, pathophysiology and hormonal and metabolic differences in females who present with OSA/OSAHS in comparison to males.

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Section: Clinical Presentationmentioning

confidence: 99%

Sex differences in obstructive sleep apnoea

2019

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Altered K-complex morphology during sustained inspiratory airflow limitation is associated with next-day lapses in vigilance in obstructive sleep apnea

Parekh

Kam

Mullins

et al. 2021

Sleep

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Study Objectives Determine if changes in K-complexes associated with sustained inspiratory airflow limitation (SIFL) during N2 sleep are associated with next-day vigilance and objective sleepiness. Methods Data from thirty subjects with moderate-to-severe obstructive sleep apnea who completed three in-lab polysomnograms: diagnostic, on therapeutic continuous positive airway pressure (CPAP), and on suboptimal CPAP (4 cmH2O below optimal titrated CPAP level) were analyzed. Four 20-min psychomotor vigilance tests (PVT) were performed after each PSG, every 2 h. Changes in the proportion of spontaneous K-complexes and spectral characteristics surrounding K-complexes were evaluated for K-complexes associated with both delta (∆SWAK), alpha (∆αK) frequencies. Results Suboptimal CPAP induced SIFL (14.7 (20.9) vs 2.9 (9.2); %total sleep time, p < 0.001) with a small increase in apnea–hypopnea index (AHI3A: 6.5 (7.7) vs 1.9 (2.3); p < 0.01) versus optimal CPAP. K-complex density (num./min of stage N2) was higher on suboptimal CPAP (0.97 ± 0.7 vs 0.65±0.5, #/min, mean ± SD, p < 0.01) above and beyond the effect of age, sex, AHI3A, and duration of SIFL. A decrease in ∆SWAK with suboptimal CPAP was associated with increased PVT lapses and explained 17% of additional variance in PVT lapses. Within-night during suboptimal CPAP K-complexes appeared to alternate between promoting sleep and as arousal surrogates. Electroencephalographic changes were not associated with objective sleepiness. Conclusions Sustained inspiratory airflow limitation is associated with altered K-complex morphology including the increased occurrence of K-complexes with bursts of alpha as arousal surrogates. These findings suggest that sustained inspiratory flow limitation may be associated with nonvisible sleep fragmentation and contribute to increased lapses in vigilance.

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Prolonged partial obstruction during sleep is a NREM phenomenon

Cited by 2 publications

References 54 publications

Sex differences in obstructive sleep apnoea

Sex differences in obstructive sleep apnoea

Altered K-complex morphology during sustained inspiratory airflow limitation is associated with next-day lapses in vigilance in obstructive sleep apnea

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