Sleep and respiratory stimulus specific dampening of cortical responsiveness in OSAS

Afifi, Lamia; Guilleminault, Christian; Colrain, Ian M.

doi:10.1016/s1569-9048(03)00084-3

Cited by 72 publications

(61 citation statements)

References 49 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In the present study, we confirmed those results and also showed blunting of the N550 peak and delayed latency, which has been well documented in adults (17,28). Importantly, this study demonstrated no RREP improvement after treatment of OSAS.…”

Section: Rrep During Sleepsupporting

confidence: 92%

“…Because all these peaks were present in OSAS and control subjects, this finding suggests that OSAS does not affect the children's ability to properly process auditory information during sleep. 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).…”

Section: Aep During Sleepsupporting

confidence: 92%

“…These data suggest that the abnormalities in central nervous system processing of afferent signals in children with OSAS during sleep are limited to respiratory stimuli. This is similar to adults with OSAS, who have been shown to have normal early RREP components during wakefulness, blunted longer latency RREP components during sleep, but to have normal AEP components during wakefulness and sleep (17)(18)(19)(20).…”

Section: Discussionsupporting

confidence: 72%

See 2 more Smart Citations

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

Huang¹,

Marcus²,

Davenport³

et al. 2013

Am J Respir Crit Care Med

Self Cite

View full text Add to dashboard Cite

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...

show abstract

Section: Rrep During Sleepsupporting

confidence: 92%

Section: Aep During Sleepsupporting

confidence: 92%

Section: Discussionsupporting

confidence: 72%

See 1 more Smart Citation

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

Huang¹,

Marcus²,

Davenport³

et al. 2013

Am J Respir Crit Care Med

Self Cite

View full text Add to dashboard Cite

show abstract

“…However, given the state-dependent nature of the disorder, how sensory impairment during wakefulness affects upper airway function during sleep is unclear (142). Consistent with a state-dependent phenomenon, sensory processing of respiratory afferent information as measured by cortical evoked potentials has been shown to be impaired in OSA during sleep but not during wakefulness (143,144). Thus, adaptive compensatory mechanisms may ensure a patent airway during wakefulness in OSA despite impaired upper airway sensory function, but are less able to do so during sleep.…”

Section: Upper Airway Sensory Neuropathy/impaired Sensory Processingmentioning

confidence: 99%

Pathophysiology of Adult Obstructive Sleep Apnea

Eckert¹,

Malhotra²

2008

Proceedings of the American Thoracic Society

510

321

View full text Add to dashboard Cite

Obstructive sleep apnea (OSA) is a common disorder characterized by repetitive narrowing or collapse of the pharyngeal airway during sleep. The disorder is associated with major comorbidities including excessive daytime sleepiness and increased risk of cardiovascular disease. The underlying pathophysiology is multifactorial and may vary considerably between individuals. Important risk factors include obesity, male sex, and aging. However, the physiological mechanisms underlying these risk factors are not clearly understood. This brief review summarizes the current understanding of OSA pathophysiology in adults and highlights the potential mechanisms underlying the principal risk factors. In addition, some of the pathophysiological characteristics associated with OSA that may modulate disease severity are illustrated. Finally, the potential for novel treatment strategies, based on an improved understanding of the underlying pathophysiology, is also discussed with the ultimate aim of stimulating research ideas in areas where knowledge is lacking.

show abstract

“…The respiratory-related evoked potentials (RREPs) during wakefulness in OSA revealed a reduction in the amplitude but not the latency of the early RREP components [44,47] reflecting sensory processing is reduced in the OSA patients [48]. Other studies revealed no changes [49][50][51].…”

Section: Sleep Apnea -Recent Updatesmentioning

confidence: 94%

Nerve and Muscle Changes in the Upper Airways of Subjects with Obstructive Sleep Apnea: Structural Basis for the Neurogenic Theory

Cobo¹,

Macías²,

Alvarez³

et al. 2017

Sleep Apnea - Recent Updates

View full text Add to dashboard Cite

Obstructive sleep apnea syndrome (OSAS) is a widely diffused disease associated with specific genetics, age, gender, craniofacial and upper airways anatomy, obesity, and endocrine conditions, but not with ethnicity profiles. The so-called neurogenic neurogenic theory of OSAS postulates that the collapse of the upper airways that characterize this disease is due to peripheral nerve degeneration that leads to muscle atrophy and collapse. This review attempts to summarize the structural and functional changes in both the sensory and motor innervation of the walls of the upper air ways in patients suffering from OSAS.

show abstract

Sleep and respiratory stimulus specific dampening of cortical responsiveness in OSAS

Cited by 72 publications

References 49 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

Pathophysiology of Adult Obstructive Sleep Apnea

Nerve and Muscle Changes in the Upper Airways of Subjects with Obstructive Sleep Apnea: Structural Basis for the Neurogenic Theory

Contact Info

Product

Resources

About