scholarly journals The Importance of Sleep Fragmentation on the Hemodynamic Dipping in Obstructive Sleep Apnea Patients

2020 ◽  
Vol 11 ◽  
Author(s):  
Richard Staats ◽  
Inês Barros ◽  
Dina Fernandes ◽  
Dina Grencho ◽  
Cátia Reis ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Sleep Fragmentation ◽  
Obstructive Sleep

scholarly journals Differential associations of hypoxia, sleep fragmentation, and depressive symptoms with cognitive dysfunction in obstructive sleep apnea

SLEEP ◽  
2020 ◽  
Author(s):  
Ridwan M Alomri ◽  
Gerard A Kennedy ◽  
Siraj Omar Wali ◽  
Faris Ahejaili ◽  
Stephen R Robinson
Keyword(s):  
Obstructive Sleep Apnea ◽  
Depressive Symptoms ◽  
Sleep Apnea ◽  
Sustained Attention ◽  
Sleep Fragmentation ◽  
Sleep Disruption ◽  
Visuospatial Ability ◽  
Treatment Interventions ◽  
Visuospatial Deficits ◽  
Obstructive Sleep

Abstract Obstructive sleep apnea (OSA) is characterized by recurrent episodes of partial or complete cessation of breathing during sleep and increased effort to breathe. This study examined patients who underwent overnight polysomnographic studies in a major sleep laboratory in Saudi Arabia. The study aimed to determine the extent to which intermittent hypoxia, sleep disruption, and depressive symptoms are independently associated with cognitive impairments in OSA. In the sample of 90 participants, 14 had no OSA, 30 mild OSA, 23 moderate OSA, and 23 severe OSA. The findings revealed that hypoxia and sleep fragmentation are independently associated with impairments of sustained attention and reaction time (RT). Sleep fragmentation, but not hypoxia, was independently associated with impairments in visuospatial deficits. Depressive symptoms were independently associated with impairments in the domains of sustained attention, RT, visuospatial ability, and semantic and episodic autobiographical memories. Since the depressive symptoms are independent of hypoxia and sleep fragmentation, effective reversal of cognitive impairment in OSA may require treatment interventions that target each of these factors.

scholarly journals The Association between Obstructive Sleep Apnea and Post Traumatic Stress Disorder

2021 ◽  
pp. 1-4
Author(s):  
Hani Raoul Khouzam ◽  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Stress Disorder ◽  
Sleep Fragmentation ◽  
Post Traumatic Stress ◽  
Accurate Identification ◽  
Sleep Related Breathing Disorders ◽  
Treatment Interventions ◽  
Appropriate Treatment ◽  
Obstructive Sleep

Obstructive sleep apnea (OSA)is a type of sleep-related breathing disorders which is associated with frequent awakenings leading to sleep fragmentation. Posttraumatic stress disorder (PTSD) is a psychiatric disorder that is also associated with sleep fragmentation and disruption. A possible link between OSA and PTSD needs to be accurately identified in patients who present with either OSA or PTSD. This article will review the diagnostic criteria of OSA and PTSD, the proposed link between these two distinct clinical entities and the treatment interventions for both disorders. The accurate identification and appropriate treatment of OSA and PTSD would ultimately prevent sleep disruption and its serious medical and mental complications, leading to improved functioning in patients whose lives are adversely impacted by these disabling medical and mental disorders.

scholarly journals Sleep Fragmentation in Obstructive Sleep Apnea

SLEEP ◽  
1996 ◽  
Vol 19 (suppl_9) ◽  
pp. S61-S66 ◽  
Author(s):  
R. John Kimoff
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Sleep Fragmentation ◽  
Obstructive Sleep

scholarly journals Increased sympathetic responses induced by chronic obstructive sleep apnea are caused by sleep fragmentation

2020 ◽  
Vol 129 (1) ◽  
pp. 163-172 ◽  
Author(s):  
Caroline B. Ferreira ◽  
Guus H. Schoorlemmer ◽  
Antonio A. Rocha ◽  
Sergio L. Cravo
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Sleep Fragmentation ◽  
Sleep Disruption ◽  
Chronic Obstructive ◽  
Sympathetic Activation ◽  
Pathophysiologic Mechanism ◽  
Obstructive Sleep ◽  
Sympathetic Responses

Obstructive sleep apnea causes a hyperactive chemoreflex, with increased sympathetic activation. However, it is not clear whether this pathophysiologic mechanism is due to repeated hypoxia or to sleep disruption. The present study suggests that sleep fragmentation contributes importantly to increased sympathetic activation after chemoreceptor stimulation. This suggests that sleep fragmentation has an important role in the sympathetic activation seen in sleep apnea patients.

Neuropsychological Consequences of Sleep-Disordered Breathing

2010 ◽  
Author(s):  
Jennifer Janusz ◽  
Ann Halbower
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Airway Obstruction ◽  
Sleep Disordered Breathing ◽  
Upper Airway ◽  
Sleep Fragmentation ◽  
Primary Snoring ◽  
Respiratory Events ◽  
Obstructive Sleep ◽  
Disordered Breathing

Pediatric sleep disorders have been gaining awareness among practitioners due to their potential for cognitive, behavioral, and somatic effects (Gozal 2008; Moore et al. 2006). Sleep-disordered breathing (SDB) is commonly seen in children and encompasses a range of disorders, in primary snoring to obstructive sleep apnea (Marcus 2000). Sleep-disordered breathing is characterized by partial or complete upper airway obstruction during sleep due to collapse or narrowing of the pharynx. This can result in sleep fragmentation due to brief arousals during the night, as well as disruption or cessation of airflow (Blunden and Beebe 2006; Halbower and Mahone 2006). This chapter describes the neuropsychological and behavioral consequences of SDB, comorbid disorders, and effects of treatment. Sleep-disordered breathing is considered a spectrum of airflow limitation, from mild to severe. For instance, primary snoring (PS), defined as snoring without oxygen desaturation or sleep arousals, is at the mild end of the spectrum. Upper airway resistance syndrome (UARS), in the middle of the spectrum, is characterized by increased negative intrathoracic pressure with sleep arousals and sleep fragmentation but no oxygen desaturations (Bao and Guilleminault 2004; Garetz 2008; Lumeng and Chervin 2008). In obstructive sleep apnea (OSA), at the severe end of the spectrum, there are repeated episodes of blockage of the airway with changes in oxygenation. Obstructive sleep apnea results from a combination of factors, including anatomical obstruction from adenoids, tonsils, or a narrow pharynx, and decreased neuromuscular tone required to maintain airway patency (Arens and Marcus 2004). An overnight polysomnogram (PSG) completed in a sleep laboratory and measuring sleep–wake states, respiration, movement, blood levels of oxygen and carbon dioxide, and cardiac activity, is considered the “gold standard” for the diagnosis of OSA (American Academy of Pediatrics 2002). The PSG is used to diagnose respiratory events, cardiac changes, and arousals from different sleep states. Respiratory events include obstructive apneas and hypopneas. Obstructive apnea events are episodes of complete airway obstruction, while hypopneas are partial obstructions or airflow limitations (Garetz 2008; Redline et al. 2007).

scholarly journals Independent Association between Sleep Fragmentation and Dyslipidemia in Patients with Obstructive Sleep Apnea

2016 ◽  
Vol 6 (1) ◽  
Author(s):  
Yingjun Qian ◽  
Hongliang Yi ◽  
Jianyin Zou ◽  
Lili Meng ◽  
Xulan Tang ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Sleep Fragmentation ◽  
Obstructive Sleep ◽  
Independent Association

Effect of obstructive sleep apnea versus sleep fragmentation on responses to airway occlusion.

1997 ◽  
Vol 155 (5) ◽  
pp. 1609-1617 ◽  
Author(s):  
D Brooks ◽  
R L Horner ◽  
R J Kimoff ◽  
L F Kozar ◽  
C L Render-Teixeira ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Sleep Fragmentation ◽  
Airway Occlusion ◽  
Obstructive Sleep

scholarly journals Assessment of Obstructive Sleep Apnea-Related Sleep Fragmentation Utilizing Deep Learning-Based Sleep Staging from Photoplethysmography

SLEEP ◽  
2021 ◽  
Author(s):  
R Huttunen ◽  
T Leppänen ◽  
B Duce ◽  
A Oksenberg ◽  
S Myllymaa ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Deep Learning ◽  
Sleep Apnea ◽  
Proportional Hazards ◽  
Cox Proportional Hazards ◽  
Sleep Fragmentation ◽  
Sleep Staging ◽  
Hazard Ratios ◽  
Obstructive Sleep ◽  
The Relationship

Abstract Study Objectives To assess the relationship between obstructive sleep apnea (OSA) severity and sleep fragmentation, accurate differentiation between sleep and wakefulness is needed. Sleep staging is usually performed manually using electroencephalography (EEG). This is time-consuming due to complexity of EEG setup and the amount of work in manual scoring. In this study, we aimed to develop an automated deep learning-based solution to assess OSA-related sleep fragmentation based on photoplethysmography (PPG)-signal. Methods A combination of convolutional and recurrent neural networks was used for PPG-based sleep staging. The models were trained using two large clinical datasets from Israel (n=2149) and Australia (n=877) and tested separately on three-class (wake/NREM/REM), four-class (wake/N1+N2/N3/REM), and five-class (wake/N1/N2/N3/REM) classification. The relationship between OSA severity categories and sleep fragmentation was assessed using survival analysis of mean continuous sleep. Overlapping PPG epochs were applied to artificially obtain denser hypnograms for better identification of fragmented sleep. Results Automatic PPG-based sleep staging showed accuracy of 83.3% on three-class, 74.1% on four-class, and 68.7% on five-class models. The hazard ratios for decreased mean continuous sleep compared to the non-OSA group obtained with Cox proportional hazards models with 5-second epoch-to-epoch intervals were 1.70, 3.30, and 8.11 for mild, moderate, and severe OSA, respectively. With manually scored EEG-based hypnograms, the corresponding hazard ratios were 1.18, 1.78, and 2.90. Conclusions PPG-based automatic sleep staging can be used to differentiate between OSA severity categories based on sleep continuity. The differences between the OSA severity categories become more apparent when a shorter epoch-to-epoch interval is used.

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