Cyclic Alternating Pattern in Obstructive Sleep Apnea Patients with versus without Excessive Sleepiness

Korkmaz, Selda; Bilecenoglu, Nedime Tugce; Aksu, Murat; Yoldaş, Tahir Kurtuluş

doi:10.1155/2018/8713409

Cited by 22 publications

(13 citation statements)

References 31 publications

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“…In our DoA sample, the excess of SWS probably accounted for the lack of sleepiness in most patients (77%). On the contrary, in the SHE group, the protective action of N3 on daytime vigilance was counteracted by an excessive amount of CAP rate, a magnitude already described in severe obstructive sleep apnea (27)(28)(29), which is often accompanied by daytime sleepiness. The supplement of unstable sleep in the SHE group is fueled by a number of disturbing factors including ictal and interictal EEG paroxysms acting as noise equivalents on the neural circuitry (Figure 3).…”

Section: Sleep Texturementioning

confidence: 84%

Commonalities and Differences in NREM Parasomnias and Sleep-Related Epilepsy: Is There a Continuum Between the Two Conditions?

et al. 2020

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Introduction: Differential diagnosis between disorders of arousal (DoA) and sleep-related hypermotor epilepsy (SHE) often represents a clinical challenge. The two conditions may be indistinguishable from a semiological point of view and the scalp video-polysomnography is often uninformative. Both disorders are associated with variable hypermotor manifestations ranging from major events to fragments of a hierarchical continuum of increasing intensity, complexity, and duration. Given their semiological overlap we decided to explore the sleep texture of DoA and SHE seeking for similarities and differences.Methods: We analyzed sleep macrostructure and CAP (cyclic alternating pattern) parameters in a cohort of 35 adult DoA patients, 40 SHE patients and 24 healthy sleepers, all recorded and scored in the same sleep laboratory. Nocturnal behavioral manifestations included minor motor events, paroxysmal arousals and major attacks in SHE, and simple, rising, or complex arousal movements in DoA.Results: Compared to healthy controls, DoA and SHE showed similar amounts of sleep efficiency, light sleep, deep sleep, REM sleep, CAP subtypes. Both groups also showed slow wave sleep fragmentation and an increased representation of stage N3 in the second part of the night. The only discriminating elements between the two conditions regarded sleep length (more reduced in DoA) and sleep instability (more elevated in SHE). In DoA recordings, all motor episodes arose from NREM sleep: 37% during light NREM stages and 63% during stage N3 (simple arousal movements: 94%). In SHE recordings, 57% of major attacks occurred during stage N3.Conclusions: So far, emphasis has been placed on the differentiation of sleep-related epilepsy and NREM arousal disorders. However, the impressive analogies between DoA and SHE suggest the existence of an underestimated continuum across the conditions, linked by increased levels of sleep instability, higher amounts of slow wave sleep and NREM/REM sleep imbalance. Sleep texture is extremely similar in the two conditions, although CAP metrics disclose quantitative differences. In particular, SHE patients show a higher arousal instability compared to DoA subjects. Given their clinical and epidemiological overlap, a common genetic background is also hypothesized. In such a perspective, we suggest that the consolidated dichotomy DoA vs. SHE should be reappraised.

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Section: Sleep Texturementioning

confidence: 84%

Commonalities and Differences in NREM Parasomnias and Sleep-Related Epilepsy: Is There a Continuum Between the Two Conditions?

et al. 2020

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“…In this perspective, arousals shape the individual course of night sleep as a variation of the sleep program ( Halasz et al, 2004 ). Obstructive sleep apnea hypopnea syndrome patients have increased CAP measures ( Korkmaz et al, 2018 ); therefore, they are more conditioned to suffer from nightmares and other parasomnias. Changes in the CAP, a biomarker of arousal instability in NREM sleep, are noted in NREM parasomnias ( Parrino et al, 2012 ) and some neurodegenerative diseases ( Melpignano et al, 2019 ).…”

Section: Discussionmentioning

confidence: 99%

Case Report: Parasomnia Overlap Disorder Induced by Obstructive Sleep Hypopnea Apnea Syndrome: A Case Report and Literature Review

Sun

Zhang

et al. 2020

Front. Neurosci.

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Obstructive sleep apnea hypopnea syndrome (OSAHS) and parasomnia overlap disorder (POD) are types of sleep disorders. When the symptoms of both conditions coexist, the POD symptoms are most likely caused by OSAHS. In these cases, the symptoms of POD will be relieved when OSAHS is effectively treated. We refer to these cases as symptomatic POD (related to OSAHS), which differs in pathophysiology, complications, and treatment from idiopathic POD. It is important to note that the treatment for idiopathic POD may aggravate the symptoms of OSAHS. In this case, we used video polysomnography (v-PSG) on a POD patient with suspected OSAHS to distinguish idiopathic POD from symptomatic POD, to inform the appropriate treatment course. The video results and clinical features lead us to diagnose symptomatic POD, and we treated the patient with auto-set continuous positive airway pressure to address their OSAHS. This course of treatment resolved all POD-related symptoms. Here, we discuss this case and review the relevant literature. This report highlights the importance of the use of v-PSG in the clinical diagnosis, differential diagnosis, and subsequent treatment of POD.

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“…This project is about developing a clinical depression assistant which gives depression severity status based on Heart Rate Variability [12], Cyclic Alternation Pattern [13] and Random Eye Movement [14] of sleep, Static facial features [15] and Dynamic facial features [16] of a patient. The stated patient data access from the patient's fitness tracker and Camera of a smartphone via developed application.…”

Section: Methodsmentioning

confidence: 99%

Dheergayu: Clinical Depression Monitoring Assistant

A.A.M.R¹,

K.G.T.D²,

N.I.R³

et al. 2020

GJCST

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Depression is identified as one of the most common mental health disorders in the world. Depression not only impacts the patient but also their families and relatives. If not properly treated, due to these reasons it leads people to hazardous situations. Nonetheless existing clinical diagnosis tools for monitoring illness trajectory are inadequate. Traditionally, psychiatrists use one to one interaction assessments to diagnose depression levels. However, these clinic- centered services can pose several operational challenges. In order to monitor clinical depressive disorders, patients are required to travel regularly to a clinical center within its limited operating hours. These procedures are highly resource intensive because they require skilled clinician and laboratories. To address these issues, we propose a personal and ubiquitous sensing technologies, such as fitness trackers and smartphones, which can monitor human vitals in an unobtrusive manner.

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Cyclic Alternating Pattern in Obstructive Sleep Apnea Patients with versus without Excessive Sleepiness

Cited by 22 publications

References 31 publications

Commonalities and Differences in NREM Parasomnias and Sleep-Related Epilepsy: Is There a Continuum Between the Two Conditions?

Commonalities and Differences in NREM Parasomnias and Sleep-Related Epilepsy: Is There a Continuum Between the Two Conditions?

Case Report: Parasomnia Overlap Disorder Induced by Obstructive Sleep Hypopnea Apnea Syndrome: A Case Report and Literature Review

Dheergayu: Clinical Depression Monitoring Assistant

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