Effects of Chronic Sleep Fragmentation on Wake-Active Neurons and the Hypercapnic Arousal Response

Li, Yanpeng; Panossian, Lori A.; Zhang, Jing; Zhu, Yan; Zhan, Guanxia; Chou, Yu-Ting; Fenik, Polina; Bhatnagar, Seema; Piel, David; Beck, Sheryl G.; Veasey, Sigrid C.

doi:10.5665/sleep.3306

Cited by 68 publications

(66 citation statements)

References 69 publications

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“…In OSAS patients, the consequence of SF or chronic blood gas disturbance may underlie the lack of response to continuous theta burst stimulation, suggesting impaired long-term depression-like neuroplasticity in these subjects [26]. Moreover, the effects of chronic SF have been also tested in adult male mice undergoing orbital platform SF [27]. The authors found that four weeks of SF impairs arousal responses to hypercapnia and reduces wake neuron projections and locus coeruleus neuronal excitability, supporting the concept that some effects of SF may contribute to impaired arousal responses in sleep apnea.…”

Section: Discussionmentioning

confidence: 98%

Direct comparison of cortical excitability to transcranial magnetic stimulation in obstructive sleep apnea syndrome and restless legs syndrome

et al. 2015

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Section: Discussionmentioning

confidence: 98%

Direct comparison of cortical excitability to transcranial magnetic stimulation in obstructive sleep apnea syndrome and restless legs syndrome

et al. 2015

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“…OSA-related sleep fragmentation also has detrimental effects on the brain. It has been implicated in decreased neuronal excitability in regions including the locus coeruleus [23]. Additionally, sleep fragmentation due to OSA could impair homeostatic effects of sleep.…”

Section: Discussionmentioning

confidence: 99%

Obstructive sleep apnea, CPAP therapy and Parkinson's disease motor function: A longitudinal study

Meng

Benedetti

Lafontaine

et al. 2020

Parkinsonism & Related Disorders

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“…Although more frequent arousals are associated with risk of hypertension and can adversely affect the cardiovascular system, 33 34 arousals may also serve as a protective mechanism to terminate apnoeic episodes. 35 In fact, a low arousal index has been linked to increased risk for brainstem white matter disease and incident stroke. 8 36 Thus, two distinct pathophysiological scenarios are plausible-that is, while frequent arousals may indicate excessive sympathetic activation, low arousal responses may reflect abnormalities in autonomic control, respiratory reflexes, or result from chronic sleep fragmentation.…”

Section: Arousal Index and Afmentioning

confidence: 99%

Association of sleep characteristics with atrial fibrillation: the Multi-Ethnic Study of Atherosclerosis

Kwon

Gharib

Biggs

et al. 2015

Thorax

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Background Population-based studies have linked measures of sleep disordered breathing (SDB) to nocturnally occurring atrial fibrillation (AF) episodes. Whether measures of SDB and sleep quality are associated with prevalent AF has not been studied in an unselected population. We investigated the cross-sectional association with prevalent AF of objectively collected prespecified measures of overnight sleep breathing disturbances, sleep stage distributions, arousal, and sleep duration. Methods AF prevalence, defined by diagnosis codes, study electrocardiography and sleep study was examined among Multi-Ethnic Study of Atherosclerosis (MESA) participants who underwent polysomnography in the MESA Sleep Study (n=2048). Measurements and Main Results Higher apnea hypopnea index (AHI) was associated with increased odds of AF, although the significance was attenuated after full adjustment for covariates including prevalent cardiovascular disease (OR: 1.22 [0.99–1.49] per SD [17/hr], p=0.06). Analyses of sleep architecture measures and AF revealed significantly lower odds of AF associated with longer duration of slow wave sleep (SWS) (OR: 0.66 [0.5–0.89] per SD [34 min], p=0.01) which persisted after additionally adjusting for AHI (OR: 0.68 [0.51–0.92], p=0.01). Higher sleep efficiency was significantly associated with lower likelihood of AF but the significance was lost when adjusted for AHI. No significant association was present between sleep duration and AF. In a model including both AHI and arousal index, the association between AHI and AF was strengthened (AHI: OR 1.49 [1.15–1.91] per SD, p=0.002) and a significant inverse association between arousal index and AF was observed (OR 0.65 [0.50–0.86] per SD [12/hr], p=0.005). Conclusions In a study of a large multi-ethnic population, AF was not only associated with AHI severity, but was also more common in individuals with poor sleep quality as measured by reduced SWS time, a finding that was independent of AHI.

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Effects of Chronic Sleep Fragmentation on Wake-Active Neurons and the Hypercapnic Arousal Response

Cited by 68 publications

References 69 publications

Direct comparison of cortical excitability to transcranial magnetic stimulation in obstructive sleep apnea syndrome and restless legs syndrome

Direct comparison of cortical excitability to transcranial magnetic stimulation in obstructive sleep apnea syndrome and restless legs syndrome

Obstructive sleep apnea, CPAP therapy and Parkinson's disease motor function: A longitudinal study

Association of sleep characteristics with atrial fibrillation: the Multi-Ethnic Study of Atherosclerosis

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