Peripheral vasoconstriction during REM sleep detected by a new plethysmographic method

Lavie, Peretz; Schnall, Robert P.; Sheffy, Jacob; Shlitner, Arie

doi:10.1038/76135

Cited by 102 publications

(63 citation statements)

References 5 publications

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“…This is the case for the pulse transit time, a non-invasive measure of blood pressure, a semiquantitative measure of respiratory effort [25][26][27] and a sensitive marker of autonomic arousals [20]. The recently developed peripheral arterial tonometry, based on detection of peripheral vasoconstriction, has been shown to be a sensitive marker of sympathetic arousal [28] and apneas [9,29]. In our study, we evaluated changes in peripheral arterial volume by photoplethysmography using a standard oxymeter.…”

Section: Discussionmentioning

confidence: 99%

Obstructive sleep apnea syndrome: effect of respiratory events and arousal on pulse wave amplitude measured by photoplethysmography in NREM sleep

et al. 2005

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Obstructive sleep apnea syndrome: effect of respiratory events and arousal on pulse wave amplitude measured by photoplethysmography in NREM sleep Abstract The objective of the study is to evaluate changes in finger pulse wave amplitude (PWA), as measured by photoplethysmography, and heart rate (HR), related to obstructive respiratory events and associated arousals during sleep. We analyzed 1,431 respiratory events in NREM sleep from 12 patients according to (1) the type of event (apnea, hypopnea, upper airway resistance episode) and (2) the duration of the associated EEG arousal (>10, 3-10, <3 s). Obstructive respiratory events provoked a relative bradycardia and vasodilation followed by HR increase and vasoconstriction. Relative PWA changes were significantly greater than HR changes. These responses differed significantly according to EEG-arousal grades (time×arousal interaction, p<0.0001), with longer arousals producing greater responses, but not to the type of respiratory event (time×event interaction, p = ns). Obstructive respiratory events provoke HR and PWA changes, the magnitude seemingly related to the intensity of central nervous activation, with PWA changes greater than HR. PWA obtained from a simple pulse oxymeter might be a valuable method to evaluate sleep fragmentation in sleep breathing disorders.

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Section: Discussionmentioning

confidence: 99%

Obstructive sleep apnea syndrome: effect of respiratory events and arousal on pulse wave amplitude measured by photoplethysmography in NREM sleep

et al. 2005

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“…23 Based on these assumptions, it may be hypothesized that an algorithm that includes PAT, pulse rate and the actigraphy may be able to detect sleep/wake status with reasonable accuracy. Regardless of the method used, essentially all studies have reported that OSA is associated with increased sympathetic activity.…”

Section: Light/deep Sleep Detectionmentioning

confidence: 99%

Sleep Staging Based on Autonomic Signals: A Multi-Center Validation Study

Hedner

White

Malhotra

et al. 2011

Journal of Clinical Sleep Medicine

123

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Study Objectives: One of the most important caveats of ambulatory devices is the inability to record and stage sleep. We assessed an algorithm determining 4 different stages: wake, light sleep, deep sleep, and REM sleep using signals derived from the portable monitor Watch-PAT100 (PAT recorder). Methods: Participants (38 normal subjects and 189 patients with obstructive sleep apnea [OSA]) underwent simultaneous overnight recordings with polysomnography (PSG) and the PAT recorder in a study originally designed to assess the accuracy of the PAT recorder in diagnosing OSA. Light/deep sleep and REM sleep from the PAT recorder recording were automatically scored based on features extracted from time series of peripheral arterial tone amplitudes and inter pulse periods. The PSG scored sleep stages 1 and 2 were classified as light sleep for epoch-by-epoch comparisons. Results:The overall agreement in detecting light/deep and REM sleep were 88.6% ± 5.9% and 88.7% ± 5.5%, respectively. There was a good agreement between PSG and the PAT recorder in quantifying sleep efficiency (78.4% ± 9.9% vs. 78.8% ± 13.4%), REM latency (237 ± 148 vs. 225 ± 159 epochs), and REM percentage (14.4% ± 6.5% vs. 19.3% ± 8.7%). OSA severity did not affect the sensitivity and specificity of the algorithm. The Cohen κ coefficient for detecting all sleep stages: sleep from wake, REM from NREM sleep, and deep from light sleep were 0.48, 0.55, 0.59, and 0.46, respectively. Conclusions: Analysis of autonomic signals from the PAT recorder can detect sleep stages with moderate agreement to more standard techniques in normal subjects and OSA patients. This novel algorithm may provide insights on sleep and sleep architecture when applying the PAT recorder for OSA diagnosis.

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“…Recently, a finger plethysmographic device allowing the detection of pulsatile arterial volume changes has been introduced [56,58]. Similar to the assessment of endothelial function via the FMD technique by ultrasound of the brachial artery, a pressure cuff is placed on one upper arm, while the other arm serves as a control.…”

Section: Finger Plethysmographymentioning

confidence: 99%

Human endothelial dysfunction: EDRFs

Flammer

Lüscher

2010

Pflugers Arch - Eur J Physiol

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Since the detection of nitric oxide two and a half decades ago, there has been an incredible boost in endothelial function research, which is fascinating the research community. Physiologically, endothelial cells synthesize a number of vasoactive substances. In particular, several endothelium-derived relaxing factors (EDRFs) have been characterized, whereby nitric oxide is the most important. In humans, endothelial dysfunction is one of the first clinically detectable alterations in the development of atherosclerosis and is characterized by an imbalance in the release of vasoactive substances. Thus, it is the aim of this article to give an overview about endothelial function in humans, to summarize the different possibilities to assess endothelial function in this species, and to give an overview of the role of EDRFs in different cardiovascular diseases.

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Peripheral vasoconstriction during REM sleep detected by a new plethysmographic method

Cited by 102 publications

References 5 publications

Obstructive sleep apnea syndrome: effect of respiratory events and arousal on pulse wave amplitude measured by photoplethysmography in NREM sleep

Obstructive sleep apnea syndrome: effect of respiratory events and arousal on pulse wave amplitude measured by photoplethysmography in NREM sleep

Sleep Staging Based on Autonomic Signals: A Multi-Center Validation Study

Human endothelial dysfunction: EDRFs

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