Quantitative measurement of sleep quality using cardiopulmonary coupling analysis: a retrospective comparison of individuals with and without primary insomnia

Schramm, Preetam J.; Thomas, Robert J.; Feige, Bernd; Spiegelhalder, Kai; Riemann, Dieter

doi:10.1007/s11325-012-0747-6

Cited by 30 publications

(22 citation statements)

References 27 publications

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“…Schramm et al found that primary insomnia subjects (n=50) had lower HFC, and HFC/LFC ratio compared to the good sleepers (n=36). 19 In this study, ewe did not find significant CPC parameters with different profiles between RLS and PPI. Both studies applied the similar methods of analysis, however, different profiles of subjects might lead different CPC results.…”

Section: Discussioncontrasting

confidence: 49%

“…It is plausible that CPC profiles of insomnia patients are different from normal controls since insomnia has a close link to autonomic instability before and during sleep. 19 In this study, we tried to investigate whether CPC parameters are sensitive to differentiate two sleep-disorders groups with the similar sleep-related problems. Although it failed to find significant differences in CPC parameters between two groups, it is remarkable to demonstrate that vLFC indicating unstable sleep is closely associated with SE and WASO in PSG parameters in both groups.…”

Section: Discussionmentioning

confidence: 99%

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Objective Sleep Quality in Subjects with Restless Legs Syndrome versus with Psychophysiological Insomnia: Polysomnography and Cardiopulmonary Coupling Analysis

Choi

Joo

et al. 2015

J Sleep Med

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To compare the sleep quality in the view of polysomnography (PSG) and cardiopulmonary coupling (CPC) analysis in subjects with restless legs syndrome (RLS) versus with psychophysiological insomnia (PPI). Methods: The PSG data of 109 subjects with RLS and 86 with PPI (apnea-hypopnea index <5 /h) were collected. All subjects reported sleep onset and maintenance insomnia. CPC parameters were obtained using CPC analyzer in RemLogic. Sleep spectrogram by CPC analyses categorized sleep as "stable" [high-frequency coupling (HFC), 0.1-0.4 Hz] and "unstable" [low-frequency coupling (LFC), 0.1-0.01 Hz], independent of sleep stages. We compared PSG and CPC parameters between two groups and performed correlation analyses to find the PSG parameters to affect CPC parameters. Results: In PSG parameters, subjects with PPI showed significantly longer sleep latency (14.2±20.06 vs. 27.5±34.96, p<0.001), and decreased sleep efficiency (SE, 80.5±14.96 vs. 76.5±14.45, p=0.009) than RLS. CPC parameters were not significantly different between groups. In both groups HFC was positively correlated with total sleep time and SE and was negatively associated with time of wake after sleep onset in both groups. Meanwhile, very LFC showed the opposite results to HFC with the same PSG parameters. Conclusions: Although subjects with RLS or PPI present sleep onset and maintenance insomnia, objective sleep quality was worse in PPI than RLS. It suggests that CPC as a factor to differentiate sleep quality between the RLS and the PPI has a limited role.

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Section: Discussioncontrasting

confidence: 49%

Section: Discussionmentioning

confidence: 99%

Objective Sleep Quality in Subjects with Restless Legs Syndrome versus with Psychophysiological Insomnia: Polysomnography and Cardiopulmonary Coupling Analysis

Choi

Joo

et al. 2015

J Sleep Med

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“…Transitions between stable and unstable sleep are expected within an intact system to modulate in 30 – 90 minute infra radian cycles that range from 5–16 cycles in an 8-hour sleep period and correspond to the alternating periods of NREM - REM sleep (Gianaros et al 2005). Disease states may negatively impact this rhythm (Schramm et al 2012; Thomas et al 2004; Thomas et al 2005). Stable-unstable sleep transitions defined as shifts from stable sleep to unstable sleep were automatically detected by the algorithm and summed manually for each recording.…”

Section: Methodsmentioning

confidence: 99%

“…CPC and polysomnography (PSG) sleep quality measures equally captured the worsening of sleep under the stress of the first night in a sleep lab in primary insomnia patients and matched control subjects (Schramm et al 2012). Decreased sleep stability and increased unstable sleep in non-medicated depressive patients was recently reported suggesting this might indicate a long term risk for adverse cardiovascular risk in depressed patients (Yang et al 2010).…”

Section: Introductionmentioning

confidence: 99%

Bupropion response on sleep quality in patients with depression: Implications for increased cardiovascular disease risk

Schramm¹,

Poland

Rao

2014

European Neuropsychopharmacology

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Depression could be an independent risk factor for cardiovascular disease. We assessed bupropion response in depressed patients by polysomnography (PSG) and cardiopulmonary coupling (CPC) variables. Nineteen subjects participated in a two-session, two consecutive night PSG protocol. Participants received either placebo or bupropion-SR 150 mg, orally, in a randomized, double-blind cross-over fashion on night two. Outcome variables were: sleep stages, REM latency, stable, unstable sleep and very low frequency coupling (VLFC). CPC analysis uses heart rate variability and the electrocardiogram’s R-wave amplitude fluctuations associated with respiration to generate frequency maps. Bupropion increased REM latency (p=0.043) but did not impact PSG sleep continuity, architecture and CPC variables. A trend (p=0.092) was observed towards increasing VLFC duration. Bupropion increased the number of stable-unstable sleep transitions (p=0.036). Moderate to strong correlations between PSG and CPC variables were found on placebo and bupropion nights. Limitations include a small sample size, limited power to detect CPC changes and lack of normal controls for comparison. Increased stable-unstable sleep transitions and VLFC duration may indicate vulnerability to cardiovascular disease due to their association with low heart rate variability that has been associated with increased mortality raising the question whether the beneficial effects of the antidepressant medication outweighs the impact on cardiopulmonary dynamics.

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“…Wake and REM sleep exhibit very low-frequency coupling (LFC). Elevated LFC is a subset of LFC that is associated with fragmented sleep of various aetiologies [19]. Cardiopulmonary coupling measures can differentiate normal individuals from those with moderate-tosevere OSA [20].…”

Section: Cardiopulmonary Coupling Analysismentioning

confidence: 99%

Applications of evolving technologies in sleep medicine

Verbraecken

2013

Breathe

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SummaryNocturnal polysomnography (PSG) is the most important laboratory technique in the management of sleep–wake disturbances and is considered the “gold standard” [1]. New sensor technologies are entering the field, and rapid development in telecommunications and mobile technology has accelerated the introduction of telemedicine as a viable and reliable option [2]. The present broad review is an amalgam of the current knowledge with proposed new sensors and remote control. The reader should note that not all of the techniques discussed here have strong clinical validation, and this should be considered when purchasing equipment.

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Quantitative measurement of sleep quality using cardiopulmonary coupling analysis: a retrospective comparison of individuals with and without primary insomnia

Cited by 30 publications

References 27 publications

Objective Sleep Quality in Subjects with Restless Legs Syndrome versus with Psychophysiological Insomnia: Polysomnography and Cardiopulmonary Coupling Analysis

Objective Sleep Quality in Subjects with Restless Legs Syndrome versus with Psychophysiological Insomnia: Polysomnography and Cardiopulmonary Coupling Analysis

Bupropion response on sleep quality in patients with depression: Implications for increased cardiovascular disease risk

Applications of evolving technologies in sleep medicine

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