Relationship of symptoms with sleep-stage abnormalities in obstructive sleep apnea-hypopnea syndrome

Abstract

BackgroundPatients with obstructive sleep apnea-hypopnea syndrome (OSAHS) present with a variety of sleep-related symptoms. In polysomnography, sleep architecture is almost always abnormal, but it is not known which of the sleep-stage abnormalities are related to symptoms. Finding key sleep-stage abnormality that cause symptoms may be of therapeutic importance to alleviate symptoms. So far the mainstay of treatment is continuous positive airway pressure (CPAP)/bi-level positive airway pressure (BIPAP) therapy, but many patients are non-compliant to it. Correcting the sleep-stage abnormality that cause symptoms by pharmacotherapy may become an important adjunct to CPAP/BIPAP therapy.MethodsA cross-sectional study. Adult subjects who attended a sleep laboratory for diagnostic polysomnography for a period of 1 month were recruited consecutively. OSAHS was diagnosed using American Academy of Sleep Medicine criteria. Subjects filled a questionnaire for symptoms prior to polysomnography.ResultsThirty subjects, of whom 83.3% were obese, met diagnostic criteria, with males constituting 46.7% and females constituting 53%. Mean age was 53.40±11.60 years. Sleep architecture comprised N1 19.50±19.00%, N2 53.93±13.39%, N3 3.90±19.50%, and rapid eye movement 8.92±6.21%. Excessive fatigue or sleepiness, waking up tired, falling asleep during the day, trouble paying attention, snoring and insomnia were significantly related to decreased N3 sleep.ConclusionsMost of the symptoms in OSAHS in adults are related to decreased stage N3 sleep. If confirmed by larger controlled studies, correcting N3 sleep deficiency by pharmacotherapy may become an important adjunct to CPAP/BIPAP therapy to alleviate symptoms.

Towards Validating the Effectiveness of Obstructive Sleep Apnea Classification from Electronic Health Records Using Machine Learning

“…Sleep architecture is estimated by leveraging wearable sensors or smartwatches with machine learning methods and its effect on OSA screening is observed in [72,73]. Specifically, stage 1 and stage 3 sleep exhibited anomalous behavior in the case of OSA patients, as stated in [74][75][76]. Interestingly, the findings of our presented work does not reveal strong predictive powers when using the features of sleep stages (stage 1, stage 2, stage 3 and REM) as well as sleep duration metrics.…”

Clinical and Polysomnographic Features Associated with Poor Sleep Quality in Patients with Obstructive Sleep Apnea

“…The study by Buysee et al [ 11 ] revealed that symptoms assessed by the ESS and PSQI are not correlated with objective sleep features measured by PSG. Basunia et al [ 35 ] reported that among patients with OSA, symptoms such as excessive fatigue or sleepiness, falling asleep during the day, waking up tired, trouble paying attention, snoring, and insomnia were significantly related to a decreased percentage of N3 sleep. Conversely, in our study, increasing N3 percentages of total sleep time were linked to higher risks of poor sleep quality.…”

The Level and Meaning of IL-18 and Other Factors in Peripheral Blood of Patients with OSAHS Under ERAS Management

“…It can increase the expression of inflammatory cytokines such as IL-18 and IL-6 and produce synergistic amplification [15]. IL-6 is a member of the IL-12 family, secreted mainly by activated macrophages and dendritic cells, and has an important role in the maintenance of Th17 cell activation [18]. It stimulates the proliferation of Th17 cells and the secretion of IL-18, and promotes the production of chronic inflammatory factors and proinflammatory chemokines in activated Th17 cells.…”