Sleep fragmentation: comparison of two definitions of short arousals during sleep in OSAS patients

Abstract

The measurement of arousals during sleep is useful to quantify sleep fragmentation. The criteria for electroencephalography (EEG) arousals de®ned by the American Sleep Disorders Association (ASDA) have recently been criticized because of lack of interobserver agreement. The authors have adopted a scoring method that associates the increase in chin electromyography (EMG) with the occurrence of an arhythm in all sleep stages (Universite  Catholique de Louvain (UCL) de®nition of arousals). The aim of the present study was to compare the two scoring de®nitions in terms of agreement and repeatability and the time taken for scoring in patients with obstructive sleep apnoea syndrome (OSAS) of varying severity.Two readers using both ASDA and UCL de®nitions scored twenty polysomnographies (PSGs) each on two occasions. The PSGs were chosen retrospectively to represent a wide range of arousal index (from 6±82) in OSAS patients.There was no difference in the arousal indices between readers and between scoring methods. The meanSD difference between the two de®nitions (the bias) was 1.13.76 (95% con®dence interval: -0.66±2.86). There was a strong linear relationship between the arousal index scored with the two de®nitions (r=0.981, p<0.001). MeanSD scoring duration was signi®cantly shorter for UCL than for ASDA de®nitions (18.55.4 versus 25.36.6 min, p<0.001).In conclusion, it has been found that in obstructive sleep apnoea syndrome patients, the American Sleep Disorders Association and Universite  Catholique de Louvain de®nitions were comparable in terms of agreement and repeatability.

On arousal from sleep: time-frequency analysis

“…On the other hand, Smurra et al [42] compared the feasibility of the visual scoring of the arousals using ASDA and UCL definitions (from the EEG and electromyography activity during NREM sleep). They found that arousals scored in the two methods were comparable in terms of concurrence and reproducibility.…”

Large-scale validation of an automatic EEG arousal detection algorithm using different heterogeneous databases

“…Apparently this range is consistent with the values obtained for the datasets used in this study. [43]. Although ICC is an adequate statistic to quantify rater (human or automatic) variability, comparison of the different results across the literature is not straightforward.…”

“…The highest inter-rater agreement published in the literature can be found in the study of Smurra et al [43], who analyzed both the inter-and the intra-scorer reliability for two different scorers on a set of 20 OSA patients. Their analysis was carried out according to two different scoring standards, namely the ASDA1992 and the ULC.…”

Association between Nocturnal Frequency and Erectile Function in Eugonadal Men with Benign Prostatic Obstruction: A Cross Sectional Study

“…Nocturia is the most bothersome symptom among LUTS [19,20], and the frequency of nocturia seems to be significantly associated with poor sleep quality [21]. The negative effects of nocturia include sleep fragmentation [22], which typically refers to brief arousals that occur during a sleep period [23]. Furthermore, it has been suggested that SRE could be important to maintain erectile function [24]; thus, the long-term effect of nocturia, which exerts a great influence on sleep quality [25], may gradually decrease erectile function by disturbing SRE.…”