Slow wave sleep rebound and REM rebound following the first night of treatment with CPAP for sleep apnea: correlation with subjective improvement in sleep quality

Verma, Amit; Radtke, Rodney A.; VanLandingham, Kevan; King, John H.; Husain, Aatif M.

doi:10.1016/s1389-9457(00)00069-1

Cited by 54 publications

(41 citation statements)

References 30 publications

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“…It is thought to occur as an initial response to a restored sleep cycle after chronic sleep fragmentation. 17 The patient in case 2 was discovered to have REM atonia after a recurrence of previously well-treated OSA. It is unknown whether the onset of REM atonia occurred before or after the onset of enuresis, though it is possible that this condition predisposed him to enuresis.…”

Section: Discussionmentioning

confidence: 97%

CPAP Treats Enuresis in Adults With Obstructive Sleep Apnea

McInnis

Dodds

Johnsen

et al. 2017

Journal of Clinical Sleep Medicine

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Enuresis, or "bedwetting," in children is associated with obstructive sleep apnea (OSA), and often resolves with treatment of OSA. However, it is poorly understood whether a similar relationship exists in adults. We describe a case series of 5 adult patients in whom OSA was diagnosed by laboratory polysomnography, who presented with enuresis that resolved after treatment with continuous positive airway pressure (CPAP). All cases occurred in the setting of obesity, in addition to other known risk factors for urinary incontinence and enuresis. OSA was diagnosed as severe in all but one case, which was mild. One patient noted recurrence of enuresis that coincided with malfunction of his CPAP machine. There is growing evidence that CPAP therapy may alleviate OSA and enuresis in adults with both conditions. Clinicians should routinely ask about enuresis in patients suspected of having OSA. A systematic study of the association between enuresis and OSA in adults is warranted.

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Section: Discussionmentioning

confidence: 97%

CPAP Treats Enuresis in Adults With Obstructive Sleep Apnea

McInnis

Dodds

Johnsen

et al. 2017

Journal of Clinical Sleep Medicine

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“…In older subjects with SDB, treatment with CPAP improves sleep architecture including SWS. 41 In older subjects without SDB, transcranial magnetic stimulation 42 and existing medications 43,44 may increase or trigger SWS and reduce Aβ42 production. Whether such interventions affect Aβ42 metabolism and/or disease progression remains to be tested, but our current findings support further investigation.…”

Section: Discussionmentioning

confidence: 99%

Reduced Slow-Wave Sleep Is Associated with High Cerebrospinal Fluid Aβ42 Levels in Cognitively Normal Elderly

Varga

Wohlleber

Giménez

et al. 2016

Sleep

159

130

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Study Objectives: Emerging evidence suggests a role for sleep in contributing to the progression of Alzheimer disease (AD). Slow wave sleep (SWS) is the stage during which synaptic activity is minimal and clearance of neuronal metabolites is high, making it an ideal state to regulate levels of amyloid beta (Aβ). We thus aimed to examine relationships between concentrations of Aβ42 in the cerebrospinal fluid (CSF) and measures of SWS in cognitively normal elderly subjects. Methods: Thirty-six subjects underwent a clinical and cognitive assessment, a structural MRI, a morning to early afternoon lumbar puncture, and nocturnal polysomnography. Correlations and linear regression analyses were used to assess for associations between CSF Aβ42 levels and measures of SWS controlling for potential confounders. Resulting models were compared to each other using ordinary least squared linear regression analysis. Additionally, the participant sample was dichotomized into "high" and "low" Aβ42 groups to compare SWS bout length using survival analyses. Results: A significant inverse correlation was found between CSF Aβ42 levels, SWS duration and other SWS characteristics. Collectively, total SWA in the frontal lead was the best predictor of reduced CSF Aβ42 levels when controlling for age and ApoE status. Total sleep time, time spent in NREM1, NREM2, or REM sleep were not correlated with CSF Aβ42. Conclusions: In cognitively normal elderly, reduced and fragmented SWS is associated with increases in CSF Aβ42, suggesting that disturbed sleep might drive an increase in soluble brain Aβ levels prior to amyloid deposition.

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“…Verma ve ark. [6] PSG verilerine göre; orta TUAS hastalarında uykunun üçüncü evresini %10.6, REM uyku evresini %13.1 olarak hesaplarken, ağır TUAS hastalarında uykunun üçüncü evresini %12.8, REM uyku evresini ise %7.9 olarak hesaplamışlardır. Çalışmamızda PSG sonuçlarına göre uykunun üçüncü evresi %23, REM uyku evresi ise %16 olarak hesaplandı.…”

Section: Discussionunclassified

“…Ağır TUAS hastalarında ise uykunun üçüncü evresinde %32, REM uyku evresinde ise %72 oranında rebound artışlar saptanmıştır. [6] Sürekli pozitif hava yolu basıncı titrasyonunun uyku evreleri üzerine etkisini araştıran başka bir çalışmada, uykunun üçüncü evresi %16'dan %23.7'ye yükselirken; REM uyku evresi ise %13.3'ten %21.6'ya yük-selmiştir. Çalışma sonucunda uykunun üçüncü evresinde ve REM uykusunda belirgin reboundlar görülmemiştir.…”

Section: Discussionunclassified

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The effect of obstructive sleep apne syndrome and continuous positive airway pressure titration on stage 3 and REM sleeps

Atan¹

2017

Kulak Burun Bogaz Ihtis Derg

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ÖZAmaç: Bu çalışmada tıkayıcı uyku apnesi sendromu (TUAS) hastalarında hastalık şiddetinin ve sürekli pozitif havayolu basıncı (SPHB) titrasyonunun evre 3 ve REM (rapid eye movement) uykusu üzerine etkisi araştırıldı. Hastalar ve Yöntemler:Çalışmaya polisomnografi (PSG) ile orta veya ağır TUAS tanısı konulan 114 hasta (87 erkek, 27 kadın, ort. yaş 51.1±10.5 yıl; dağılım 34-66 yıl) dahil edildi. Apne hipopne indeksi ve uyku evrelerinin yüzde değerleri ayrı ayrı istatistiksel olarak karşılaştırıldı. Sürekli pozitif havayolu basıncı titrasyonu sırasında hesaplanan uyku evrelerinin yüzde değerleri tespit edildi ve ilk PSG ile karşılaştırıldı. Bulgular:Polisomnografi sonucuna göre 114 hastanın 41'i orta (30 erkek, 11 kadın; ort. yaş 49.8±10.2 yıl), 73'ü ağır (57 erkek, 16 kadın; ort. yaş 51.8±10.8 yıl) TUAS idi. Apne hipopne indeksi arttıkça evre 2 uykusu artarken, evre 3 ve REM uykusu azaldı; değişimler istatistiksel olarak anlamlı idi (p<0.001, p=0.002, p=0.002). Sürekli pozitif havayolu basıncı titrasyonu sırasında tespit edilen uyku evreleri ile ilk PSG karşılaştırıldığında, evre 3 uykusu orta TUAS hastalarında %22, ağır TUAS hastalarında %45 arttı. REM uykusu orta TUAS hastalarında artmazken ağır TUAS hastalarında %28 arttı.Sonuç: Sürekli pozitif havayolu basıncı titrasyonu sırasında evre 3 uykusunda %40, REM uykusunda %20 artış geri tepme olarak kabul edildiğinde, orta TUAS'ta evre 3 ve REM uykusunda geri tepme olmazken ağır TUAS'ta hem evre 3 hem REM uykusunda geri tepme görüldü.Anahtar Sözcükler: Sürekli pozitif havayolu basıncı; polisomnografi; uyku apne sendromu; uyku evreleri. ABSTRACTObjectives: This study aims to investigate the effect of disease severity and continuous positive airway pressure (CPAP) titration on stage 3 and rapid eye movement (REM) sleeps in obstructive sleep apnea syndrome (OSAS) patients. Patients and Methods:The study included 114 patients (87 males, 27 females; mean age 51.1±10.5 years; range 34 to 66 years) who were diagnosed as moderate or severe OSAS with polysomnography (PSG). Percentage values of apnea hypopnea index and sleep stages were individually statistically compared. Percentage values of sleep stages calculated during CPAP titration were determined and compared with first PSG.Results: According to the polysomnography result, of 114 patients, 41 were moderate (30 males, 11 females; mean age 49.8±10.2 years), 73 were severe (57 males, 16 females; mean age 51.8±10.8 years) OSAS. As the apnea hypopnea index increased, stage 2 sleep increased, while stage 3 and REM sleeps decreased; changes were statistically significant (p<0.001, p=0.002, p=0.002). When the sleep stages detected during CPAP titration were compared to the first PSG, stage 3 sleep increased by 22% in moderate OSAS patients and by 45% in severe OSAS patients. While REM sleep did not increase in moderate OSAS patients, it increased by 28% in the severe OSAS patients. Conclusion:When an increase by 40% in stage 3 sleep and by 20% in REM sleep were accepted as rebound during CPAP titration, while there was no re...

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Slow wave sleep rebound and REM rebound following the first night of treatment with CPAP for sleep apnea: correlation with subjective improvement in sleep quality

Cited by 54 publications

References 30 publications

CPAP Treats Enuresis in Adults With Obstructive Sleep Apnea

CPAP Treats Enuresis in Adults With Obstructive Sleep Apnea

Reduced Slow-Wave Sleep Is Associated with High Cerebrospinal Fluid Aβ42 Levels in Cognitively Normal Elderly

The effect of obstructive sleep apne syndrome and continuous positive airway pressure titration on stage 3 and REM sleeps

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