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Marked reduction in obstructive sleep apnea severity in slow wave sleep

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dc.contributor.authorRatnavadivel, R.
dc.contributor.authorChau, N.
dc.contributor.authorStadler, D.
dc.contributor.authorYeo, A.
dc.contributor.authorMcEvoy, R.
dc.contributor.authorCatcheside, P.
dc.date.issued2009
dc.description.abstractIntroduction: Obstructive sleep apnea (OSA) is widely accepted to improve during slow wave sleep (SWS) compared to lighter stages of NREM sleep. However, supporting data to establish the magnitude and prevalence of this effect is lacking. Consequently, we examined this phenomenon, controlling for posture, in a large group of patients investigated for OSA at an academic clinical sleep service. Methods: A detailed retrospective analysis was conducted on data obtained from each 30-sec epoch of sleep in 253 consecutive full-night diagnostic polysomnography studies performed over a 3-month period. Respiratory and arousal event rates were calculated within each stage of sleep, in the supine and lateral postures, and across the whole night, with OSA patients classified on the basis of an overall apnea-hypopnea index (AHI) ≥ 15 events/h. Central sleep apnea (CSA) patients were defined by a central apnea index ≥ 5/h. Sleep latency and time, and respiratory and arousal event rates in OSA, CSA, and non-OSA patients were compared between sleep stages and postures using linear mixed model analysis. The numbers of patients achieving reduced event rates in SWS and in the lateral posture were also examined. Results: There were 171 patients with OSA, 14 with CSA, and 68 non-OSA patients. OSA patients took significantly longer to achieve slow wave and REM sleep (p < 0.001) than non-OSA patients and had less stage 4 sleep (p = 0.037). There were striking improvements in AHI and arousal index (AI) from stage 1 to 4 NREM sleep (p < 0.001), with intermediate levels in REM sleep. AHI and AI were also markedly reduced in lateral versus supine sleep in all sleep stages (p < 0.001), with an effect size comparable to that of the slow wave sleep effect. The majority of OSA patients achieved low respiratory event rates in SWS. Eighty-two percent of patients achieved an AHI < 15 and 57% < 5 events/hour during stage 4 sleep.
dc.description.statementofresponsibilityRajeev Ratnavadivel, Nuy Chau, Daniel Stadler, Aeneas Yeo, R. Doug McEvoy, Peter G. Catcheside
dc.identifier.citationJournal of Clinical Sleep Medicine, 2009; 5(6):519-524
dc.identifier.doi10.5664/jcsm.27651
dc.identifier.issn1550-9389
dc.identifier.issn1550-9397
dc.identifier.orcidMcEvoy, R. [0000-0002-5759-0094]
dc.identifier.orcidCatcheside, P. [0000-0002-9372-6788]
dc.identifier.urihttp://hdl.handle.net/2440/58731
dc.language.isoen
dc.publisherThe American Academy of Sleep Medicine
dc.relation.granthttp://purl.org/au-research/grants/nhmrc/480438
dc.rightsCopyright status unknown
dc.source.urihttps://doi.org/10.5664/jcsm.27651
dc.subjectObstructive sleep apnea
dc.subjectslow wave sleep
dc.subjectventilatory control
dc.subjectposture
dc.subjectdelta sleep
dc.subjectarousal
dc.subjectsleep stage
dc.titleMarked reduction in obstructive sleep apnea severity in slow wave sleep
dc.typeJournal article
pubs.publication-statusPublished

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