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Arousability in sleep apnoea/hypopnoea syndrome patients

¹ Respiratory Medicine Unit, University of Edinburgh, UK. ² Respiratory Medicine, Charite, Berlin, Germany. ³ Dynesys Ltd, Edinburgh, UK

CORRESPONDENCE: N.J. Douglas, Dept of Medicine, Royal Infirmary, Edinburgh, EH3 9YW, UK. Fax: 44 1315363255. E-mail: n.j.douglas@ed.ac.uk

Keywords: arousal, sleep apnoea, sleep stage

Received: July 19, 2001
Accepted April 11, 2002

K. Dingli was supported by a Research Fellowship from the European Respiratory Society.

Sleep disruption and daytime sleepiness in obstructive sleep apnoea/hypopnoea syndrome (OSAHS) patients result from recurrent apnoeas/hypopnoeas and arousals from sleep. Around 30% of apnoeas/hypopnoeas are not terminated by visible cortical arousals. The current authors tested the hypotheses that arousal induction is linked to sleep stage, oxygen desaturation, event type, event duration and time of occurrence during the night.

Fifteen patients with OSAHS of varying severity were studied and all their apnoeas/hypopnoeas were evaluated.

Eight of 15 patients had apnoeas/hypopnoeas in all sleep stages, and all their 610 apnoeas/hypopnoeas were analysed in the between stages comparison; data from all 15 patients were included in other comparisons. Thirty-four per cent of apnoeas/hypopnoeas during slow wave sleep (SWS) were associated with arousal, significantly less than the 77% during nonrapid eye movement (NREM) 1 and 2 and 62% during rapid eye movement (REM) sleep. Arousal induction was not affected by oxygen desaturation, event type, duration or time of the night. The apnoea/hypopnoea index was 39·h^–1 in NREM 1 and 2, significantly higher compared to 17·h^–1 in REM or to 11·h^–1 in SWS sleep.

In conclusion, apnoeas/hypopnoeas in slow wave sleep are associated with fewer cortically apparent, visually detected arousals.

This article has been cited by other articles:

				I. Fietze, K. Dingli, K. Diefenbach, N.J. Douglas, M. Glos, M. Tallafuss, W. Terhalle, and C. Witt Night-to-night variation of the oxygen desaturation index in sleep apnoea syndrome Eur. Respir. J., December 1, 2004; 24(6): 987 - 993. [Abstract] [Full Text] [PDF]

				M. Younes Role of Arousals in the Pathogenesis of Obstructive Sleep Apnea Am. J. Respir. Crit. Care Med., March 1, 2004; 169(5): 623 - 633. [Abstract] [Full Text] [PDF]