Abstract
Introduction
Sleep disruption and blood gas abnormalities, observed in patients with obstructive sleep apnoea (OSA) syndrome, prevent sleep-related restorative processes and induce chemical or structural central nervous system cellular injury. The aim of the study was to determine electroencephalogram (EEG) alterations related to the severity of OSA in patients with OSAS and the effect of the nasal continuous positive air pressure (nCPAP) treatment.
Materials and methods
Polysomnography and vigilant EEGs were performed in subjects with possible OSA. The mean relative power was calculated for delta, theta, alpha and beta frequency bands. Thirty subjects without and 131 with OSA participated in this study. In 29 male patients with severe OSA, quantitative EEGs were re-evaluated after 6 months of CPAP treatment.
Results
Compared to subjects without OSA, patients with severe OSA showed an increase in relative theta and delta power (occipital, temporal and parietal areas). Six months of nCPAP treatment improved daytime sleepiness of OSA patients. EEG demonstrated a decrease in alpha (frontal, central and temporal areas) and theta (frontal areas) relative power. However, beta relative power was increased mainly in central, and delta relative power, in all brain areas.
Discussion
In conclusion, EEG slowing was observed in OSA patients. CPAP treatment improved daytime sleepiness of OSA patients in contrast to the alterations in alpha (decreased) and delta (increased) relative power suggesting a possible persistent brain dysfunction.
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References
Naegele B, Thouvard V, Pépin JL, Lévy P, Bonnet C, Perret JE, Pellat J, Feuerstein C (1995) Deficits of cognitive executive functions in patients with sleep apnea syndrome. Sleep 18:43–52
Roux F, D'Ambrosio C, Mohsenin V (2000) Sleep-related breathing disorders and cardiovascular disease. Am J Med 108:396–402
Leung RS, Bradley TD (2001) Sleep apnea and cardiovascular disease. Am J Respir Crit Care Med 164:2147–2165
White DP (2006) Sleep apnea. Pro Am Thorac Soc 3:124–128
Beebe DW, Gozal D (2002) Obstructive sleep apnea and the prefrontal cortex: towards a comprehensive model linking nocturnal upper airway obstruction to daytime cognitive and behavioral deficits. J Sleep Res 11:1–16
Hayakawa T, Terashima M, Kayukawa Y, Ohta T, Okada T (1996) Changes in cerebral oxygenation and hemodynamics during obstructive sleep apneas. Chest 109:916–921
Kamba M, Inoue Y, Higami S, Suto Y, Ogawa T, Chen W (2001) Cerebral metabolic impairment in patients with obstructive sleep apnoea: an independent association of obstructive sleep apnoea with white matter change. J Neurol Neurosurg Psychiatry 71:334–339
Macey PM, Henderson LA, Macey KE, Alger JR, Frysinger RC, Woo MA, Harper RC, Yan-Go FL, Harper RM (2002) Brain morphology associated with obstructive sleep apnea. Am J Respir Crit Care Med 166:1305–1306
Morisson F, Lavigne G, Petit D, Nielsen T, Malo J, Montplaisir J (1998) Spectral analysis of wakefulness and REM sleep EEG in patients with sleep apnoea syndrome. Eur Respir J 11:1135–1140
Morisson F, Decary A, Petit D, Lavigne G, Malo J, Montplaisir J (2001) Daytime sleepiness and EEG spectral analysis in apneic patients before and after treatment with continuous positive airway pressure. Chest 119:45–52
Johns M (1991) A new method for measuring daytime sleepiness: the Epworth sleepiness scale. Sleep 14:540–545
Johns M (1992) Reliability and factor analysis of the Epworth sleepiness scale. Sleep 15:376–381
Fountoulakis C, Tsolaki M, Chazi H, Kazis A (1994) Mini Mental State Examination (MMSE): α validation study in dementia patients from the elderly Greek population. Encephalos 31:93–102
Rechtschaffen A, Kales A (eds) (1968) A manual of standardized terminology: techniques and scoring system for sleep stages of human subjects. UCLA Brain Information Service/Brain Research Institute, Los Angeles
Cooley WJ, Tukey JW (1965) An algorithm for the machine calculation of complex Fourier series. Math Comput 19:165–172
Petit D, Lorrain D, Gauthier S, Montplaisir J (1992) Regional spectral analysis of the REM sleep EEG in mild to moderate Alzheimer's disease. Neurobiol Aging 14:141–145
Petit D, Montplaisir J, Lorrain D, Gauthier S (1992) Spectral analysis of the rapid eye movement sleep electroencephalogram in right and left temporal regions: a biological marker of Alzheimer's disease. Ann Neurol 32:172–176
Saletu B, Grünberger J, Anderer P, Linzmayer L, König P (1996) On the cerebro-protective effects of caroverine, a calcium-channel blocker and antiglutamatergic drug: double-blind, placebo-controlled, EEG mapping and psychometric studies under hypoxia. Br J Clin Pharmacol 41(2):89–99
Walsleben JA, O'malley EB, Bonnet K, Norman RG, Rapoport DM (1993) The utility of topographic EEG mapping in obstructive sleep apnea syndrome. Sleep 16:76–78
Klimesch W (1999) EEG alpha and theta oscillations reflect cognitive and memory performance: a review and analysis. Brain Res Rev 29:169–195
Kraaier V, Van Huffelen AC, Wieneke GH (1988) Quantitative EEG changes due to hypobaric hypoxia in normal subjects. Electroencephalogr Clin Neurophysiol 69:303–312
Kuskowski MA, Mortimer JA, Morley GK, Malone SM, Okaya AJ (1993) Rate of cognitive decline in Alzheimer's disease is associated with EEG alpha power. Biol Psychiatry 33:659–662
Pozzi D, Petracchi M, Sabe L, Golimstock A, Garcia H, Starkstein S (1995) Quantified electroencephalographic correlates of neuropsychological deficits in Alzheimer's disease. J Neuropsychiatry Clin Neurosci 7:61–67
Findley LJ, Barth JT, Powers DC, Wilhait SC, Boyd DG, Suratt PM (1986) Cognitive impairment in patients with obstructive sleep apnea and associated hypoxemia. Chest 90:686–690
Greenberg GD, Watson RK (1987) Neuropsychological dysfunction in sleep apnea. Sleep 10:254–262
Montplaisir J, Bèdard MA, Richer F, Rouleau I (1992) Neurobehavioral manifestations in obstructive sleep apnea syndrome before and after treatment with continuous positive airway pressure. Sleep 15:17–19
Guilleminault C, Partinen M, Quera-Salva MA, Hayes B, Dement WC, Nino-Murcia G (1988) Determinants of daytime sleepiness in obstructive sleep apnea. Chest 94:32–37
Engleman HM, Martin SE, Deary IJ, Douglas NJ (1994) Effect of continuous positive airway pressure treatment on daytime function in sleep apnoea/hypopnoea syndrome. Lancet 343:572–575
Bédard MA, Montplaisir J, Malo J, Richer F (1991) Sleep disruption and nocturnal hypoxemia as determinants of vigilance impairment in sleep apnea syndrome. Chest 100:367–370
Kotterba S, Rasche K, Widding W, Duscha C, Blombach S, Schultze-Werninghouse G, Malin JP (1998) Neuropsychological investigations and event-related potentials in obstructive sleep apnea syndrome before and during CPAP-therapy. J Neurol Sci 159:45–50
Naegele B, Pepin JL, Levy P, Bonnet C, Pellat J, Feuerstein C (1998) Cognitive executive dysfunction in patients with obstructive sleep apnea syndrome (OSAS) after CPAP treatment. Sleep 21:392–397
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Xiromeritis, A.G., Hatziefthimiou, A.A., Hadjigeorgiou, G.M. et al. Quantitative spectral analysis of vigilance EEG in patients with obstructive sleep apnoea syndrome. Sleep Breath 15, 121–128 (2011). https://doi.org/10.1007/s11325-010-0335-6
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DOI: https://doi.org/10.1007/s11325-010-0335-6