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Kang JM, Cho SE, Lee GB, Cho SJ, Park KH, Kim ST, Kang SG. Relationship between the Spectral Power Density of Sleep Electroencephalography and Psychiatric Symptoms in Patients with Breathing-related Sleep Disorder. CLINICAL PSYCHOPHARMACOLOGY AND NEUROSCIENCE 2021; 19:521-529. [PMID: 34294621 PMCID: PMC8316670 DOI: 10.9758/cpn.2021.19.3.521] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Revised: 08/28/2020] [Accepted: 09/05/2020] [Indexed: 11/18/2022]
Abstract
Objective Patients with breathing-related sleep disorder (BRSD) often complain of psychiatric symptoms such as depression in addition to snoring, excessive sleepiness, and disturbed sleep. However, the relationship between psychiatric symptoms and severity of sleep apnea in BRSD is controversial. We conducted this study to investigate the relationship between psychiatric symptoms and sleep electroencephalography (EEG) findings in BRSD patients using spectral analysis. Methods All participants underwent polysomnography and evaluation using Symptom Checklist-90-Revised (SCL-90-R) scale. We analyzed the absolute spectral power density values of standard EEG frequency bands in the participants (n = 169) with BRSD during the non-rapid eye movement (NREM) sleep period. We performed correlation analysis between the domain scores of SCL-90-R scale and the absolute values of the EEG frequency bands. Results Significant positive correlation was observed between the absolute spectral power density values in the slow oscillation band and the degree of paranoid ideation (r = 0.226, p = 0.028) and depression (r = 0.216, p = 0.044) in SCL-90-R. The multiple linear regression model showed that higher paranoid ideation domain score (B = 0.007, p = 0.020), younger age (B = −0.011, p < 0.001), and female sex (B = 0.213, p = 0.004) were associated with higher slow oscillation power during NREM sleep. Conclusion The results of the present study suggested a relationship between sleep EEG and psychiatric symptoms in patients with BRSD. This relationship needs to be validated with further studies.
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Affiliation(s)
- Jae Myeong Kang
- Department of Psychiatry, Gachon University Gil Medical Center, Gachon University College of Medicine, Incheon, Korea
| | - Seo-Eun Cho
- Department of Psychiatry, Gachon University Gil Medical Center, Gachon University College of Medicine, Incheon, Korea
| | - Gun Bae Lee
- Gachon Sleep Medicine Center, Gachon University Gil Medical Center, Incheon, Korea
| | - Seong-Jin Cho
- Department of Psychiatry, Gachon University Gil Medical Center, Gachon University College of Medicine, Incheon, Korea
| | - Kee Hyung Park
- Department of Neurology, Gachon University Gil Medical Center, Gachon University College of Medicine, Incheon, Korea
| | - Seon Tae Kim
- Department of Otolaryngology, Gachon University Gil Medical Center, Gachon University College of Medicine, Incheon, Korea
| | - Seung-Gul Kang
- Department of Psychiatry, Gachon University Gil Medical Center, Gachon University College of Medicine, Incheon, Korea
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Zhao X, Chen X, Duan W, Zhao W, Lei X. Impaired alpha rhythm in bad sleeper during nap: A high-density electroencephalogram study. J Sleep Res 2021; 31:e13419. [PMID: 34131989 DOI: 10.1111/jsr.13419] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Revised: 04/30/2021] [Accepted: 05/14/2021] [Indexed: 11/30/2022]
Abstract
As the pace of life accelerates, poor sleep quality has become a common health problem. A wealth of sleep studies based on electroencephalogram (EEG) have found that poor sleep quality has decreased alpha rhythm during night-time sleep. However, whether the EEG rhythm during an afternoon nap has a similar impairment has seldom been investigated. By recruiting 35 subjects for a 90-min nap, we explored the relationship between sleep quality and the alpha rhythm, and the contribution of naps to subjective sleep experience. We found that the power of alpha rhythm in the occipital lobe negatively correlated with sleep quality. However, there was no correlation between the sleep quality at night and the sleep duration of the nap, nor the sleep quality and the proportion of each sleep period of a nap. Our present results indicated that the quality of night-time sleep did not affect the macrostructure of the nap. Interestingly, the negative correlation between the alpha rhythm of a nap and sleep quality at night continuously existed in Wake, N1 sleep, and N2 sleep, and had the most substantial value during N2 sleep of a nap. This implies that an impaired occipital lobe alpha rhythm is a robust biomarker for poor sleep. The research is of particular significance for developing electrical neural stimulation therapy to improve sleep quality, especially for the stimuli regions for selection and the time windows for implementation.
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Affiliation(s)
- Xiangyue Zhao
- Sleep and NeuroImaging Center, Faculty of Psychology, Southwest University, Chongqing, China.,Key Laboratory of Cognition and Personality (Southwest University), Ministry of Education, Chongqing, China
| | - Xinyuan Chen
- Sleep and NeuroImaging Center, Faculty of Psychology, Southwest University, Chongqing, China.,Key Laboratory of Cognition and Personality (Southwest University), Ministry of Education, Chongqing, China
| | - Wei Duan
- Sleep and NeuroImaging Center, Faculty of Psychology, Southwest University, Chongqing, China.,Key Laboratory of Cognition and Personality (Southwest University), Ministry of Education, Chongqing, China
| | - Wenrui Zhao
- Sleep and NeuroImaging Center, Faculty of Psychology, Southwest University, Chongqing, China.,Key Laboratory of Cognition and Personality (Southwest University), Ministry of Education, Chongqing, China
| | - Xu Lei
- Sleep and NeuroImaging Center, Faculty of Psychology, Southwest University, Chongqing, China.,Key Laboratory of Cognition and Personality (Southwest University), Ministry of Education, Chongqing, China
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Difference in spectral power density of sleep EEG between patients with simple snoring and those with obstructive sleep apnoea. Sci Rep 2020; 10:6135. [PMID: 32273528 PMCID: PMC7145832 DOI: 10.1038/s41598-020-62915-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2019] [Accepted: 03/20/2020] [Indexed: 11/29/2022] Open
Abstract
Patients with simple snoring (SS) often complain of poor sleep quality despite a normal apnoea-hypopnoea index (AHI). We aimed to identify the difference in power spectral density of electroencephalography (EEG) between patients with SS and those with obstructive sleep apnoea (OSA). We compared the absolute power spectral density values of standard EEG frequency bands between the SS (n = 42) and OSA (n = 129) groups during the non-rapid eye movement (NREM) sleep period, after controlling for age and sex. We also analysed partial correlation between AHI and the absolute values of the EEG frequency bands. The absolute power spectral density values in the beta and delta bands were higher in the OSA group than in the SS group. AHI also positively correlated with beta power in the OSA group as well as in the combined group (OSA + SS). In conclusion, higher delta and beta power during NREM sleep were found in the OSA group than in the SS group, and beta power was correlated with AHI. These findings are microstructural characteristics of sleep-related breathing disorders.
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Muñoz-Torres Z, Jiménez-Correa U, Montes-Rodríguez CJ. Sex differences in brain oscillatory activity during sleep and wakefulness in obstructive sleep apnea. J Sleep Res 2020; 29:e12977. [PMID: 31912604 DOI: 10.1111/jsr.12977] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2019] [Revised: 12/08/2019] [Accepted: 12/12/2019] [Indexed: 11/30/2022]
Abstract
Epidemiological studies consistently show a male predominance in obstructive sleep apnea (OSA). Hormonal differences, breathing control, upper airway anatomy and fat distribution have been proposed as causes of gender differences in OSA. Clinical manifestations are accentuated in men, although white matter structural integrity is affected in women. To the best of our knowledge, no previous studies have explored gender differences in the electrical brain activity features of OSA. Polysomnography was performed on 43 patients with untreated OSA (21 women, 22 men), and power spectral density (1-50 Hz) was compared between groups across sleep and wakefulness at two levels of OSA severity. Severe versus moderate OSA showed decreased power for fast frequencies (25-29 Hz) during wakefulness. OSA men displayed decreased power of a large frequency range (sigma, beta and gamma) during sleep compared with women. Comparisons of men with severe versus moderate OSA presented significantly decreased sigma power during non-rapid eye movement (NREM) sleep, but significantly increased delta activity during REM sleep. Meanwhile, women with severe versus moderate OSA showed no significant power differences in any condition. These findings indicated a different evolution of brain oscillations between OSA men and women with significant impairment of brain activity related to cognitive processes. Our study emphasizes the importance of understanding the differential effects of sleep disorders on men and women in order to develop more precise diagnostic criteria according to gender, including quantitative electroencephalogram (EEG) analysis tools.
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Affiliation(s)
- Zeidy Muñoz-Torres
- Psychobiology and Neuroscience, Faculty of Psychology, Universidad Nacional Autonoma de Mexico, Mexico City, Mexico.,Neural Dynamics Group, Centro de Ciencias de la Complejidad (C3), Universidad Nacional Autonoma de Mexico, Mexico City, Mexico
| | - Ulises Jiménez-Correa
- Clinic for Sleep Disorders, Research Division, Faculty of Medicine, Universidad Nacional Autonoma de Mexico, Mexico City, Mexico
| | - Corinne J Montes-Rodríguez
- Group of Synaptic Plasticity and Neural Ensembles, Centro de Ciencias de la Complejidad (C3), Universidad Nacional Autonoma de Mexico, Mexico City, Mexico
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Puskás S, Kozák N, Sulina D, Csiba L, Magyar MT. Quantitative EEG in obstructive sleep apnea syndrome: a review of the literature. Rev Neurosci 2018; 28:265-270. [PMID: 28099139 DOI: 10.1515/revneuro-2016-0064] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2016] [Accepted: 11/30/2016] [Indexed: 11/15/2022]
Abstract
Obstructive sleep apnea syndrome (OSAS) is characterized by the recurrent cessation (apnea) or reduction (hypopnea) of airflow due to the partial or complete upper airway collapse during sleep. Respiratory disturbances causing sleep fragmentation and repetitive nocturnal hypoxia are responsible for a variety of nocturnal and daytime complaints of sleep apnea patients, such as snoring, daytime sleepiness, fatigue, or impaired cognitive functions. Different techniques, such as magnetic resonance imaging, magnetic resonance spectroscopy, and positron emission tomography, are used to evaluate the structural and functional changes in OSAS patients. With quantitative electroencephalographic (qEEG) analysis, the possible existence of alterations in the brain electrical activity of OSAS patients can be investigated. We review the articles on qEEG results of sleep apnea patients and summarize the possible explanations of these qEEG measures. Finally, we review the impact of continuous positive airway pressure (CPAP) treatment on these alterations to assess whether CPAP use can eliminate alterations in the brain activity of OSAS patients.
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Toth M, Kondakor I, Faludi B. Differences of brain electrical activity between moderate and severe obstructive sleep apneic patients: a LORETA study. J Sleep Res 2016; 25:596-604. [DOI: 10.1111/jsr.12403] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2015] [Accepted: 02/02/2016] [Indexed: 11/30/2022]
Affiliation(s)
- Marton Toth
- Department of Neurology; University of Pécs; Pécs Hungary
| | - Istvan Kondakor
- Department of Neurology; Balassa Janos Teaching Hospital; Szekszárd Hungary
| | - Bela Faludi
- Department of Neurology; University of Pécs; Pécs Hungary
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Jones SG, Riedner BA, Smith RF, Ferrarelli F, Tononi G, Davidson RJ, Benca RM. Regional reductions in sleep electroencephalography power in obstructive sleep apnea: a high-density EEG study. Sleep 2014; 37:399-407. [PMID: 24497668 DOI: 10.5665/sleep.3424] [Citation(s) in RCA: 54] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
STUDY OBJECTIVES Obstructive sleep apnea (OSA) is associated with significant alterations in neuronal integrity resulting from either hypoxemia and/or sleep loss. A large body of imaging research supports reductions in gray matter volume, alterations in white matter integrity and resting state activity, and functional abnormalities in response to cognitive challenge in various brain regions in patients with OSA. In this study, we used high-density electroencephalography (hdEEG), a functional imaging tool that could potentially be used during routine clinical care, to examine the regional distribution of neural activity in a non-clinical sample of untreated men and women with moderate/severe OSA. DESIGN Sleep was recorded with 256-channel EEG in relatively healthy subjects with apnea-hypopnea index (AHI) > 10, as well as age-, sex-, and body mass index-matched controls selected from a research population initially recruited for a study on sleep and meditation. SETTING Sleep laboratory. PATIENTS OR PARTICIPANTS Nine subjects with AHI > 10 and nine matched controls. INTERVENTIONS N/A. MEASUREMENTS AND RESULTS Topographic analysis of hdEEG data revealed a broadband reduction in EEG power in a circumscribed region overlying the parietal cortex in OSA subjects. This parietal reduction in neural activity was present, to some extent, across all frequency bands in all stages and episodes of nonrapid eye movement sleep. CONCLUSION This investigation suggests that regional deficits in electroencephalography (EEG) power generation may be a useful clinical marker for neural disruption in obstructive sleep apnea, and that high-density EEG may have the sensitivity to detect pathological cortical changes early in the disease process.
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Affiliation(s)
| | | | | | | | | | - Richard J Davidson
- Department of Psychiatry ; Department of Psychology, University of Wisconsin-Madison, Madison, WI
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Toth M, Faludi B, Kondakor I. Effects of CPAP-Therapy on Brain Electrical Activity in Obstructive Sleep Apneic Patients: A Combined EEG Study Using LORETA and Omega Complexity. Brain Topogr 2012; 25:450-60. [DOI: 10.1007/s10548-012-0243-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2011] [Accepted: 07/20/2012] [Indexed: 10/28/2022]
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Song MK, Ha JH, Ryu SH, Yu J, Park DH. The effect of aging and severity of sleep apnea on heart rate variability indices in obstructive sleep apnea syndrome. Psychiatry Investig 2012; 9:65-72. [PMID: 22396687 PMCID: PMC3285743 DOI: 10.4306/pi.2012.9.1.65] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2011] [Revised: 10/30/2011] [Accepted: 11/01/2011] [Indexed: 01/29/2023] Open
Abstract
OBJECTIVE This study aims to analyze how much heart rate variability (HRV) indices discriminatively respond to age and severity of sleep apnea in the obstructive sleep apnea syndrome (OSAS). METHODS 176 male OSAS patients were classified into four groups according to their age and apnea-hypopnea index (AHI). The HRV indices were compared via analysis of covariance (ANCOVA). In particular, the partial correlation method was performed to identify the most statistically significant HRV indices in the time and frequency domains. Stepwise multiple linear regressions were further executed to examine the effects of age, AHI, body mass index (BMI), systolic blood pressure (SBP), diastolic blood pressure (DBP), and sleep parameters on the significant HRV indices. RESULTS The partial correlation analysis yielded the NN50 count (defined as the number of adjacent R-wave to R-wave intervals differing by more than 50 ms) and low frequency/high frequency (LF/HF) ratio to be two most statistically significant HRV indices in both time and frequency domains. The two indices showed significant differences between the groups. The NN50 count was affected by age (p<0.001) and DBP (p=0.039), while the LF/HF ratio was affected by AHI (p<0.001), the amount of Stage 2 sleep (p=0.005), and age (p=0.021) in the order named in the regression analysis. CONCLUSION The NN50 count more sensitively responded to age than to AHI, suggesting that the index is mainly associated with an age-related parasympathetic system. On the contrary, the LF/HF ratio responded to AHI more sensitively than to age, suggesting that it is mainly associated with a sympathetic tone likely reflecting the severity of sleep apnea.
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Affiliation(s)
- Man-Kyu Song
- Department of Neuropsychiatry, Konkuk University Hospital, Seoul, Korea
- Department of Psychiatry, Konkuk University School of Medicine, Seoul, Korea
| | - Jee Hyun Ha
- Department of Neuropsychiatry, Konkuk University Hospital, Seoul, Korea
- Department of Psychiatry, Konkuk University School of Medicine, Seoul, Korea
| | - Seung-Ho Ryu
- Department of Neuropsychiatry, Konkuk University Hospital, Seoul, Korea
- Department of Psychiatry, Konkuk University School of Medicine, Seoul, Korea
| | - Jaehak Yu
- Department of Neuropsychiatry, Konkuk University Hospital, Seoul, Korea
- Department of Psychiatry, Konkuk University School of Medicine, Seoul, Korea
| | - Doo-Heum Park
- Department of Neuropsychiatry, Konkuk University Hospital, Seoul, Korea
- Department of Psychiatry, Konkuk University School of Medicine, Seoul, Korea
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