Quantitative Spectral Analysis of Waking Electroencephalography in Patients With Moderate to Severe Obstructive Sleep Apnea and Excessive Daytime Sleepiness: A Case–Control Matched Pilot Study
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Objectives: This study aims to examine the differences in spectral analysis of waking electroencephalography (EEG) patterns between patients with moderate to severe obstructive sleep apnea (OSA) experiencing excessive daytime sleepiness (EDS) and matched healthy participants, to gain insights into the neurophysiological underpinnings of daytime impairments. Methods: A cross-sectional analysis was conducted involving 17 patients with moderate to severe OSA confirmed by overnight polysomnography (PSG). These patients had ≥15 per hour apnea–hypopnea index (AHI) and ≥11 Epworth Sleepiness Scale (ESS). EEG recordings were captured within 30 minutes of awakening. A corresponding group of the equal number of age and sex-matched healthy participants was also analyzed for comparative purposes. Spectral analysis of quantitative EEG (qEEG) of patients with OSA compared with that of an equal number of age- and sex-matched healthy participants. Results: The analysis included 17 patients (16 males, average age 57.2 years) with moderate to severe OSA experiencing EDS (mean AHI 38.1±20.5; ESS 14.4±3.2). The patients with OSA exhibited altered sleep architecture during diagnostic PSG, significantly higher EEG delta band power in the frontal regions upon awakening after night sleep, and decreased connection of delta band in frontal area than normal participants (3.78±5.53 vs. 3.22±0.98 μV<sup>2</sup>, <i>p</i>=0.03). Conclusions: The study demonstrated difference in delta activity and connectivity in the frontal area between patients with OSA experiencing EDS and the control group. These findings suggest awakening qEEG in OSA may helpful to guide or enhance understanding of daytime functional impairment and EDS.
Abstract
Objectives: This study aims to examine the differences in spectral analysis of waking electroencephalography (EEG) patterns between patients with moderate to severe obstructive sleep apnea (OSA) experiencing excessive daytime sleepiness (EDS) and matched healthy participants, to gain insights into the neurophysiological underpinnings of daytime impairments. Methods: A cross-sectional analysis was conducted involving 17 patients with moderate to severe OSA confirmed by overnight polysomnography (PSG). These patients had ≥15 per hour apnea–hypopnea index (AHI) and ≥11 Epworth Sleepiness Scale (ESS). EEG recordings were captured within 30 minutes of awakening. A corresponding group of the equal number of age and sex-matched healthy participants was also analyzed for comparative purposes. Spectral analysis of quantitative EEG (qEEG) of patients with OSA compared with that of an equal number of age- and sex-matched healthy participants. Results: The analysis included 17 patients (16 males, average age 57.2 years) with moderate to severe OSA experiencing EDS (mean AHI 38.1±20.5; ESS 14.4±3.2). The patients with OSA exhibited altered sleep architecture during diagnostic PSG, significantly higher EEG delta band power in the frontal regions upon awakening after night sleep, and decreased connection of delta band in frontal area than normal participants (3.78±5.53 vs. 3.22±0.98 μV<sup>2</sup>, <i>p</i>=0.03). Conclusions: The study demonstrated difference in delta activity and connectivity in the frontal area between patients with OSA experiencing EDS and the control group. These findings suggest awakening qEEG in OSA may helpful to guide or enhance understanding of daytime functional impairment and EDS.
참고문헌 (33)
- Seneviratne U, "Excessive daytime sleepiness in obstructive sleep apnea : prevalence, severity, and predictors", Sleep Med, 5, pp.339~343 (2004)[DOI]
- Zhou J, "A review of neurocognitive function and obstructive sleep apnea with or without daytime sleepiness", Sleep Med, 23, pp.99~108 (2016)[DOI]
- Javaheri S, "Update on persistent excessive daytime sleepiness in OSA", Chest, 158, pp.776~786 (2020)[DOI]
- Miyata S, "Delayed sleep", wake rhythm and excessive daytime sleepiness correlate with decreased daytime brain activity during cognitive task in university students, 2019, pp.50, 171~179
- Liu S, "EEG power spectral analysis of abnormal cortical activations during REM", NREM sleep in obstructive sleep apnea, 2021, pp.12, 643855~
- Pase MP, "Sleep architecture, obstructive sleep apnea, and cognitive function in adults", JAMA Netw Open, 6, pp.e2325152~ (2023)[DOI]
- Zou D, "Validation a portable monitoring device for sleep apnea diagnosis in a population based cohort using synchronized home polysomnography", Sleep, 29, pp.367~374 (2006)[DOI]
- Johns MW, "A new method for measuring daytime sleepiness : the Epworth sleepiness scale", Sleep, 14, pp.540~545 (1991)[DOI]
- Ko J, "Quantitative electroencephalogram standardization : a sex-and age-differentiated normative database", Front Neurosci, 15, pp.766781~ (2021)[DOI]
- Berry RB, "Rules for scoring respiratory events in sleep : update of the 2007 AASM manual for the scoring of sleep and associated events", J Clin Sleep Med, 8, pp.597~619 (2012)[DOI]
- Han SH, "Differences between memory encoding and retrieval failure in mild cognitive impairment : results from quantitative electroencephalography and magnetic resonance volumetry", Alzheimers Res Ther, 13, pp.3~ (2021)[DOI]
- Jeong HT, "Power spectral changes of quantitative EEG in the subjective cognitive decline : comparison of community normal control groups", Neuropsychiatr Dis Treat, 17, pp.2783~2790 (2021)[DOI]
- Delorme A, "Independent EEG sources are dipolar", PLoS One, 7, pp.e30135~ (2012)[DOI]
- Delorme A, "EEGLAB : an open source toolbox for analysis of single-trial EEG dynamics including independent component analysis", J Neurosci Methods, 134, pp.9~21 (2004)[DOI]
- AMICA: An adaptive mixture of independent component analyzers with shared components, "Palmer JA", Swartz Center for Computatonal Neursoscience, University of California, 1~15 (2012)
- Holmes CJ, "Enhancement of MR images using registration for signal averaging", J Comput Assist Tomogr, 22, pp.324~333 (1998)[DOI]
- Rubinov M, "Complex network measures of brain connectivity : uses and interpretations", Neuroimage, 52, pp.1059~1069 (2010)[DOI]
- Baik K, "Donepezil for mild cognitive impairment in Parkinson’s disease", Sci Rep, 11, pp.4734~ (2021)[DOI]
- Chervin RD, "Sleepiness, fatigue, tiredness, and lack of energy in obstructive sleep apnea", Chest, 118, pp.372~379 (2000)[DOI]
- Lal C, "Excessive daytime sleepiness in obstructive sleep apnea. Mechanisms and clinical management", Ann Am Thorac Soc, 18, pp.757~768 (2021)[DOI]
- Léger D, "The economic and societal burden of excessive daytime sleepiness in patients with obstructive sleep apnea", Sleep Med Rev, 51, pp.101275~ (2020)[DOI]
- Gozal D, "Correlation analysis between NEPSY battery scores and respiratory disturbance index in snoring 6-year old children : a preliminary report", Sleep, 24(Abstract supple), pp.A126~ (2001)
- Beebe DW, "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, pp.1~16 (2002)[DOI]
- Bianchi MT, "Obstructive sleep apnea alters sleep stage transition dynamics", PLoS One, 5, pp.e11356~ (2010)[DOI]
- Boulos MI, "Normal polysomnography parameters in healthy adults : a systematic review and meta-analysis", Lancet Respir Med, 7, pp.533~543 (2019)[DOI]
- Esser SK, "Sleep homeostasis and cortical synchronization : I. Modeling the effects of synaptic strength on sleep slow waves", Sleep, 30, pp.1617~1630 (2007)[DOI]
- Göder R, "Delta power in sleep in relation to neuropsychological performance in healthy subjects and schizophrenia patients", J Neuropsychiatry Clin Neurosci, 18, pp.529~535 (2006)[DOI]
- Long S, "Sleep quality and electroencephalogram delta power", Front Neurosci, 15, pp.803507~ (2021)[DOI]
- Howarth T, "Excessive daytime sleepiness is associated with relative delta frequency power among patients with mild OSA", Front Neurol, 15, pp.1367860~ (2024)[DOI]
- El-Mekkawy L, "Screening of non-restorative sleep by quantitative EEG", Egypt J Neurol Psychiatry Neurosurg, 58, pp.11~ (2022)[DOI]
- Harmony T, "The functional significance of delta oscillations in cognitive processing", Front Integr Neurosci, 7, pp.83~ (2013)[DOI]
- Anderson C, "Prefrontal cortex : links between low frequency delta EEG in sleep and neuropsychological performance in healthy, older people", Psychophysiology, 40, pp.349~357 (2003)[DOI]
- Münch M, "The frontal predominance in human EEG delta activity after sleep loss decreases with age", Eur J Neurosci, 20, pp.1402~1410 (2004)[DOI]
