Obstructive sleep apnea alters sleep stage transition dynamics.
Obstructive sleep apnea alters sleep stage transition dynamics.
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DOI：
10.1371/journal.pone.0011356
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发表时间：
2010-06-28
期刊：
影响因子：
3.7
通讯作者：
Thomas R
中科院分区：
文献类型：
--
作者：
Bianchi MT;Cash SS;Mietus J;Peng CK;Thomas R
与阶段百分比和睡眠效率等常规多导睡眠图指标相比，增强睡眠结构的表征可以改善碎片睡眠的预测表型。一种方法涉及使用阶段转换分析来表征睡眠连续性。我们使用以下阶段名称分析了睡眠心脏健康研究 (SHHS) 参与者的催眠图：入睡后觉醒 (WASO)、非快速眼动 (NREM) 睡眠和快速眼动睡眠。我们表明，个体患者的睡眠图包含的次数不足以充分描述转变动力学，因此需要汇集数据。我们将没有药物、阻塞性睡眠呼吸暂停 (OSA)、医疗共病或嗜睡的对照组 (n = 374) 与轻度 (n = 496) 或重度 OSA (n = 338) 的个体进行比较。 WASO、REM 睡眠和 NREM 睡眠持续时间表现出多指数时间动态。 OSA 的存在加速了 NREM 和 REM 睡眠发作的“衰减”率，导致不稳定，表现为发作时间缩短和阶段转换次数增加。对于 WASO 回合，之前归因于幂律过程，多指数衰减很好地描述了数据。模拟表明，多指数过程可以模拟幂律分布。 OSA 通过降低 NREM 和 REM 睡眠周期的时间稳定性来改变睡眠结构动态。多指数拟合优于常规单指数拟合，因此可以提供改进的睡眠连续性预测指标。然而，由于一晚的睡眠包含的转变不足以表征这些动态，因此可能需要在家里对睡眠进行长期监测，以实现个性化的临床应用。
Enhanced characterization of sleep architecture, compared with routine polysomnographic metrics such as stage percentages and sleep efficiency, may improve the predictive phenotyping of fragmented sleep. One approach involves using stage transition analysis to characterize sleep continuity. We analyzed hypnograms from Sleep Heart Health Study (SHHS) participants using the following stage designations: wake after sleep onset (WASO), non-rapid eye movement (NREM) sleep, and REM sleep. We show that individual patient hypnograms contain insufficient number of bouts to adequately describe the transition kinetics, necessitating pooling of data. We compared a control group of individuals free of medications, obstructive sleep apnea (OSA), medical co-morbidities, or sleepiness (n = 374) with mild (n = 496) or severe OSA (n = 338). WASO, REM sleep, and NREM sleep bout durations exhibited multi-exponential temporal dynamics. The presence of OSA accelerated the “decay” rate of NREM and REM sleep bouts, resulting in instability manifesting as shorter bouts and increased number of stage transitions. For WASO bouts, previously attributed to a power law process, a multi-exponential decay described the data well. Simulations demonstrated that a multi-exponential process can mimic a power law distribution. OSA alters sleep architecture dynamics by decreasing the temporal stability of NREM and REM sleep bouts. Multi-exponential fitting is superior to routine mono-exponential fitting, and may thus provide improved predictive metrics of sleep continuity. However, because a single night of sleep contains insufficient transitions to characterize these dynamics, extended monitoring of sleep, probably at home, would be necessary for individualized clinical application.
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影响因子：
4.2
作者：
CARSKADON, MA;BROWN, ED;DEMENT, WC
通讯作者：
DEMENT, WC
DOI：
10.1152/ajpregu.00925.2007
发表时间：
2008-06-01
影响因子：
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影响因子：
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作者：
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DOI：
10.1073/pnas.0408242101
发表时间：
2004-12-14
影响因子：
11.1
作者：
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通讯作者：
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影响因子：
3.5
作者：
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通讯作者：
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