Cumulative brain desaturation: Time to consider brain derived parameters to measure daytime sleepiness in obstructive sleep apnea.
Sleep Med
; 113: 338-341, 2024 01.
Article
em En
| MEDLINE
| ID: mdl-38103465
ABSTRACT
OBJECTIVE:
/Background:
The change in cerebral hemodynamics induced by sleep apneas and hypopneas may contribute to the daytime sleepiness in patients with obstructive sleep apnea (OSA). However, previous studies failed to discovery their relationship. We propose and test a new parameter, the cumulative brain oxygen desaturation, which may contribute to OSA patient's daytime sleepiness. PATIENTS/METHODS:
22 patients with severe OSA (apnea-hypopnea index (AHI) at diagnosis [mean ± standard deviation, std.] 52.1 ± 21.6/h, median 45.1/h, interquartile range 34.4-60.2/h) were monitored by polysomnography during routine continuous positive airway pressure titration. The reductions of brain tissue oxygen saturation (StO2) in all respiratory events at baseline sleep were measured by frequency-domain near-infrared spectroscopy (NIRS). The cumulative brain desaturation was calculated as AHI times the mean StO2 desaturation (i.e., AHI×ΔStO2â¾). Similarly, cumulative peripheral desaturation was also calculated, i.e., AHI×ΔSpO2â¾ where ΔSpO2â¾ was the mean reduction of peripheral arterial oxygen saturation (SpO2). The correlations between Epworth sleepiness scale (ESS) and AHI, ΔStO2â¾, AHI×ΔStO2â¾, and AHI×ΔSpO2â¾ were tested, respectively. Linear regression was applied to predict ESS using AHI×ΔStO2â¾ and AHI×ΔSpO2â¾, with age and BMI as covariates.RESULTS:
ESS significantly correlates to the cumulative brain desaturation (Pearson's correlation coefficient 0.68, p = 0.00056), not the other parameters. Regression analysis only finds significant association between ESS and the cumulative cerebral desaturation (p = 0.00195) but not the cumulative peripheral desaturation (p = 0.71).CONCLUSIONS:
The cumulative brain oxygen desaturation, which comprehensively combines total sleep time, the frequency of apnea and hypopnea events, and the severity of cerebral oxygen desaturation, is a new indicator for daytime sleepiness in severe OSA.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Síndromes da Apneia do Sono
/
Apneia Obstrutiva do Sono
/
Distúrbios do Sono por Sonolência Excessiva
Limite:
Humans
Idioma:
En
Revista:
Sleep Med
Ano de publicação:
2024
Tipo de documento:
Article