Impaired post-sleep apnea autonomic arousals in patients with drug-resistant epilepsy.
Clin Neurophysiol
; 160: 1-11, 2024 04.
Article
em En
| MEDLINE
| ID: mdl-38367308
ABSTRACT
OBJECTIVE:
Sudden and unexpected deaths in epilepsy (SUDEP) pathophysiology may involve an interaction between respiratory dysfunction and sleep/wake state regulation. We investigated whether patients with epilepsy exhibit impaired sleep apnea-related arousals.METHODS:
Patients with drug-resistant (N = 20) or drug-sensitive (N = 20) epilepsy and obstructive sleep apnea, as well as patients with sleep apnea but without epilepsy (controls, N = 20) were included. We explored (1) the respiratory arousal threshold based on nadir oxygen saturation, apnea-hypopnea index, and fraction of hypopnea among respiratory events; (2) the cardiac autonomic response to apnea/hypopnea quantified as percentages of changes from the baseline in RR intervals (RRI), high (HF) and low (LF) frequency powers, and LF/HF.RESULTS:
The respiratory arousal threshold did not differ between groups. At arousal onset, RRI decreased (-9.42%) and LF power (179%) and LF/HF ratio (190%) increased. This was followed by an increase in HF power (118%), p < 0.05. The RRI decrease was lower in drug-resistant (-7.40%) than in drug-sensitive patients (-9.94%) and controls (-10.91%), p < 0.05. LF and HF power increases were higher in drug-resistant (188%/126%) than in drug-sensitive patients (172%/126%) and controls (177%/115%), p < 0.05.CONCLUSIONS:
Cardiac reactivity following sleep apnea is impaired in drug-resistant epilepsy.SIGNIFICANCE:
This autonomic dysfunction might contribute to SUDEP pathophysiology.Palavras-chave
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Síndromes da Apneia do Sono
/
Epilepsia Resistente a Medicamentos
/
Morte Súbita Inesperada na Epilepsia
Limite:
Humans
Idioma:
En
Revista:
Clin Neurophysiol
Assunto da revista:
NEUROLOGIA
/
PSICOFISIOLOGIA
Ano de publicação:
2024
Tipo de documento:
Article
País de afiliação:
França