ANPHY-Sleep: an Open Sleep Database from Healthy Adults Using High-Density Scalp Electroencephalogram.

Well-documented sleep datasets from healthy adults are important for sleep pattern analysis and comparison with a wide range of neuropsychiatric disorders. Currently, available sleep datasets from healthy adults are acquired using low-density arrays with a minimum of four electrodes in a typical sleep montage. The low spatial resolution is thus prohibitive for the analysis of the spatial structure of sleep. Here we introduce an open-access sleep dataset from 29 healthy adults (13 female, aged 32.17 ± 6.30 years) acquired at the Montreal Neurological Institute. The dataset includes overnight polysomnograms with high-density scalp electroencephalograms incorporating 83 electrodes, electrocardiogram, electromyogram, electrooculogram, and an average of electrode positions using manual co-registrations and sleep scoring annotations. Data characteristics and group-level analysis of sleep properties were assessed. The database can be accessed through ( https://doi.org/10.17605/OSF.IO/R26FH ). This is the first high-density electroencephalogram open sleep database from healthy adults, allowing researchers to investigate sleep physiology at high spatial resolution. We expect that this database will serve as a valuable resource for studying sleep physiology and for benchmarking sleep pathology.

Rinitis alérgica, apnea-hipopnea obstructiva del sueño y sensibilización a ácaros / Allergic rhinitis, obstructive sleep apnea-hypopnea and mite sensitization

La asociación de rinitis alérgica y el síndrome de apnea-hipopnea obstructiva del sueño se presenta en diferentes edades. En la rinitis alérgica y el síndrome de apnea-hipopnea obstructiva del sueño, puede estar involucrada la sensibilización a ácaros, principalmente: Dermatophagoides pteronyssinus, Dermatophagoides siboney y Blomia tropicalis. Con el objetivo de diagnosticar el síndrome de apnea-hipopnea obstructiva del sueño se seleccionaron 120 individuos del registro de alergia del Policlínico Previsora, Camagüey, Cuba, con diagnóstico presuntivo de rinitis alérgica y edad entre 5 y 15 años cumplidos. Todos tenían realizada la prueba de punción cutánea con Dermatophagoides pteronyssinus, Dermatophagoides siboney y Blomia tropicalis; algunos también, la poligrafía cardiorrespiratoria mediante el dispositivo ApneaLinkAirTM (Resmed Corp., RFA), utilizando el marcaje automático de eventos. La muestra fue de 40 casos (respiración oral, ronquidos) y 80 controles (sin respiración oral, ni ronquidos). La media del tamaño del habón fue de 7,9 mm en los casos y 4,1 mm en los controles (p꞊0,030). El índice de apnea-hipopnea fue positivo en 47 (39,1 por ciento) pacientes, de ellos, 36 (30 por ciento) casos y 11 (9,1 por ciento) controles (p=0,001). La sensibilidad y especificidad de la poligrafía cardiorrespiratoria mostró valores de 85,00 por ciento y 91,25 por ciento respectivamente que permiten afirmar el grado de eficacia de la prueba para diagnosticar apnea e hipopnea obstructiva del sueño. Los pacientes con síndrome de apnea-hipopnea obstructiva del sueño en los casos y controles presentaron incremento, con predominio para casos. La poligrafía cardiorrespiratoria con el dispositivo ApneaLink permite hacer el diagnóstico del síndrome de apnea-hipopnea obstructiva del sueño en rinitis alérgica(AU)

The association of allergic rhinitis and obstructive sleep apnea-hypopnea syndrome occurs at different ages. In allergic rhinitis and obstructive sleep apnea-hypopnea syndrome, sensitization to mites may be involved, mainly: Dermatophagoides pteronyssinus, Dermatophagoides siboney and Blomia tropicalis. With the objective to diagnose obstructive sleep apnea-hypopnea syndrome, 120 individuals were selected from the allergy registry of the Previsora Polyclinic, Camagüey, Cuba, with a presumptive diagnosis of allergic rhinitis and ages between 5 and 15 years old. All had the skin prick test with Dermatophagoides pteronyssinus, Dermatophagoides siboney and Blomia tropicalis; some also, cardio-respiratory polygraphy with the ApneaLink AirTM device (Resmed Corp., RFA), using automatic event marking. The sample consisted of 40 cases (oral breathing, snoring) and 80 controls (no oral breathing or snoring). The mean size of the wheal was 7.9 mm in the cases and 4.1 mm in the controls (p꞊0.030). The apnea and hypopnea index was positive in 47 (39.1 percent) patients, of which 36 (30 percent) were cases and 11 (9.1 percent) were controls (p=0.001). The sensitivity and specificity of the cardiorespiratory polygraphy showed values of 85.00 percent and 91.25 percent, respectively, which allow affirming the degree of efficacy of the test to diagnose obstructive sleep apnea-hypopnea. Patients with obstructive sleep apnea-hypopnea syndrome in cases and controls presented an increase, with a predominance for cases. Cardiorespiratory polygraphy with the ApneaLink device allows the diagnosis of obstructive sleep apnea-hypopnea syndrome in allergic rhinitis(AU)

Inmunoterapia con alérgenos de ácaros en pacientes con rinitis alérgica y apnea obstructiva del sueño / Immunotherapy with mite allergens in patients with allergic rhinitis and obstructive sleep apnea

Para confirmar la presencia de apneea obstructiva del sueño (OSA) en rinitis alérgica (RA), se realizó poligrafía cardiorrespiratoria (CRP) y para tratar ambas condiciones, inmunoterapia alérgeno específica (ITAE). El diseño fue descriptivo en el universo de pacientes del servicio de Alergología del policlínico Previsora en Camagüey, Cuba, desde diciembre 2018 a marzo 2020. Se seleccionaron 326 pacientes en orden consecutivo de asistencia a la consulta, teniendo en cuenta los criterios: ≥5 años con RA, sospecha de OSA y prueba cutánea con ácaros: Dermatophagoides pteronyssinus, Dermatophagoides siboney y Blomia tropicalis, producidos en: Centro Nacional de Biopreparados de Cuba. Todos recibieron ASIT por ≥10 meses y se realizó CRP antes y después de la ASIT. La CRP se realizó utilizando el marcaje automático de eventos de ApneaLink AirTM (Resmed Corp., RFA), validado para estudiar los trastornos del sueño en el hogar. Los resultados de la prueba cutánea y de CRP se evaluaron antes y después de la ASIT; también la eficacia de la ASIT según criterios de pacientes y profesionales. De la muestra, 152 fueron del sexo femenino y 174 del sexo masculino para un 46,6 por ciento y 53,4 por ciento respectivamente; aquellos con habón de 5 a 6 mm fueron los más representados (p=0,04). Hubo descenso en los niveles de gravedad de OSA después de la ASIT (p=0,025). En la valoración de la eficacia de la ASIT, hubo un número significativo de mejorados (p=0,012). La CRP proporciona el diagnóstico de OSA en RA, y la ASIT cambia el curso de ambas condiciones(AU)

To confirm the presence of obstructive sleep apnea (OSA) in allergic rhinitis (AR), cardiorespiratory polygraphy (CRP) was performed, and to treat both conditions, the allergen specific immunotherapy (ASIT) was used in order to change their course. Descriptive study in the universe of patients from Previsora polyclinic Allergology service, Camagüey, Cuba was carried-out from December 2018 to March 2020. 326 patients were selected in consecutive order of attendance at the consultation, taking into account the criteria: ≥5 years with AR, suspicion of OSA and positive skin test to: Dermatophagoides pteronyssinus, Dermatophagoides siboney and Blomia tropicalis, supplied by the National Center for Biopreparations in Cuba. All patients received ASIT for ≥10 months and CRP was performed before and after ASIT. The CRP results were taken from the automatic scoring of the ApneaLink AirTM device (Resmed Corp., Australia), validated to study OSA at home. The skin test and CRP results were evaluated before and after the ASIT. In addition, the assessment of the ASIT efficacy according to criteria of patients and professionals was performed. The sample was made-up of 152 female patients (46.6 percent) and 174 males (53.4 percent); those with 5 to 6 mm wheal were the most represented (p=0.04). There was decrease in OSA severity levels after ASIT (p=0.025). The ASIT efficacy was proved with a significant number of improvements (p=0.012). CRP provides the diagnosis of OSA in AR, and ASIT changes the course of both conditions(AU)

Importancia de los alérgenos de ácaros domésticos en el diagnóstico de la rinitis alérgica con síndrome de apnea-hipopnea del sueño / Importance of household mite allergens in the diagnosis of allergic rhinitis with sleep apnea-hypopnea syndrome

Los ácaros Dermatophagoides pteronyssinus (Dp), Dermatophagoides siboney (Ds) y Blomia tropicalis (Bt), constituyen la herramienta fundamental para diagnóstico e inmunoterapia de rinitis alérgica (RA), que en muchas ocasiones se asocia al síndrome apnea-hipopnea obstructiva del sueño (SAHOS). Para diagnosticar SAHOS se seleccionaron 465 individuos del registro de alergia del Policlínico Previsora, Camagüey, Cuba, con diagnóstico presuntivo de RA. Se descartaron aquellos con prueba cutánea Prick test negativa a Dp, Ds y Bt y sin poligrafía cardio-respiratoria (PCR), quedando para estudio 236 pacientes entre 8 y 70 años de edad: 102 casos (43,2 por ciento) definidos como aquellos con respiración oral y ronquidos y 134 controles (56,7 por ciento) sin respiración oral ni ronquidos. La PCR se realizó utilizando el marcaje automático de eventos del dispositivo ApneaLink AirTM (Resmed Corp., RFA). La media del tamaño del habón fue de 5,9 mm en los casos (p=0,02). El índice de apnea e hipopnea (IAH) fue positivo en 129 pacientes (54,6 por ciento); de ellos, 97 casos (41,1 por ciento) y 32 controles (13,5 por ciento). Los pacientes con IAH˃20/h predominaron en los casos con 21 individuos (8,8 por ciento) (p꞊0,048). La sensibilidad del PCR fue del 95,10 por ciento, su especificidad del 76,12 por ciento. Los valores predictivos positivos y negativos del 75,19 por ciento y 95,33 por ciento respectivamente. Se estimó en 3,98 la razón de verosimilitud positiva y de 0,06 la negativa. Los pacientes con SAHOS en los casos y controles presentan incremento con predominio para casos (p=0,002). La PCR con el dispositivo ApneaLink permite hacer el diagnóstico de SAHOS en RA(AU)

The mites Dermatophagoides pteronyssinus (Dp), Dermatophagoides siboney (Ds) and Blomia tropicalis (Bt) are the primary tool for the diagnosis and immunotherapy of Allergic Rhinitis (AR), which is often associated with the Obstructive Sleep Apnea-Hypopnea Syndrome (OSAHS). To diagnose OSAHS, 465 individuals were selected from the allergy registry of the Previsora Polyclinic, Camagüey, Cuba, with presumptive diagnosis of AR. Those with a skin test (Prick test) negative to Dp, Ds and Bt, and without a previous Cardiorespiratory Polygraphy (CRP) were discarded, leaving 236 patients between 8 and 70 years old: 102 cases (43.2 percent) those with oral breathing and snoring and 134 controls (56.7 percent) without oral breathing or snoring. The CRP data analysis was performed using the automatic algorithm of the ApneaLink AirTM device (Resmed Corp., Germany). The average size of the wheal was 5.9 mm in cases (p = 0.02). The Apnea Hypopnea Index (AHI) was greater than 5 events/hour in 129 patients (54.6 percent); of those, 97 cases (41.1 percent) and 32 controls (13.5 percent). Patients with AHI˃20/h predominated in cases with 21 individuals (8.8 percent) (p꞊0.048). The sensitivity of the PCR was 95.10 percent, its specificity 76.12 percent. The positive and negative predictive values were 75.19 percent and 95.33 percent respectively. The positive likelihood ratio was 3.98 and the negative one was 0.06. The prevalence of OSAHS was significantly higher in cases compared to controls (p =0.002). The CRP with the ApneaLink device allows the diagnosis of SAHOS in AR(AU)

Leak profile inspection during nasal continuous positive airway pressure.

BACKGROUND: Patients treated with nasal continuous positive airway pressure (nasal CPAP) for obstructive sleep apnea (OSA) often have adverse effects from and poor adherence to CPAP. OBJECTIVE: To describe abnormal CPAP leak profiles and assess inter-observer reliability in identifying leak profiles and the correlation of leak profiles with leak rate and clinical outcomes. METHODS: In a sleep-disorders clinic we prospectively studied 35 consecutive patients newly diagnosed with moderate or severe OSA, and who had undergone polysomnographic diagnosis and nasal CPAP titration. We analyzed the data recorded by their CPAP machines during their first week of CPAP. Two independent clinical sleep specialists inspected each night's leak profiles. We defined a "continuous" leak profile segment as a leak increase of ≥ 20 L/min for > 5 min. We defined a "serrated" leak profile segment as a leak that oscillated up to ≥ 20 L/min in ≤ 5 min. With a validated questionnaire, we surveyed the patients about adverse effects. RESULTS: Overall inter-observer agreement was 88% for continuous leak and 92% for serrated leaks. The kappa values were 0.76 and 0.85, respectively. Deviance (± 2 SD) between scorers was -14% to 11% for continuous leaks, and -15% to 9% for serrated leaks. The duration of manually scored profiles correlated modestly but significantly with the machine-recorded leaks. The mean ± SD adherence to CPAP was lower in the patients with the highest quartile of continuous leak (5.28 ± 2.24 h/night versus 6.66 ± 1.72 h/night). Adverse effects increased with increasing serrated leak (P = .01). CONCLUSIONS: Manually scored leak profiles in patients treated with nasal CPAP can guide clinicians with respect to short-term adherence to nasal CPAP and adverse effects.

Attenuation of the 40-hertz auditory steady state response by propofol involves the cortical and subcortical generators.

BACKGROUND: The 40-Hz auditory steady state response (40-Hz ASSR) provides a reliable marker of anesthetic-induced unconsciousness. Brain electric source analysis indicates that the 40-Hz ASSR arises from cortical and subcortical generators. The authors used source analysis to assess the effect of propofol anesthesia on the cerebral generators of the 40-Hz ASSR. They also examined the effect of propofol on two auditory evoked potentials of cortical origin: the N1 and the sustained potential. METHODS: Eleven healthy human volunteers were anesthetized with propofol given in target-concentration mode at the minimal concentration causing unconsciousness. The 40-Hz ASSR was recorded before, during, and after anesthesia. The source model consisted of five concurrently active generator dipoles: two in the contralateral auditory cortex (one tangentially oriented, one radially oriented), two in the ipsilateral auditory cortex (same orientations), and one in the midline brainstem. RESULTS: During anesthesia, the strength of the cortical and brainstem dipoles was reduced to the same extent (to 54% of baseline for the four cortical dipoles pooled vs. 53% for the brainstem dipole). Dipole strength during anesthesia was significantly less (P < 0.01) than during baseline and recovery for both cortical and brainstem dipoles. The N1 and sustained potential were no longer recordable during anesthesia. CONCLUSIONS: The attenuation of the 40-Hz ASSR during propofol anesthesia results from a reduction of similar magnitude of the activity of the cortical and brainstem generators. The N1 and sustained potential are so profoundly attenuated during propofol anesthesia that they are no longer recordable from the scalp.