Cyclic alternating patterns and arousals: what is relevant in obstructive sleep apnea? In Memoriam Mario Giovanni Terzano
| Autor: | Liborio Parrino, Nicoletta Azzi, Francesco Rausa, Carlotta Mutti, Irene Pollara |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
Pulmonary and Respiratory Medicine
medicine.medical_specialty Sleep Apnea Obstructive Continuous Positive Airway Pressure business.industry medicine.medical_treatment Polysomnography Eye movement Excessive daytime sleepiness Cognition medicine.disease Sleep architecture Sleep in non-human animals Treatment efficacy Obstructive sleep apnea Physical medicine and rehabilitation medicine Humans Continuous positive airway pressure medicine.symptom business Arousal Sleep |
| Zdroj: | Current opinion in pulmonary medicine. 27(6) |
| ISSN: | 1531-6971 |
| Popis: | Purpose of review To review main knowledges and gaps in the field of sleep microstructure, represented by the cyclic alternating pattern (CAP), in obstructive sleep apnea (OSA). Recent findings The (electroencephalographic and autonomic) 'intensity' of arousals in OSA patients, measured through the metrics of CAP, correlate with OSA severity and with disease burden. Continuous positive airway pressure determines variations in sleep architecture (conventional parameters) and at the microstructural level, at different time points. Summary CAP is not only an 'attractor' of arousals, but also organizes distribution of K-complexes and delta bursts in non-rapid eye movement sleep. Although attention is always concentrated on the A-phase of CAP, a crucial role is play by the phase B, which reflects a period of transient inhibition. Respiratory events in OSA are a typical example of phase B-associated condition, as they occur during the interval between successive A-phases. Accordingly sleep microstructure provides useful insights in the pathophysiology and estimation of OSA severity and may be exploited to follow-up treatment efficacy. In the complex relationship among sleep fragmentation, excessive daytime sleepiness, cognition and cardiovascular risk the CAP framework can offer an integrative perspective in a multidisciplinary scenario. |
| Databáze: | OpenAIRE |
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