Volume 9, Issue 2 (March & April 2018 2018)                   BCN 2018, 9(2): 147-156 | Back to browse issues page

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Shahveisi K, Jalali A, Moloudi M R, Moradi S, Maroufi A, Khazaie H. Sleep Architecture in Patients With Primary Snoring and Obstructive Sleep Apnea. BCN 2018; 9 (2) :147-156
URL: http://bcn.iums.ac.ir/article-1-895-en.html
1- Sleep Disorders Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran.
2- Department of Psychiatric Nursing, Faculty of Nursing & Midwifery, Kermanshah University of Medical Sciences, Kermanshah, Iran.
3- Neurosciences Research Center, Kurdistan University of Medical Sciences, Sanandaj, Iran.

Introduction: This study aimed to investigate sleep architecture in patients with primary snoring and obstructive sleep apnea.
Methods: In this study, we analyzed polysomnographic data of 391 clients who referred to Sleep Disorders Research Center (SDRS). These people were classified into three groups based on their Apnea-Hypopnea Index (AHI) and snoring; control, Primary Snoring (PS), and Obstructive Sleep Apnea (OSA) group. Sleep architecture variables were then assessed in all groups.
Results: The results of this study indicated a decrease in deep sleep or Slow Waves Sleep (SWS) and increase in light sleep or stage 1 of non-REM sleep (N1) in OSA patients compared with the control and PS groups. After controlling the effects of confounding factors, i.e. age and Body Mass Index (BMI) (which was performed through multiple regression analysis) significant differences were observed among the three groups with regard to N1. However, with regard to SWS, after controlling confounding variables (age and BMI), no significant difference was found among the groups.
Conclusion: The results indicated that OSA, regardless of age and BMI, may increase light (N1) sleep possibly via a decline in blood oxygen saturation (SpO2). Such increase in N1 may be responsible for brain arousal. In addition, by controlling confounding factors (age and BMI), OSA did not affect SWS in OSA patients. However, further research is necessary to determine sleep architecture in more detail in the patients with OSA.

Type of Study: Original | Subject: Clinical Neuroscience
Received: 2017/01/7 | Accepted: 2017/07/27 | Published: 2018/03/3

1. Alabi, B. S., Abdulkarim, A. A., Musa, I. O., Adegboye, O., Aremu, S. K., Abdur-Rahman, L. O., et al. (2012). Prevalence of snoring and symptoms of sleep disordered breathing among primary school pupils in Ilorin, Nigeria. International Journal of Pediatric Otorhinolaryngology, 76(5), 646-8. doi: 10.1016/j.ijporl.2012.01.029 [DOI:10.1016/j.ijporl.2012.01.029]
2. Ayalon, L., Ancoli Israel, S., & Drummond, S. P. A. (2010). Obstructive sleep apnea and age: A double insult to brain function. American Journal of Respiratory and Critical Care Medicine, 182(3), 413-9. doi: 10.1164/rccm.200912-1805OC [DOI:10.1164/rccm.200912-1805OC]
3. Barone, D. A., & Krieger, A. C. (2013). Stroke and obstructive sleep apnea: A review. Current Atherosclerosis Reports, 15(7), 334. doi: 10.1007/s11883-013-0334-8 [DOI:10.1007/s11883-013-0334-8]
4. Bixler, E., Vgontzas, A., TenHave, T., Tyson, K., & Kales, A. (1998). Effects of age on sleep apnea in men. American Journal of Respiratory and Critical Care Medicine, 157(1), 144-8. doi: 10.1164/ajrccm.157.1.9706079 [DOI:10.1164/ajrccm.157.1.9706079]
5. Bouscoulet, L. T., Vazquez-Garcia, J. C., Muino, A., Marquez, M., Lopez, M. V., de Oca, M. M., et al. (2008). Prevalence of sleep related symptoms in four Latin American cities. Journal of Clinical Sleep Medicine, 4(6), 579-85. PMCID: PMC2603536 [PMID] [PMCID]
6. Cass, A. R., Alonso, W. J., Islam, J., & Weller, S. C. (2013). Risk of obstructive sleep apnea in patients with type 2 diabetes mellitus. Family Medicine Journal, 45(7), 492-500. PMID: 23846968
7. Chan, C. H., Wong, B. M., Tang, J. l., & Ng, D. K. (2012). Gender difference in snoring and how it changes with age: Systematic review and meta-regression. Sleep and Breathing, 16(4), 977-86. doi: 10.1007/s11325-011-0596-8 [DOI:10.1007/s11325-011-0596-8]
8. De Torres Alba, F., Gemma, D., Armada Romero, E., Rey Blas, J. R., Lopez de Sa, E., & Lopez Sendon, J. L. (2013). Obstructive sleep apnea and coronary artery disease: From pathophysiology to clinical implications. Pulmonary Medicine, 2013, 768064. doi: 10.1155/2013/768064 [DOI:10.1155/2013/768064]
9. Devulapally, K., Pongonis, R., Jr., & Khayat, R. (2009). OSA: The new cardiovascular disease: Part II: Overview of cardiovascular diseases associated with obstructive sleep apnea. Heart Failure Reviews, 14(3), 155-64. doi: 10.1007/s10741-008-9101-2 [DOI:10.1007/s10741-008-9101-2]
10. Dorffner, G., Vitr, M., & Anderer, P. (2015). The effects of aging on sleep architecture in healthy subjects. Advances in Experimental Medicine and Biology, 821, 93-100. doi: 10.1007/978-3-319-08939-3_13 [DOI:10.1007/978-3-319-08939-3_13]
11. Fuentes-Pradera, M. A., Botebol, G., Sanchez Armengol, A., Carmona, C., Garcia Fernandez, A., Castillo Gomez, J., et al. (2003). Effect of snoring and obstructive respiratory events on sleep architecture in adolescents. Archives of Pediatrics & Adolescent Medicine, 157(7), 649-54. doi: 10.1001/archpedi.157.7.649 [DOI:10.1001/archpedi.157.7.649]
12. Gislason, T., Almqvist, M., Eriksson, G., Taube, A., & Boman, G. (1988). Prevalence of sleep apnea syndrome among Swedish men--an epidemiological study. Journal of Clinical Epidemiology, 41(6), 571-6. PMID: 3385458 [DOI:10.1016/0895-4356(88)90061-3]
13. Hirshkowitz, M. (2004). Normal human sleep: An overview. Medical Clinics of North America, 88(3), 551-65, vii. doi: 10.1016/j.mcna.2004.01.001 [DOI:10.1016/j.mcna.2004.01.001]
14. Hoffstein, V., Mateika, J. H., & Mateika, S. (1991). Snoring and sleep architecture. The American Review of Respiratory Disease, 143(1), 92-6. doi: 10.1164/ajrccm/143.1.92 [DOI:10.1164/ajrccm/143.1.92]
15. Jennum, P., & Riha, R. L. (2009). Epidemiology of sleep apnoea/hypopnoea syndrome and sleep-disordered breathing. European Respiratory Journal, 33(4), 907-14. doi: 10.1183/09031936.00180108 [DOI:10.1183/09031936.00180108]
16. Kapoor, M., & Greenough, G. (2015). Home sleep tests for Obstructive Sleep Apnea (OSA). The Journal of the American Board of Family Medicine, 28(4), 504-9. doi: 10.3122/jabfm.2015.04.140266 [DOI:10.3122/jabfm.2015.04.140266]
17. Kapur, V. K., Baldwin, C. M., Resnick, H. E., Gottlieb, D. J., & Nieto, F. J. (2005). Sleepiness in patients with moderate to severe sleep-disordered breathing. Sleep, 28(4), 472-77. PMID: 16171292 [DOI:10.1093/sleep/28.4.472] [PMID]
18. Khazaie, H., & Maroufi, A. (2014). Obstructive sleep apnea syndrome: A neglected cause of traffic collision among Iranian public transport drivers. Journal of Injury & Violence Research, 6(2), 99. doi: 10.5249/jivr.v6i2.577 [DOI:10.5249/jivr.v6i2.577]
19. Khazaie, H., Najafi, F., Rezaie, L., Tahmasian, M., Sepehry, A. A., & Herth, F. J. (2011). Prevalence of symptoms and risk of obstructive sleep apnea syndrome in the general population. Archives of Iranian Medicine, 14(5), 335-8. doi: 009. PMID: 21888458
20. Lee, W., Nagubadi, S., Kryger, M. H., & Mokhlesi, B. (2008). Epidemiology of obstructive sleep apnea: A population-based perspective. Expert Review of Respiratory Medicine, 2(3), 349-64. doi: 10.1586/17476348.2.3.349 [DOI:10.1586/17476348.2.3.349]
21. Malhotra, A., & White, D. P. (2002). Obstructive sleep apnoea. Lancet, 360(9328), 237-45. doi: 10.1016/S0140-6736(02)09464-3 [DOI:10.1016/S0140-6736(02)09464-3]
22. Moon, K., Punjabi, N. M., & Aurora, R. N. (2015). Obstructive sleep apnea and type 2 diabetes in older adults. Clinics in Geriatric Medicine, 31(1), 139-47, ix. doi: 10.1016/j.cger.2014.08.023 [DOI:10.1016/j.cger.2014.08.023]
23. Nisbet, L. C., Yiallourou, S. R., Walter, L. M., & Horne, R. S. (2014). Blood pressure regulation, autonomic control and sleep disordered breathing in children. Sleep Medicine Reviews, 18(2), 179-89. doi: 10.1016/j.smrv.2013.04.006 [DOI:10.1016/j.smrv.2013.04.006]
24. Ohayon, M. M., Carskadon, M. A., Guilleminault, C., & Vitiello, M. V. (2004). Meta-analysis of quantitative sleep parameters from childhood to old age in healthy individuals: Developing normative sleep values across the human lifespan. Sleep, 27(7), 1255-73. PMID: 15586779 [DOI:10.1093/sleep/27.7.1255] [PMID]
25. Pamidi, S., Knutson, K. L., Ghods, F., & Mokhlesi, B. (2011). Depressive symptoms and obesity as predictors of sleepiness and quality of life in patients with REM-related obstructive sleep apnea: cross-sectional analysis of a large clinical population. Sleep Medicine Reviews, 12(9), 827-31. doi: 10.1016/j.sleep.2011.08.003 [DOI:10.1016/j.sleep.2011.08.003]
26. Punjabi, N. M. (2008). The epidemiology of adult obstructive sleep apnea. Proceedings of the American Thoracic Society, 5(2), 136-43. doi: 10.1513/pats.200709-155MG [DOI:10.1513/pats.200709-155MG]
27. Quintana Gallego, E., Carmona Bernal, C., Capote, F., Sánchez Armengol, Á., Botebol Benhamou, G., Polo Padillo, J., & Castillo Gómez, J. (2004). Gender differences in obstructive sleep apnea syndrome: A clinical study of 1166 patients. Respiratory Medicine, 98(10), 984-9. doi: 10.1016/j.rmed.2004.03.002 [DOI:10.1016/j.rmed.2004.03.002]
28. Rao, M. N., Blackwell, T., Redline, S., Stefanick, M. L., Ancoli-Israel, S., & Stone, K. L. (2009). Association between sleep architecture and measures of body composition. Sleep, 32(4), 483-490. PMCID: PMC2663862 [DOI:10.1093/sleep/32.4.483] [PMID] [PMCID]
29. Redline, S., Kirchner, H., Quan, S. F., Gottlieb, D. J., Kapur, V., & Newman, A. (2004). The effects of age, sex, ethnicity, and sleep-disordered breathing on sleep architecture. Archives of Internal Medicine, 164(4), 406-18. doi: 10.1001/archinte.164.4.406 [DOI:10.1001/archinte.164.4.406]
30. Redline, S., Kump, K., Tishler, P. V., Browner, I., & Ferrette, V. (1994). Gender differences in sleep disordered breathing in a community-based sample. American Journal of Respiratory and Critical Care Medicine, 149(3), 722-6. doi: 10.1164/ajrccm.149.3.8118642 [DOI:10.1164/ajrccm.149.3.8118642]
31. Roure, N., Gomez, S., Mediano, O., Duran, J., Pena Mde, L., Capote, F., et al. (2008). Daytime sleepiness and polysomnography in obstructive sleep apnea patients. Sleep Medicine, 9(7), 727-31. doi: 10.1016/j.sleep.2008.02.006 [DOI:10.1016/j.sleep.2008.02.006]
32. Smagula, S. F., Reynolds, C. F., Ancoli Israel, S., Barrett Connor, E., Dam, T. T., Hughes Austin, J. M., et al. (2015). Sleep architecture and mental health among community-dwelling older men. The Journals of Gerontology: Series B, Psychological Sciences and Social Sciences, 70(5), 673-81. doi: 10.1093/geronb/gbt125 [DOI:10.1093/geronb/gbt125]
33. Spicuzza, L., Caruso, D., & Di Maria, G. (2015). Obstructive sleep apnoea syndrome and its management. Therapeutic Advances in Chronic Disease, 6(5), 273-85. doi: 10.1177/2040622315590318 [DOI:10.1177/2040622315590318]
34. Tasali, E., Mokhlesi, B., & Van Cauter, E. (2008). Obstructive sleep apnea and type 2 diabetes: Interacting epidemics. Chest, 133(2), 496-506. doi: 10.1378/chest.07-0828 [DOI:10.1378/chest.07-0828]
35. Torres, G., Sanchez-de-la-Torre, M., & Barbe, F. (2015). Relationship Between OSA and Hypertension. Chest, 148(3), 824-32. doi: 10.1378/chest.15-0136 [DOI:10.1378/chest.15-0136]
36. Vlachantoni, I. T., Dikaiakou, E., Antonopoulos, C. N., Stefanadis, C., Daskalopoulou, S. S., & Petridou, E. T. (2013). Effects of Continuous Positive Airway Pressure (CPAP) treatment for obstructive sleep apnea in arterial stiffness: A meta-analysis. Sleep Medicine Reviews, 17(1), 19-28. doi: 10.1016/j.smrv.2012.01.002 [DOI:10.1016/j.smrv.2012.01.002]
37. Young, T., Peppard, P. E., & Gottlieb, D. J. (2002). Epidemiology of obstructive sleep apnea. American Journal of Respiratory and Critical Care Medicine, 165(9), 1217-39. doi: 10.1164/rccm.2109080 [DOI:10.1164/rccm.2109080]
38. Zhu, Y., Au, C. T., Lam, H. S., Chan, C. C., Ho, C., Wing, Y. K., et al. (2014). Sleep architecture in school-aged children with primary snoring. Sleep Medicine Reviews, 15(3), 303-8. doi: 10.1016/j.sleep.2013.08.801 [DOI:10.1016/j.sleep.2013.08.801]

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