Respiratory cycle-related EEG changes during sleep reflect esophageal pressures.
OBJECTIVE
Respiratory cycle-related EEG changes (RCREC) have been demonstrated during sleep by digital analysis and hypothesized to represent subtle inspiratory microarousals that may help to explain daytime sleepiness in patients with sleep-disordered breathing. We therefore examined for the first time associations between RCREC and esophageal pressure swings (deltaPes) that reflect work of breathing.


METHODS
Retrospective analysis.


METHODS
Academic sleep laboratory.


METHODS
Forty adults referred for suspected sleep disordered breathing.


METHODS
Polysomnography with esophageal pressure monitoring and automatic computation of deltaPes using a novel algorithm.


RESULTS
Computed deltaPes for nearly all respiratory cycles during sleep correlated well with visual scoring of selected respiratory cycle samples (Spearman rho = 0.86, P < 0.0001). The RCREC within the sigma EEG range (12.5-15.5 Hz) rather than that within other frequency ranges most often showed significant within-subject inverse correlations with deltaPes. In contrast, in between-subject comparisons, beta (15.5-30.5 Hz) and to a lesser extent theta (4.5-7.5 Hz) RCREC, rather than sigma RCREC, showed significant inverse associations with mean APes.


CONCLUSIONS
Variation within subjects of sigma RCREC with APes supports previous evidence that RCREC within this range may reflect microarousals exacerbated by increased work of breathing. Correlation of beta and theta, but not sigma RCREC with deltaPes in between-subject comparisons is more difficult to explain but suggests that ranges other than sigma also deserve further investigation for clinical utility.
Chervin
Ronald D
RD
Sleep Disorders Center and Department of Neurology, University of Michigan, Ann Arbor 48109-0845, USA. chervin@umich.edu
Malhotra
Raman K
RK
Burns
Joseph W
JW
D000328:Adult; D000368:Aged; D000465:Algorithms; D001143:Arousal / Q000502:physiology; D001611:Beta Rhythm; D002540:Cerebral Cortex / Q000503:physiopathology; D006970:Disorders of Excessive Somnolence / Q000503:physiopathology*; D004569:Electroencephalography; D004947:Esophagus / Q000503:physiopathology*; D005260:Female; D005583:Fourier Analysis; D006801:Humans; D001239:Inhalation / Q000502:physiology*; D008297:Male; D008365:Manometry; D008875:Middle Aged; D017286:Polysomnography; D012815:Signal Processing, Computer-Assisted; D020181:Sleep Apnea, Obstructive / Q000175:diagnosis / Q000503:physiopathology*; D013826:Theta Rhythm; D014939:Work of Breathing / Q000502:physiology; D055815:Young Adult