title: Impact of microarousal associated with increased negative esophageal pressure in sleep-disordered breathing.
abstract: OBJECTIVE
  "Microarousals" during sleep have not been analyzed systematically. We investigated the importance of "microarousals" (lasting 1.5-3 s).
  
  
  METHODS
  Standard polysomnography including esophageal pressure (Pes) assessment was performed on ten patients (aged 54.0 +/- 5.0 years) with respiratory effort-related arousal > or =5/h. We measured the number of arousals per hour (American Sleep Disorders Association (ASDA) arousal index) and the number of microarousals lasting 1.5-3 s per hour (mASDA arousal index). On the night after the baseline sleep study, we performed overnight continuous positive airway pressure (CPAP) titration.
  
  
  RESULTS
  mASDA arousals, characterized by lower Pes values, were observed more frequently in patients with sleep-disordered breathing. The Pes results did not differ significantly between ASDA and mASDA arousals (-15.6 +/- -5.0 vs -15.0 +/- -4.4 cmH(2)O). mASDA arousals were significantly improved by CPAP treatment (mASDA arousals, 82.6 +/- 60.1 vs 6.0 +/- 1.4/h).
  
  
  CONCLUSIONS
  mASDA arousals were characterized by an increase in Pes. mASDA arousals are thus key to our understanding of clinical manifestations in patients with sleep-disordered breathing.
authors.affiliation: Department of Medical Technology, Nagoya University School of Health Sciences, Higashi-ku, Aichi, Japan.
authors.forename: Mayo
authors.initials: M
authors.lastname: Sukegawa
authors.forename: Akiko
authors.initials: A
authors.lastname: Noda
authors.forename: Yoshinari
authors.initials: Y
authors.lastname: Yasuda
authors.forename: Seiichi
authors.initials: S
authors.lastname: Nakata
authors.forename: Tatsuki
authors.initials: T
authors.lastname: Sugiura
authors.forename: Seiko
authors.initials: S
authors.lastname: Miyata
authors.forename: Kumiko
authors.initials: K
authors.lastname: Honda
authors.forename: Yoshinori
authors.initials: Y
authors.lastname: Hasegawa
authors.forename: Tsutomu
authors.initials: T
authors.lastname: Nakashima
authors.forename: Yasuo
authors.initials: Y
authors.lastname: Koike
mesh_terms: D001143:Arousal / Q000502:physiology*; D045422:Continuous Positive Airway Pressure; D004947:Esophagus / Q000503:physiopathology*; D005260:Female; D006801:Humans; D008297:Male; D008365:Manometry; D008875:Middle Aged; D017286:Polysomnography; D020181:Sleep Apnea, Obstructive / Q000503:physiopathology* / Q000628:therapy; D012894:Sleep Stages / Q000502:physiology; D014939:Work of Breathing / Q000502:physiology*