Impact of microarousal associated with increased negative esophageal pressure in sleep-disordered breathing.
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.
Sukegawa
Mayo
M
Department of Medical Technology, Nagoya University School of Health Sciences, Higashi-ku, Aichi, Japan.
Noda
Akiko
A
Yasuda
Yoshinari
Y
Nakata
Seiichi
S
Sugiura
Tatsuki
T
Miyata
Seiko
S
Honda
Kumiko
K
Hasegawa
Yoshinori
Y
Nakashima
Tsutomu
T
Koike
Yasuo
Y
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*