Division of Sleep and Circadian Disorders, Department of Medicine, Brigham and Women's Hospital and Division of Sleep Medicine, Harvard Medical School, Boston, Massachusetts.
J Clin Sleep Med. 2023 May 1;19(5):899-912. doi: 10.5664/jcsm.10492.
The American Academy of Sleep Medicine recommends scoring hypopneas in adults when there is a ≥ 3% oxygen desaturation or when the event is associated with an arousal. However, there is no rule regarding the duration of the interval between the event termination and the associated arousal. The purpose of this study is to explore the timing between arousals and sleep-disordered breathing (SDB) events.
We analyzed cortical arousals (> 1.6 million) and SDB events (> 350,000 apneas and > 1.9 million hypopneas) from 11,400 manually scored polysomnography recordings. Only arousals that started within ±30 seconds from the end of SDB events were included. We used the 2 local minimums on either side of the arousal distribution as the start/end times for the distribution and to define which arousals are associated with SDB events. Finally, we calculated arousal probability near the end of SDB events.
Cortical arousals with start times that fell within the 2 minimums were considered to be associated with SDB events. Using this definition, we found that 90% of apnea-associated arousals started no earlier than 4 seconds before and no later than 9 seconds after the end of apneas. Similarly, 90% of hypopnea-associated arousals started no earlier than 6 seconds before and no later than 14 seconds after the end of hypopneas, with the peak of the distribution coinciding with event end time. Arousal probability was highest during the first 10 seconds after the end of the event and was higher for longer events.
Our results suggest that 90% of SDB-associated arousals start no earlier than 6 seconds before and no later than 14 seconds after the end of the respiratory events.
Zitting K-M, Lockyer BJ, Azarbarzin A, et al. Association of cortical arousals with sleep-disordered breathing events. . 2023;19(5):899-912.
美国睡眠医学学会建议在成人中出现≥3%的氧减饱和度或事件与觉醒相关时，对低通气进行评分。然而，对于事件结束与相关觉醒之间的间隔持续时间没有规定。本研究旨在探讨觉醒与睡眠呼吸障碍（SDB）事件之间的时间关系。
我们分析了来自 11400 次手动评分多导睡眠图记录的皮质觉醒（>160 万次）和 SDB 事件（>35 万次呼吸暂停和>190 万次低通气）。仅包括从 SDB 事件结束开始的觉醒时间在±30 秒内的觉醒。我们使用觉醒分布两侧的 2 个局部最小值作为分布的起始/结束时间，并定义哪些觉醒与 SDB 事件相关。最后，我们计算了 SDB 事件结束附近的觉醒概率。
皮质觉醒的起始时间落在这两个最小值内，被认为与 SDB 事件相关。使用这个定义，我们发现 90%的与呼吸暂停相关的觉醒开始时间不早于呼吸暂停结束前 4 秒，不晚于结束后 9 秒。同样，90%的与低通气相关的觉醒开始时间不早于低通气结束前 6 秒，不晚于结束后 14 秒，分布的峰值与事件结束时间一致。觉醒概率在事件结束后 10 秒内最高，且持续时间较长的事件觉醒概率更高。
我们的结果表明，90%的与 SDB 相关的觉醒开始时间不早于呼吸事件结束前 6 秒，不晚于结束后 14 秒。
Zitting K-M, Lockyer BJ, Azarbarzin A, et al. Association of cortical arousals with sleep-disordered breathing events.. 2023;19(5):899-912.
