ArticleJournal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine2020
Mechanism of excessive wake time when associated with obstructive sleep apnea or periodic limb movements.
Article in Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers.
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17 citing papers in PubMed.
- Cognitive behavioral therapy for insomnia is associated with reduced sleep apnea severity but not its endotype traits in those with comorbid insomnia and sleep apnea.Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine · 2025Trial
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- Association of Novel Sleep EEG Biomarkers with All-Cause Mortality in a Large Community-Based Cohort.Nature and science of sleep · 2025Article
- Sleep Deficiency in Obstructive Sleep Apnea.Sleep medicine clinics · 2024Review
- Effects of combined morbid insomnia and sleep apnea on long-term cardiovascular risk and all-cause mortality in elderly patients: a prospective cohort study.BMC geriatrics · 2024Article
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- New insights and potential clinical implications of the odds ratio product.Frontiers in neurology · 2023Article
- Adherence Index: sleep depth and nocturnal hypoventilation predict long-term adherence with positive airway pressure therapy in severe obstructive sleep apnea.Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine · 2022Article
- Sleep Deficiency in Obstructive Sleep Apnea.Clinics in chest medicine · 2022Review
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- Sleep medicine: Practice, challenges and new frontiers.Frontiers in neurology · 2022Review
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- Effects of Sedatives on Sleep Architecture Measured With Odds Ratio Product in Critically Ill Patients.Critical care explorations · 2021Article
- Review
- New and Emerging Approaches to Better Define Sleep Disruption and Its Consequences.Frontiers in neuroscience · 2021Review
- Impaired central control of sleep depth propensity as a common mechanism for excessive overnight wake time: implications for sleep apnea, insomnia and beyond.Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine · 2020Article
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Abstract
STUDY
objectivesIt is uncertain whether obstructive apnea (OSA) or periodic limb movements (PLMs) contribute to excessive wake time (EWT) when EWT and these disorders coexist. We hypothesized that such EWT is an independent disorder related to central regulation of sleep depth. Accordingly, we compared sleep depth in patients with EWT and OSA/PLMs (EWT+P) with patients with EWT and no OSA/PLMs (EWT-NP) and patients with a normal wake time.
methodsA total of 267 participants were divided into five groups: (1) EWT+P: n = 100 (wake time > 20% total recording time; TRT) with OSA (apnea-hypopnea index 5-110 events/h) and/or PLMs (PLM index 10-151 events/h); (2) EWT-NP: n = 49 (wake time > 20%TRT), no associated pathology; (3) normal wake time (NWT)+P: n = 54 (wake time < 20%TRT, with OSA/PLMs); (4) NWT-NP: n = 26; (5) Healthy participants: n = 38 (no sleep complaints, NWT and no OSA/PLMs). Sleep depth was evaluated by the odds ratio product (ORP; 0 = deep sleep, 2.5 = fully alert). We also measured ORP in the 9 seconds immediately following arousals (ORP-9) to distinguish between peripheral and central mechanisms of light sleep.
resultsORP during sleep was higher (lighter sleep) in both EWT groups than in the three NWT groups (P < 1E-11) with no difference between those with and those without OSA/PLMs. ORP-9 was also significantly higher in the EWT groups than in the NWT groups (P < 1E-19), also with no difference between those with and without OSA/PLMs, indicating that the lighter sleep was of central origin. There were highly significant correlations between wake time and ORP-9 across all groups (P < 1E-35).
conclusionsEWT associated with OSA/PLMs is independent of OSA/PLMs and related to abnormal central regulation of sleep depth.
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