ArticleJournal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine2023
Association of cortical arousals with sleep-disordered breathing events.
Article in Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
What it found
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
5 citing papers in PubMed, 6 citations in OpenAlex.
- Differential associations of arousals and respiratory events on oxygen desaturation and resaturation parameters in sleep.Sleep & breathing = Schlaf & Atmung · 2026Article
- Delayed Arousal Response to Sleep Apnea Encodes Mortality.medRxiv : the preprint server for health sciences · 2026Article
- Refuting a Temporal Correlation: Interictal Epileptic Discharges Do Not Preferentially Occur During Respiratory Events in Patients With Sleep-Related Breathing Disorder and Epilepsy.Journal of sleep research · 2025Article
- Exploring the Arousal Intensity in Patients with Obstructive Sleep Apnea: Based on Odds Ratio Product.Nature and science of sleep · 2025Article
- The Contribution of Sleep Texture in the Characterization of Sleep Apnea.Diagnostics (Basel, Switzerland) · 2023Review
Corrections and comments
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Authors and funding
7 authors at 3 institutions in 1 country.
Funding
Abstract
STUDY
objectivesThe 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.
methodsWe 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.
resultsCortical 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.
conclusionsOur 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. CITATION: Zitting K-M, Lockyer BJ, Azarbarzin A, et al. Association of cortical arousals with sleep-disordered breathing events.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.