The association between obstructive sleep apnea and sleep spindles in middle-aged and older men: a community-based cohort study

Jesse L Parker; Yohannes Adama Melaku; Angela L D'Rozario; Gary A Wittert; Sean A Martin; Peter G Catcheside; Bastien Lechat; Alison J Teare; Robert J Adams; Sarah L Appleton; Andrew Vakulin

doi:10.1093/sleep/zsab282

The association between obstructive sleep apnea and sleep spindles in middle-aged and older men: a community-based cohort study

Sleep. 2022 Mar 14;45(3):zsab282. doi: 10.1093/sleep/zsab282.

Authors

Jesse L Parker¹, Yohannes Adama Melaku¹, Angela L D'Rozario^{2

3}, Gary A Wittert^{4

5}, Sean A Martin^{4

5}, Peter G Catcheside¹, Bastien Lechat¹, Alison J Teare¹, Robert J Adams^{1

5

6}, Sarah L Appleton^{1

5}, Andrew Vakulin^{1

2}

Affiliations

¹ Flinders Health and Medical Research Institute, Adelaide Institute for Sleep Health, Flinders University, Adelaide, South Australia, Australia.
² CIRUS, Centre for Sleep and Chronobiology, Woolcock Institute of Medical Research, University of Sydney, Sydney, New South Wales, Australia.
³ University of Sydney, Faculty of Science, School of Psychology, Sydney, New South Wales, Australia.
⁴ Freemasons Centre for Male Health and Wellbeing, Adelaide Medical School, University of Adelaide, Adelaide, South Australia, Australia.
⁵ South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia.
⁶ Respiratory and Sleep Services, Southern Adelaide Local Health Network, Bedford Park, Adelaide, South Australia, Australia.

PMID: 34850237
DOI: 10.1093/sleep/zsab282

Abstract

Study objectives: Sleep spindles show morphological changes in obstructive sleep apnea (OSA). However, previous small studies have limited generalizability, leaving associations between OSA severity measures and spindle metrics uncertain. This study examined cross-sectional associations between OSA severity measures and spindle metrics among a large population-based sample of men.

Methods: Community-dwelling men with no previous OSA diagnosis underwent home-based polysomnography. All-night EEG (F4-M1) recordings were processed for artifacts and spindle events identified using previously validated algorithms. Spindle metrics of interest included frequency (Hz), amplitude (µV2), overall density (11-16 Hz), slow density (11-13 Hz), and fast density (13-16 Hz) (number/minute). Multivariable linear regression models controlling for demographic, biomedical, and behavioral confounders were used to examine cross-sectional associations between OSA severity measures and spindle metrics.

Results: In adjusted analyses, higher apnea-hypopnea index (AHI/h, as a continuous variable) and percentage total sleep time with oxygen saturation <90% (TST90) were associated with decreased slow spindle density (AHI, B = -0.003, p = 0.032; TST90, B = -0.004, p = 0.047) but increased frequency (AHI, B = 0.002, p = 0.009; TST90, B = 0.002, p = 0.043). Higher TST90 was also associated with greater spindle amplitude (N2 sleep, B = 0.04, p = 0.011; N3 sleep, B = 0.11, p < 0.001). Furthermore, higher arousal index was associated with greater spindle amplitude during N2 sleep (B = 0.31, p < 0.001) but decreased overall density (B = -1.27, p = 0.030) and fast density (B = -4.36, p = 0.028) during N3 sleep.

Conclusions: Among this large population-based sample of men, OSA severity measures were independently associated with spindle abnormalities. Further population studies are needed to determine associations between spindle metrics and functional outcomes.

Keywords: amplitude; density; frequency; obstructive sleep apnea; prospective; sleep spindles.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Aged
Cohort Studies
Cross-Sectional Studies
Humans
Male
Middle Aged
Polysomnography
Sleep
Sleep Apnea, Obstructive*