Effects of CPAP Treatment on Electroencephalographic Activity in Patients with Obstructive Sleep Apnea Syndrome During Deep Sleep with Consideration of Cyclic Alternating Pattern

Shuliang Chen; Qi Li; Xueliang Zou; Zhijun Zhong; Qian Ouyang; Mengmeng Wang; Yaxing Luo; Dongyuan Yao

doi:10.2147/NSS.S382305

Effects of CPAP Treatment on Electroencephalographic Activity in Patients with Obstructive Sleep Apnea Syndrome During Deep Sleep with Consideration of Cyclic Alternating Pattern

Nat Sci Sleep. 2022 Nov 21:14:2075-2089. doi: 10.2147/NSS.S382305. eCollection 2022.

Authors

Shuliang Chen^#^{1

2}, Qi Li^#¹, Xueliang Zou³, Zhijun Zhong¹, Qian Ouyang¹, Mengmeng Wang¹, Yaxing Luo¹, Dongyuan Yao¹

Affiliations

¹ Neurological Institute of Jiangxi Province and Department of Neurology, Jiangxi Provincial People's Hospital and The First Affiliated Hospital of Nanchang Medical College, Jiangxi, People's Republic of China.
² Queen Mary College, Nanchang University, Jiangxi, People's Republic of China.
³ Jiangxi Mental Hospital, Nanchang University, Jiangxi, People's Republic of China.

^# Contributed equally.

Abstract

Objective: To investigate whether continuous positive airway pressure (CPAP) treatment would change EEG activities associated with cyclic alternating pattern (CAP subtype A1, A2, and A3) and non-CAP (NCAP) during non-rapid eye movement sleep stage 3 (N3) in patients with obstructive sleep apnea (OSA).

Methods: The effects of CPAP treatment on the percentages of sleep stage N3 occupied by the CAP and NCAP, power of EEG waves in the CAP and NCAP were examined in 18 patients with moderate-to-severe OSA undergoing polysomnographic recordings.

Results: Apnea and hypopnea index during sleep stage N3 was positively correlated with ratios of phases A2 and A3 duration to total phase A duration [Phase (A2+A3) /Phase A] and negatively correlated with phase A1/phase A. With CPAP treatment, percentages of sleep stage N3 occupied by total CAPs and subtypes A2 and A3, as well as CAP A2 and CAP A3 indexes were significantly decreased while percentages of sleep stage N3 occupied by NCAP (NCAP/N3) and CAP A1 index were significantly increased. In addition, CPAP treatment significantly decreased percentage of respiratory events associated CAPs and increased percentage of non-respiratory related CAPs. Moreover, absolute and relative delta power was significantly increased during phase A1, unchanged during phase A2 and phase B2, and significantly decreased during phases B1, A3 and B3. The absolute power of faster frequency EEG waves in CAPs showed a general trend of decrease. The absolute and relative power of delta waves with amplitudes ≥75 μV, but not <75 μV, was significantly increased.

Conclusion: CPAP treatment improves the sleep quality in OSA patients mainly by increasing delta power and decreasing power of higher frequency waves during phase A1, and decreasing CAP A2 and A3 indexes as well as increasing NCAP/N3 and power of delta waves with amplitudes ≥75 μV during NCAP.

Keywords: continuous positive airway pressure; cyclic alternating pattern; non-rapid eye movement sleep; obstructive sleep apnea; polysomnographic recordings.

Grants and funding

This study was supported by Jiangxi Provincial People’s Hospital Grant 2019-009, Natural Science Foundation of China Grant 81760202, and Jiangxi Provincial Natural Science Foundation Grant S2017ZRMSB2145.