Je. Black et al., Upper airway resistance syndrome - Central electroencephalographic power and changes in breathing effort, AM J R CRIT, 162(2), 2000, pp. 406-411
Upper airway resistance syndrome (UARS) is defined by excessive daytime sle
epiness and tiredness, and is associated with increased breathing effort. I
ts polygraphic features involve progressive increases in esophageal pressur
e (Pes), terminated by arousal (AR) as defined by the American Sleep Disord
ers Association (ASDA). With the arousal there is an abrupt decrease in Res
, called Res reversal. However, Res reversal can be seen without the presen
ce of an AR. We performed spectral analysis on electroencephalographic data
from a central lead for both AR and nonarousal IN-AR) events obtained from
15 UARS patients (eight men and seven women). Delta band activity was incr
eased before and surrounding Res reversal regardless of the presence or abs
ence of AR. In the period after Res reversal, alpha, sigma, and beta activi
ty showed a greater increase in AR events than in N-AR events. The Res meas
ures were identical leading up to the point of reversal, but showed a longe
r-lasting and significantly greater decrease in respiratory effort after an
AR. The data indicate that substantial electroencephalographic changes can
be identified in association with Res events, even when ARs cannot be dete
cted according to standard criteria; however, visually identifiable electro
encephalographic arousals clearly have a greater impact on ongoing inspirat
ory effort.