Study Objectives: Besides arousals (according to the ASDA definition), slee
p contains also K-complexes and delta bursts which, in spite of their sleep
-like features, are endowed with activating effects on autonomic functions.
The link between phasic delta activities and enhancement of vegetative fun
ctions indicates the possibility of physiological activation without sleep
disruption (i.e., arousal without awakening). A functional connection seems
to include slow (K-complexes and delta bursts) and rapid (arousals) EEG ev
ents within the comprehensive term of activating complexes. CAP (cyclic alt
ernating pattern) is the spontaneous EEG rhythm that ties both slow and rap
id activating complexes together during NREM sleep. The present study aims
at exploring the relationship between arousals and CAP components in a sele
cted sample of healthy sleepers.
Design: Polysomnographic analysis according to the scoring rules for sleep
stages and arousals. CAP analysis included also tabulation of subtypes Al (
slow EEG activating complexes), A2 and A3 (activating complexes with fast E
EG components).
Setting: 40 sleep-lab accomplished recordings.
Participants: Healthy subjects belonging to a wide age range (38 +/- 20 yrs
.).
Interventions: N/A
Measurement and Results: Of all the arousals occurring in NREM sleep, 87% w
ere inserted within CAP. Subtypes A2 and A3 of CAP corresponded strikingly
with arousals (r=0.843; p <0.0001), while no statistical relationship emerg
ed when arousals were matched with subtypes Al of CAP. Subtypes Al instead
correlated positively with the percentages of deep sleep (r=0.366; p <0.02)
.
Conclusions: The CAP subtype classification encompasses both the process of
sleep maintenance (subtypes Al) and sleep fragmentation (subtypes A2 and A
3), and provides a periodicity dimension to the activating events of NREM s
leep.