Purpose of review: To review main knowledges and gaps in the field of sleep microstructure, represented by the cyclic alternating pattern (CAP), in obstructive sleep apnea (OSA). Recent findings: The (electroencephalographic and autonomic) 'intensity' of arousals in OSA patients, measured through the metrics of CAP, correlate with OSA severity and with disease burden. Continuous positive airway pressure determines variations in sleep architecture (conventional parameters) and at the microstructural level, at different time points. Summary: CAP is not only an 'attractor' of arousals, but also organizes distribution of K-complexes and delta bursts in non-rapid eye movement sleep. Although attention is always concentrated on the A-phase of CAP, a crucial role is play by the phase B, which reflects a period of transient inhibition. Respiratory events in OSA are a typical example of phase B-associated condition, as they occur during the interval between successive A-phases. Accordingly sleep microstructure provides useful insights in the pathophysiology and estimation of OSA severity and may be exploited to follow-up treatment efficacy. In the complex relationship among sleep fragmentation, excessive daytime sleepiness, cognition and cardiovascular risk the CAP framework can offer an integrative perspective in a multidisciplinary scenario.
Cyclic alternating patterns and arousals: what is relevant in obstructive sleep apnea? In Memoriam Mario Giovanni Terzano / Parrino, Liborio; Rausa, Francesco; Azzi, Nicoletta; Pollara, Irene; Mutti, Carlotta. - In: CURRENT OPINION IN PULMONARY MEDICINE. - ISSN 1070-5287. - 27:6(2021), pp. 496-504. [10.1097/MCP.0000000000000825]
Cyclic alternating patterns and arousals: what is relevant in obstructive sleep apnea? In Memoriam Mario Giovanni Terzano
Parrino, Liborio
Writing – Original Draft Preparation
;Rausa, Francesco;Azzi, Nicoletta;Pollara, Irene;Mutti, Carlotta
2021-01-01
Abstract
Purpose of review: To review main knowledges and gaps in the field of sleep microstructure, represented by the cyclic alternating pattern (CAP), in obstructive sleep apnea (OSA). Recent findings: The (electroencephalographic and autonomic) 'intensity' of arousals in OSA patients, measured through the metrics of CAP, correlate with OSA severity and with disease burden. Continuous positive airway pressure determines variations in sleep architecture (conventional parameters) and at the microstructural level, at different time points. Summary: CAP is not only an 'attractor' of arousals, but also organizes distribution of K-complexes and delta bursts in non-rapid eye movement sleep. Although attention is always concentrated on the A-phase of CAP, a crucial role is play by the phase B, which reflects a period of transient inhibition. Respiratory events in OSA are a typical example of phase B-associated condition, as they occur during the interval between successive A-phases. Accordingly sleep microstructure provides useful insights in the pathophysiology and estimation of OSA severity and may be exploited to follow-up treatment efficacy. In the complex relationship among sleep fragmentation, excessive daytime sleepiness, cognition and cardiovascular risk the CAP framework can offer an integrative perspective in a multidisciplinary scenario.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.