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Clinical Investigations: SLEEP AND BREATHING |

Slow-Wave Activity in Sleep Apnea Patients Before and After Continuous Positive Airway Pressure Treatment*: Contribution to Daytime Sleepiness

Raphaël Heinzer, MD; Hélène Gaudreau, MSc; Anne Décary, PhD; Emilia Sforza, MD, PhD; Dominique Petit, PhD; Florence Morisson, DMD; Jacques Montplaisir, MD, PhD, CRCPc
Author and Funding Information

*From the Department of Internal Medicine (Dr. Heinzer), Centre Hospitalier et Universitaire Vaudois, Lausanne, and Laboratoire de sommeil (Dr. Sforza), Division de Neuropsychiatrie, Hop̂itaux Universitaires de Genéve, Geneva, Switzerland; and Centre d’étude du sommeil (Ms. Gaudreau, and Drs. Décary, Petit, Morisson, and Montplaisir), Hôpital du Sacré-Cœur de Montréal, and Department of Psychiatry, Université de Montréal, Montreal, Quebec, Canada.

Correspondence to: Jacques Montplaisir, MD, PhD, CRCPc, Centre d’étude du sommeil, Hôpital du Sacré-Coeur, 5400 Gouin Blvd West, Montréal (Québec) H4J 1C5, Canada; e-mail: j-montplaisir@crhsc.umontreal.ca



Chest. 2001;119(6):1807-1813. doi:10.1378/chest.119.6.1807
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Study objectives: To estimate the course of slow-wave activity (SWA), its amount during the night, and its correlation with daytime sleepiness in sleep apnea syndrome (SAS) patients. This study also verified whether continuous positive airway pressure (CPAP) treatment also restores a normal pattern of SWA in severe SAS patients.

Participants: Ten patients with a diagnosis of severe SAS who showed a good clinical response to CPAP after approximately 9 months of treatment were included in this study. These patients were matched for sex and age with 10 control subjects.

Design: All subjects underwent 1 night of polysomnography (PSG), followed by the multiple sleep latency test (MSLT) the next day. For the SAS patients only, the same procedure was repeated after 9 ± 0.7 months of CPAP treatment. In addition to traditional scoring of sleep stages, apneas, hypopneas, and microarousals, the SWA, defined as the power in the 0.75- to 4.5-Hz frequency band, was evaluated.

Results: A positive correlation between SWA of the first cycle and the MSLT (r = 0.56; p = 0.045) was found before treatment. Moreover, SAS patients significantly increased their mean SWA after CPAP treatment in the first (p = 0.024) and second (p = 0.002) sleep cycles and restored a more physiologic decay of SWA across the night.

Conclusions: These results suggest that daytime sleepiness in SAS patients may be the result of a lack of SWA during the first part of the night, and show that CPAP restores a more physiologic pattern of SWA across the night.

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