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Publications

Journal Article Ahead of print

PubMed: 42691108 DOI: 10.1093/sleep/zsag241

EEG spectral analysis of nighttime sleep and daytime MSLTs and neurocognitive evaluations in obstructive sleep apnea patients with residual sleepiness.

Sleep

Authors: Yuan Shi, Xujun Feng, Fei Lei, Siqi Guan, Zhaohua Chen, Yihui Zhang, Xiaomin Zhang, Yuting Jiang, Yang Yang, Longhua Sun, Michael V Vitiello, Xiangdong Tang

Affiliations

  • Sleep Medicine Center, Mental Health Center, National Center for Mental Disorders, Sleep Research Laboratory, West China Hospital, Sichuan University, Chengdu, China.
  • Sleep Medicine Center, Mental Health Center, National Center for Mental Disorders, Sleep Research Laboratory, West China Hospital, Sichuan University, Chengdu, China. Department of Respiratory and Critical Care Medicine, the First Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi Province, China.
  • Department of Respiratory and Critical Care Medicine, the First Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi Province, China.
  • Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, WA, USA.

Abstract

STUDY OBJECTIVES

To explore neurophysiological and neurocognitive characteristics of OSA patients with residual excessive sleepiness (RES) using EEG spectral analysis and multidimensional cognitive assessments.

METHODS

This case-control study included 76 participants (38 RES, 38 Non-RES) from our RES cohort. Polysomnography (PSG) and multiple sleep latency tests (MSLTs) were recorded and used to obtain relative EEG spectral power. A series of standard neurocognitive assessments were conducted during the first MSLT interval (approximately 09:00-11:00 AM).

RESULTS

In PSG and MSLTs, RES patients showed increased delta and theta power and decreased alpha and beta power (all FDR-adjusted q<0.05). RES patients demonstrated multidimensional cognitive impairments, including longer WCST reaction time (mean difference [MD] = -642.71 ms, 95% CI: -1045.70 to -239.72, p = 0.002, partial η2 = 0.130), longer SCWT color-word reaction time (MD = -16.02 s, 95% CI: -25.32 to -6.71, p = 0.001, partial η2 = 0.148), and more PVT lapses (MD = -3.65, 95% CI: -5.28 to -2.03, p < 0.001, partial η2 = 0.228). The EEG spectral patterns of increased delta-theta power and decreased alpha-beta power were significantly associated with impairments in executive function, processing speed, working memory and selective attention, while the decreased alpha-beta power was more related to impairment of vigilance and sustained attention.

CONCLUSIONS

RES patients exhibit a characteristic EEG power spectrum marked by increased delta-theta and decreased alpha-beta power values, indicating sleep-wake dysregulation. RES patients also demonstrate multidimensional cognitive impairments, including deficits in processing speed, working memory, attention, and executive function, with distinct neurophysiological correlates.

MeSH

Memory, Short-Term, Sleep Apnea, Obstructive, Sleep, Apnea, Executive Function, Cognitive Dysfunction, Reaction Time, Cognition Disorders, Neurophysiology, Sleep Apnea Syndromes, Memory, Sleep Wake Disorders, Sleepiness