Sleep staging and respiratory events in refractory epilepsy patients: Is there a first night effect?

Linda M. Selwa, Mary L. Marzec, Ronald D. Chervin, Kevin J. Weatherwax, Bradley V. Vaughn, Nancy Foldvary-Schaefer, Lily Wang, Yanna Song, Beth A. Malow

Research output: Contribution to journalArticle

27 Citations (Scopus)

Abstract

Purpose: We performed this analysis of possible first night effects (FNEs) on sleep and respiratory parameters in order to evaluate the need for two serial night polysomnograms (PSGs) to diagnose obstructive sleep apnea (OSA) in epilepsy patients. Methods: As part of a pilot multicenter clinical trial investigating the effects of treating sleep apnea in epilepsy, two nights of PSG recording were performed for 40 patients with refractory epilepsy and OSA symptoms. Sleep architecture was examined in detail, along with respiratory parameters including apnea/hypopnea index (AHI) and minimum oxygen saturation. Analysis included two-tailed t-tests, Wilcox sign rank analysis, and Bland Altman measures of agreement. Results: Total sleep time differed between the two nights (night 1,363.8 min + 59.4 vs. 386.3 min + 68.6, p = 0.05). Rapid eye movement (REM) sleep and percentage of REM sleep were increased during night two (night 1: 12.3% + 5.9 vs. night 2: 15.5% + 6.2, p = 0.007), and the total minutes of slow-wave sleep (SWS) were increased (night 1: 35.6 + 60.7 vs. night 2: 46.4 + 68.1, p = 0.01). No other sleep or respiratory variables differed between the two nights. Given an AHI inclusion criterion of five apneas per hour, the first PSG identified all but one patient with OSA. Discussion: Respiratory parameters showed little variability between the first and second nights. Sleep architecture was mildly different between the first and second PSG night. Performing two consecutive baseline PSGs to diagnose OSA may not be routinely necessary in this population.

Original languageEnglish (US)
Pages (from-to)2063-2068
Number of pages6
JournalEpilepsia
Volume49
Issue number12
DOIs
StatePublished - Dec 1 2008
Externally publishedYes

Fingerprint

Epilepsy
Sleep
Obstructive Sleep Apnea
Apnea
REM Sleep
Sleep Apnea Syndromes
Nonparametric Statistics
Multicenter Studies
Clinical Trials
Oxygen
Population

Keywords

  • Epilepsy
  • First night effect
  • Obstructive sleep apnea
  • Polysomnogram
  • Rapid eye movement (REM) sleep
  • Slow-wave sleep (SWS)

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology

Cite this

Selwa, L. M., Marzec, M. L., Chervin, R. D., Weatherwax, K. J., Vaughn, B. V., Foldvary-Schaefer, N., ... Malow, B. A. (2008). Sleep staging and respiratory events in refractory epilepsy patients: Is there a first night effect? Epilepsia, 49(12), 2063-2068. https://doi.org/10.1111/j.1528-1167.2008.01681.x

Sleep staging and respiratory events in refractory epilepsy patients : Is there a first night effect? / Selwa, Linda M.; Marzec, Mary L.; Chervin, Ronald D.; Weatherwax, Kevin J.; Vaughn, Bradley V.; Foldvary-Schaefer, Nancy; Wang, Lily; Song, Yanna; Malow, Beth A.

In: Epilepsia, Vol. 49, No. 12, 01.12.2008, p. 2063-2068.

Research output: Contribution to journalArticle

Selwa, LM, Marzec, ML, Chervin, RD, Weatherwax, KJ, Vaughn, BV, Foldvary-Schaefer, N, Wang, L, Song, Y & Malow, BA 2008, 'Sleep staging and respiratory events in refractory epilepsy patients: Is there a first night effect?', Epilepsia, vol. 49, no. 12, pp. 2063-2068. https://doi.org/10.1111/j.1528-1167.2008.01681.x
Selwa LM, Marzec ML, Chervin RD, Weatherwax KJ, Vaughn BV, Foldvary-Schaefer N et al. Sleep staging and respiratory events in refractory epilepsy patients: Is there a first night effect? Epilepsia. 2008 Dec 1;49(12):2063-2068. https://doi.org/10.1111/j.1528-1167.2008.01681.x
Selwa, Linda M. ; Marzec, Mary L. ; Chervin, Ronald D. ; Weatherwax, Kevin J. ; Vaughn, Bradley V. ; Foldvary-Schaefer, Nancy ; Wang, Lily ; Song, Yanna ; Malow, Beth A. / Sleep staging and respiratory events in refractory epilepsy patients : Is there a first night effect?. In: Epilepsia. 2008 ; Vol. 49, No. 12. pp. 2063-2068.
@article{5b1d2f0b949e4abb8ced548294e5ba37,
title = "Sleep staging and respiratory events in refractory epilepsy patients: Is there a first night effect?",
abstract = "Purpose: We performed this analysis of possible first night effects (FNEs) on sleep and respiratory parameters in order to evaluate the need for two serial night polysomnograms (PSGs) to diagnose obstructive sleep apnea (OSA) in epilepsy patients. Methods: As part of a pilot multicenter clinical trial investigating the effects of treating sleep apnea in epilepsy, two nights of PSG recording were performed for 40 patients with refractory epilepsy and OSA symptoms. Sleep architecture was examined in detail, along with respiratory parameters including apnea/hypopnea index (AHI) and minimum oxygen saturation. Analysis included two-tailed t-tests, Wilcox sign rank analysis, and Bland Altman measures of agreement. Results: Total sleep time differed between the two nights (night 1,363.8 min + 59.4 vs. 386.3 min + 68.6, p = 0.05). Rapid eye movement (REM) sleep and percentage of REM sleep were increased during night two (night 1: 12.3{\%} + 5.9 vs. night 2: 15.5{\%} + 6.2, p = 0.007), and the total minutes of slow-wave sleep (SWS) were increased (night 1: 35.6 + 60.7 vs. night 2: 46.4 + 68.1, p = 0.01). No other sleep or respiratory variables differed between the two nights. Given an AHI inclusion criterion of five apneas per hour, the first PSG identified all but one patient with OSA. Discussion: Respiratory parameters showed little variability between the first and second nights. Sleep architecture was mildly different between the first and second PSG night. Performing two consecutive baseline PSGs to diagnose OSA may not be routinely necessary in this population.",
keywords = "Epilepsy, First night effect, Obstructive sleep apnea, Polysomnogram, Rapid eye movement (REM) sleep, Slow-wave sleep (SWS)",
author = "Selwa, {Linda M.} and Marzec, {Mary L.} and Chervin, {Ronald D.} and Weatherwax, {Kevin J.} and Vaughn, {Bradley V.} and Nancy Foldvary-Schaefer and Lily Wang and Yanna Song and Malow, {Beth A.}",
year = "2008",
month = "12",
day = "1",
doi = "10.1111/j.1528-1167.2008.01681.x",
language = "English (US)",
volume = "49",
pages = "2063--2068",
journal = "Epilepsia",
issn = "0013-9580",
publisher = "Wiley-Blackwell",
number = "12",

}

TY - JOUR

T1 - Sleep staging and respiratory events in refractory epilepsy patients

T2 - Is there a first night effect?

AU - Selwa, Linda M.

AU - Marzec, Mary L.

AU - Chervin, Ronald D.

AU - Weatherwax, Kevin J.

AU - Vaughn, Bradley V.

AU - Foldvary-Schaefer, Nancy

AU - Wang, Lily

AU - Song, Yanna

AU - Malow, Beth A.

PY - 2008/12/1

Y1 - 2008/12/1

N2 - Purpose: We performed this analysis of possible first night effects (FNEs) on sleep and respiratory parameters in order to evaluate the need for two serial night polysomnograms (PSGs) to diagnose obstructive sleep apnea (OSA) in epilepsy patients. Methods: As part of a pilot multicenter clinical trial investigating the effects of treating sleep apnea in epilepsy, two nights of PSG recording were performed for 40 patients with refractory epilepsy and OSA symptoms. Sleep architecture was examined in detail, along with respiratory parameters including apnea/hypopnea index (AHI) and minimum oxygen saturation. Analysis included two-tailed t-tests, Wilcox sign rank analysis, and Bland Altman measures of agreement. Results: Total sleep time differed between the two nights (night 1,363.8 min + 59.4 vs. 386.3 min + 68.6, p = 0.05). Rapid eye movement (REM) sleep and percentage of REM sleep were increased during night two (night 1: 12.3% + 5.9 vs. night 2: 15.5% + 6.2, p = 0.007), and the total minutes of slow-wave sleep (SWS) were increased (night 1: 35.6 + 60.7 vs. night 2: 46.4 + 68.1, p = 0.01). No other sleep or respiratory variables differed between the two nights. Given an AHI inclusion criterion of five apneas per hour, the first PSG identified all but one patient with OSA. Discussion: Respiratory parameters showed little variability between the first and second nights. Sleep architecture was mildly different between the first and second PSG night. Performing two consecutive baseline PSGs to diagnose OSA may not be routinely necessary in this population.

AB - Purpose: We performed this analysis of possible first night effects (FNEs) on sleep and respiratory parameters in order to evaluate the need for two serial night polysomnograms (PSGs) to diagnose obstructive sleep apnea (OSA) in epilepsy patients. Methods: As part of a pilot multicenter clinical trial investigating the effects of treating sleep apnea in epilepsy, two nights of PSG recording were performed for 40 patients with refractory epilepsy and OSA symptoms. Sleep architecture was examined in detail, along with respiratory parameters including apnea/hypopnea index (AHI) and minimum oxygen saturation. Analysis included two-tailed t-tests, Wilcox sign rank analysis, and Bland Altman measures of agreement. Results: Total sleep time differed between the two nights (night 1,363.8 min + 59.4 vs. 386.3 min + 68.6, p = 0.05). Rapid eye movement (REM) sleep and percentage of REM sleep were increased during night two (night 1: 12.3% + 5.9 vs. night 2: 15.5% + 6.2, p = 0.007), and the total minutes of slow-wave sleep (SWS) were increased (night 1: 35.6 + 60.7 vs. night 2: 46.4 + 68.1, p = 0.01). No other sleep or respiratory variables differed between the two nights. Given an AHI inclusion criterion of five apneas per hour, the first PSG identified all but one patient with OSA. Discussion: Respiratory parameters showed little variability between the first and second nights. Sleep architecture was mildly different between the first and second PSG night. Performing two consecutive baseline PSGs to diagnose OSA may not be routinely necessary in this population.

KW - Epilepsy

KW - First night effect

KW - Obstructive sleep apnea

KW - Polysomnogram

KW - Rapid eye movement (REM) sleep

KW - Slow-wave sleep (SWS)

UR - http://www.scopus.com/inward/record.url?scp=57449117716&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=57449117716&partnerID=8YFLogxK

U2 - 10.1111/j.1528-1167.2008.01681.x

DO - 10.1111/j.1528-1167.2008.01681.x

M3 - Article

C2 - 18513353

AN - SCOPUS:57449117716

VL - 49

SP - 2063

EP - 2068

JO - Epilepsia

JF - Epilepsia

SN - 0013-9580

IS - 12

ER -