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 language | English (US) |
|---|---|
| Pages (from-to) | 2063-2068 |
| Number of pages | 6 |
| Journal | Epilepsia |
| Volume | 49 |
| Issue number | 12 |
| DOIs | |
| State | Published - Dec 1 2008 |
| Externally published | Yes |
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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
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 journal › Article
}
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 -