393 Comparison of Oxygenation Abnormalities Between Obstructive Sleep Apnea and Central Sleep Apnea

SLEEP ◽  
2021 ◽  
Vol 44 (Supplement_2) ◽  
pp. A156-A157
Author(s):  
Sikawat Thanaviratananich ◽  
Hao Cheng ◽  
Maria Pino ◽  
Krishna Sundar
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Demographic Data ◽  
Central Sleep Apnea ◽  
Nrem Sleep ◽  
Rate Of Change ◽  
Apnea Hypopnea Index ◽  
P Value ◽  
Obstructive Sleep ◽  
Cheyne Stokes Breathing

Abstract Introduction The apnea-hypopnea index (AHI) is used as a generic index to quantify both central sleep apnea (CSA) and obstructive sleep apnea (OSA) syndromes. Patterns of oxygenation abnormalities seen in CSA and OSA may be key to understanding differing clinical impacts of these disorders. Oxygen desaturation and resaturation slopes and durations in OSA and CSA were compared between OSA and CSA patients. Methods Polysomnographic data of patients aged 18 years or older with diagnosis of OSA and CSA, at University of Iowa Hospitals and Clinics, were analyzed and demographic data were collected. Oximetric changes during hypopneas and apneas were studied for desaturation/resaturation durations and desaturation/resaturation slopes. Desaturation and resaturation slopes were calculated as rate of change in oxygen saturation (ΔSpO2/Δtime). Comparison of hypoxemia-based parameters between patients with OSA and CSA was performed using unpaired t-test. Results 32 patients with OSA with median AHI of 15.4 (IQR 5.1 to 30.55) and median ODI of 15.47 (IQR 9.50 to 29.33) were compared to 15 patients with CSA with a median AHI of 20.4 (IQR 12.6 to 47.8) and median ODI of 27.56 (IQR 17.99 to 29.57). The mean number of desaturation and resaturation events was not significantly different between patients with OSA and CSA (OSA - 106.81±87.93; CSA - 130.67±76.88 with a p-value 0.1472). 4/15 CSA patients had Cheyne-Stokes breathing, 2/15 had treatment emergent central sleep apnea, 1/15 had methadone-associated CSA and for 8/15, no etiologies for CSA were found. Mean desaturation durations was significantly longer in OSA (20.84 s ± 5.67) compared to CSA (15.94 s ± 4.54) (p=0.0053) and consequently the desaturation slopes were steeper in CSA than OSA (-0.35%/sec ±0.180 vs. -0.243 ± 0.073; p=0.0064). The resaturation duration was not significantly longer in OSA (9.76 s ± 2.02) than CSA (9.057 s ± 2.17) (p=0.2857). Differences between desaturation duration and slopes between CSA and OSA persisted during REM and NREM sleep, and in supine sleep. Conclusion As compared to OSA, patients with CSA have different patterns of desaturations and resaturations with lesser hypoxic burden with CSA. This may have implications on the clinical outcomes seen between these two disorders. Support (if any):

392 Effect of Obstructive Sleep Apnea Severity, Sleep Stage and Position on Patterns of Oximetric Desaturations and Resaturations

SLEEP ◽  
2021 ◽  
Vol 44 (Supplement_2) ◽  
pp. A156-A156
Author(s):  
Sikawat Thanaviratananich ◽  
Hao Cheng ◽  
Maria Pino ◽  
Krishna Sundar
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Sleep Stage ◽  
Rate Of Change ◽  
Sleep Stages ◽  
Sleep Position ◽  
Apnea Hypopnea Index ◽  
P Value ◽  
Obstructive Sleep ◽  
Significant Difference

Abstract Introduction Obstructive sleep apnea (OSA) severity based upon the apnea-hypopnea index (AHI) ignores many characteristics such as the duration of apnea-hypopneas, the duration and degree of oxygen desaturations (SpO2) etc. While hypoxemic burden has received increased attention given its relationship with cardiovascular outcomes, the role of oximetric resaturation vs. desaturation times is not understood. Resaturation times tend to be constant in contrast to desaturation durations. This study was done to assess desaturation and resaturation indices in patients with different OSA severity in differing sleep stages and positions. Methods Oximetric desaturation and resaturation slopes were calculated in patients with different OSA severities as rate of change in oxygen saturations (ΔSpO2/Δtime). Results 33 patients with OSA were studied (11 in each OSA severity group). Mean desaturation duration was 20.12 ±1.10 seconds with shorter NREM desaturation times (mean 19.07 ±1.11 seconds) as compared to REM desaturation durations (mean 26.66 ±2.69 seconds) (p-value 0.009). Non-supine and supine mean desaturation durations were similar (19.59 ±1.77 and 18.73 ±1.18 seconds respectively). Mean resaturation durations were shorter than desaturation durations at 12.46 ±0.84 seconds and was significantly lower in NREM sleep than in REM sleep (9.32 ±0.41 seconds vs 12.50 ±0.75 seconds p-value 0.002). Resaturation slopes (0.44 %/second (±0.028 %/second)) were steeper as compared to desaturation slopes (-0.26 %/second (±0.02 %/second)) without significant difference between NREM vs. REM desaturation or resaturation slopes. While desaturation slopes were not affected by sleep position, resaturation slopes were significantly steeper in supine compared to non-supine sleep (p-value 0.0046). Desaturation durations increased with OSA severity, but resaturation times decreased (resaturation slopes became steeper) with significant differences between patients with different OSA severity. Conclusion This study demonstrated that oxygen resaturation slopes varied according to different OSA severity and sleep position. Given that faster resaturation rates may reflect the possibility of higher degrees of reoxygenation-related oxidative stress, this should be assessed as a novel index to predicate OSA outcomes. Support (if any):

scholarly journals 0879 Outcomes of Adenotonsillectomy in Children with Down Syndrome and Obstructive Sleep Apnea

SLEEP ◽  
2020 ◽  
Vol 43 (Supplement_1) ◽  
pp. A335-A335
Author(s):  
A Morello Gearhart ◽  
B Gunaratnam ◽  
E Senthilvel
Keyword(s):  
Obstructive Sleep Apnea ◽  
Down Syndrome ◽  
Sleep Apnea ◽  
Sleep Onset ◽  
Sleep Efficiency ◽  
Apnea Hypopnea Index ◽  
P Value ◽  
Children With Down Syndrome ◽  
Arousal Index ◽  
Obstructive Sleep

Abstract Introduction Obstructive sleep apnea (OSA) is highly prevalent in children with Down Syndrome (DS). The aim of this study was to assess the effectiveness of adenotonsillectomy (T&A) on polysomnographic parameters of children with DS. Methods Retrospective chart review of children with DS who underwent T&A between 2012-2019 was performed. Preoperative OSA severity was categorized by obstructive apnea-hypopnea index (OAHI): mild = 1-4.9 events/h; moderate = 5-9.9 events/h; severe ≥ 10 events/h. Results We identified 43 DS children with pre and post T&A polysomnographic data in a population of 162 DS patients. A total of 25 were male, mean age 5.1 years (± 3.8 years) and 56% Caucasians. Preoperative data showed 19% mild OSA, 30% moderate and 51% severe. Postoperatively, apnea-hypopnea index (AHI) normalized in 9.3%, 37.2% had mild OSA, 18.6% moderate and 34.9% severe. Overall, T&A resulted in significant improvement (p-value <0.05) in mean AHI, (18.51 ± 28.05 vs 11.72 ± 16.43), SaO2 nadir (80.00 ± 14.82 vs 85.51 ± 5.94), sleep efficiency (81.97 ± 11.15 vs 85.9 ± 8.28), arousal index (16.14 ± 10.23 vs 14.45 ± 12.34), and wake after sleep onset (67.19 ± 46.89 vs 50.55 ± 40.83) and no statistical difference (p-value >0.05) in end-tidal carbon dioxide (43.86 ± 9.56 vs 44.17 ± 3.78), Rapid Eye Movement (REM)% (15.86 ± 7.75 vs 15.92 ± 7.41), sleep latency (24.03 ± 34.39 vs 22.55 ± 21.11), and central apnea index (0.86 ± 1.38 vs 0.66 ± 0.82) in pre and post T&A data. There was no statistically significant difference in pre and post T&A polysomnographic parameters between 17 DS and 17 age and gender-matched non-DS control subjects. Conclusion Adenotonsillectomy resulted in improvement in AHI, oxygen desaturation nadir, sleep efficiency, arousal index and wake after sleep onset. However, a significant portion of children with DS continued to have moderate to severe OSA after T&A. Support None.

scholarly journals Analysis of Metabolites Changes on Obstructive Sleep Apnea Patients After Multilevel Sleep Surgery

2020 ◽  
Author(s):  
Abdulmohsen Alterki ◽  
Shibu Joseph ◽  
Thangavel Alphonse Thanaraj ◽  
Irina Al-Khairi ◽  
Preethi Cherian ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Metabolic Status ◽  
Apnea Hypopnea Index ◽  
P Value ◽  
Upper Airways ◽  
Sleep Surgery ◽  
Post Surgery ◽  
Obstructive Sleep ◽  
Increased Risk

Background: Obstructive sleep apnea (OSA) is caused by partial or complete obstruction of the upper airways. Corrective surgeries aim at removing obstructions in the nasopharynx, oropharynx, and hypopharynx. OSA is associated with increased risk of various metabolic diseases. Our objective was to evaluate the effect of surgery on the plasma metabolome. Methods: This study included 39 OSA patients who underwent Multilevel Sleep Surgery (MLS). Clinical and anthropometric measures were taken at baseline and 5 months after surgery. Results: The mean Apnea Hypopnea Index (AHI) significantly dropped from 22.0 ± 18.5 events/hour to 8.97 ± 9.57 events/hour (p-Value <0.001). The Epworth’s sleepiness Score (ESS) dropped from 12.8 ± 6.23 to 2.95 ± 2.40 (p-Value <0.001) indicating success of the surgery in treating OSA. Plasma levels of metabolites, phosphocholines (PC) PC.41.5, PC.42.3, ceremide (Cer) Cer.44.0, and triglyceride (TG) TG.53.6, TG.55.6 and TG.56.8 were decreased (p-Value<0.05) whereas lysophosphatidylcholines (LPC) 20.0 and PC.39.3 were increased (p-Value<0.05) after surgery. Conclusion: This study highlights the success of MLS in treating OSA. Treatment of OSA resulted in improvement in metabolic status that was characterized by decreased TG, PCs and Cer metabolites post-surgery indicating that the success of the surgery positively impacted the metabolic status of these patients.

scholarly journals Design and Evaluation of a Non-Contact Bed-Mounted Sensing Device for Automated In-Home Detection of Obstructive Sleep Apnea: A Pilot Study

Biosensors ◽  
2019 ◽  
Vol 9 (3) ◽  
pp. 90 ◽  
Author(s):  
Mosquera-Lopez ◽  
Leitschuh ◽  
Condon ◽  
Hagen ◽  
Rajhbeharrysingh ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Pilot Study ◽  
Pressure Sensors ◽  
Diagnostic System ◽  
High Sensitivity ◽  
Apnea Hypopnea Index ◽  
P Value ◽  
Apnea Test ◽  
Obstructive Sleep

We conducted a pilot study to evaluate the accuracy of a custom built non-contactpressure-sensitive device in diagnosing obstructive sleep apnea (OSA) severity as an alternative toin-laboratory polysomnography (PSG) and a Type 3 in-home sleep apnea test (HSAT). Fourteenpatients completed PSG sleep studies for one night with simultaneous recording from ourload-cell-based sensing device in the bed. Subjects subsequently installed pressure sensors in theirbed at home and recorded signals for up to four nights. Machine learning models were optimized toclassify sleep apnea severity using a standardized American Academy of Sleep Medicine (AASM)scoring of the gold standard studies as reference. On a per-night basis, our model reached a correctOSA detection rate of 82.9% (sensitivity = 88.9%, specificity = 76.5%), and OSA severity classificationaccuracy of 74.3% (61.5% and 81.8% correctly classified in-clinic and in-home tests, respectively).There was no difference in Apnea Hypopnea Index (AHI) estimation when subjects wore HSATsensors versus load cells (LCs) only (p-value = 0.62). Our in-home diagnostic system providesan unobtrusive method for detecting OSA with high sensitivity and may potentially be used forlong-term monitoring of breathing during sleep. Further research is needed to address the lowerspecificity resulting from using the highest AHI from repeated samples.

Relevance of obstructive sleep apnea and smoking: Obstructive sleep apnea and smoking

2020 ◽  
Author(s):  
Ayse Didem Esen ◽  
Meltem Akpinar
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Rem Sleep ◽  
Demographic Data ◽  
Apnea Hypopnea Index ◽  
Obstructive Sleep ◽  
Study Results ◽  
Significant Difference ◽  
Study Population ◽  
The Impact

Abstract Background The data concerning the association of smoking and obstructive sleep apnea (OSA) are limited. The effects of cigarette smoking on OSA still remain obscure. Objectives To reveal the impact of smoking on obstructive sleep apnea. Methods About 384 patients with the diagnosis of OSA through full night polysomnographic (PSG) examination were included to the study. The demographic data (age, sex and BMI), complaints and medical history, status of smoking as non-smokers and smokers, smoking frequency (cigarettes/day), polysomnograhic data comprising apnea hypopnea index (AHI), non-REM sleep AHI (NREM AHI), REM sleep AHI (REM AHI), minimum oxygen saturation (min SaO2) were recorded for all the subjects. Non-smokers and smokers were compared in terms of severity of OSA. Results The study population consisted of 384 subjects, 253 males and 131 females. Smoking frequency was not found correlated with OSA severity. Among smokers, males had higher severe OSA rate (P = 0.002, P < 0.05). In subjects with BMI < 30, severe OSA rate was higher in smokers (34.44% versus 21%) (P = 0.027, P < 0.05). Conclusions Our study detected higher rate of severe OSA in male smokers and smokers with BMI < 30. PSG data did not yield statistically significant difference in non-smokers and smokers. OSA severity was not found correlated with smoking frequency. Along with the study results, the impact of smoking on OSA is still controversial. Prospective studies with larger sample size may be contributive to further evaluation of the association of OSA with smoking.

scholarly journals Targeted Metabolomics Analysis on Obstructive Sleep Apnea Patients after Multilevel Sleep Surgery

Metabolites ◽  
2020 ◽  
Vol 10 (9) ◽  
pp. 358
Author(s):  
Abdulmohsen Alterki ◽  
Shibu Joseph ◽  
Thangavel Alphonse Thanaraj ◽  
Irina Al-Khairi ◽  
Preethi Cherian ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Metabolic Diseases ◽  
Metabolic Status ◽  
Apnea Hypopnea Index ◽  
P Value ◽  
Upper Airways ◽  
Sleep Surgery ◽  
Obstructive Sleep ◽  
Increased Risk

Background: Obstructive sleep apnea (OSA) is caused by partial or complete obstruction of the upper airways. Corrective surgeries aim at removing obstructions in the nasopharynx, oropharynx, and hypopharynx. OSA is associated with an increased risk of various metabolic diseases. Our objective was to evaluate the effect of surgery on the plasma metabolome. Methods: This study included 39 OSA patients who underwent Multilevel Sleep Surgery (MLS). Clinical and anthropometric measures were taken at baseline and five months after surgery. Results: The mean Apnea-Hypopnea Index (AHI) significantly dropped from 22.0 ± 18.5 events/hour to 8.97 ± 9.57 events/hour (p-Value < 0.001). Epworth’s sleepiness Score (ESS) dropped from 12.8 ± 6.23 to 2.95 ± 2.40 (p-Value < 0.001), indicating the success of the surgery in treating OSA. Plasma levels of metabolites, phosphocholines (PC) PC.41.5, PC.42.3, ceremide (Cer) Cer.44.0, and triglyceride (TG) TG.53.6, TG.55.6 and TG.56.8 were decreased (p-Value < 0.05), whereas lysophosphatidylcholines (LPC) 20.0 and PC.39.3 were increased (p-Value < 0.05) after surgery. Conclusion: This study highlights the success of MLS in treating OSA. Treatment of OSA resulted in an improvement of the metabolic status that was characterized by decreased TG, PCs, and Cer metabolites after surgery, indicating that the success of the surgery positively impacted the metabolic status of these patients.

scholarly journals Plasma APRIL as a Potential Biomarker in the Diagnosis of Obstructive Sleep Apnea

2020 ◽  
Author(s):  
Wan-Wan Wen ◽  
Hai-Li Sun ◽  
Yun-Xiao Yang ◽  
Yi-Fan Jia ◽  
Meng-Ling Huang ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Plasma Levels ◽  
Demographic Data ◽  
Venous Blood ◽  
Apnea Hypopnea Index ◽  
Control Subjects ◽  
Inflammatory Pathways ◽  
Potential Biomarker ◽  
Obstructive Sleep

Abstract Background: Obstructive sleep apnea (OSA) is the most common type of sleep breathing disorder and is characterized by chronic intermittent hypoxia, which could cause inflammation and NF-KB-dependent inflammatory pathways activation. Circulating APRIL might play an important role in promoting inflammation and NF-KB-dependent inflammatory pathways activation. We explored the role of APRIL as a potential mechanism of inflammation in OSA patients. Methods: After detailed sleep evaluated, venous blood and demographic data were collected from 155 subjects with varying severity of OSA and 52 control subjects. Plasma levels of APRIL were measured by human Magnetic Luminex assay. Results: Plasma APRIL levels were significantly higher in OSA subjects compared with control subjects. Categorization of the OSA subjects into mild, moderate, and severe OSA subgroups showed that plasma levels of APRIL increased with severity. After adjusting confounding factors, found that increased plasma APRIL levels were conferred a higher odds ratio (OR) of OSA. Moreover, plasma APRIL levels were positively associated with the apnea-hypopnea index. Furthermore, plasma APRIL showed higher discriminatory accuracy in predicting the presence of OSA. Conclusions:Plasma APRIL levels were significantly associated with the occurrence of OSA and its severity. APRIL could be a plasma biomarker with a positive diagnostic value for inflammation and NF-KB–dependent inflammatory pathways activation in subjects with OSA.

scholarly journals Determinants of CPAP Adherence in Hispanics with Obstructive Sleep Apnea

2014 ◽  
Vol 2014 ◽  
pp. 1-6 ◽  
Author(s):  
Montserrat Diaz-Abad ◽  
Wissam Chatila ◽  
Matthew R. Lammi ◽  
Irene Swift ◽  
Gilbert E. D’Alonzo ◽  
...  
Keyword(s):  
Socioeconomic Status ◽  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Demographic Data ◽  
Language Barrier ◽  
Apnea Hypopnea Index ◽  
Cpap Adherence ◽  
Obstructive Sleep ◽  
Perceived Benefit ◽  
Hispanic Patients

Purpose. We hypothesized that socioeconomic factors and a language barrier would impact adherence with continuous positive airway pressure (CPAP) among Hispanics with obstructive sleep apnea (OSA).Methods. Patients with OSA who were prescribed CPAP for at least 1 year and completed a questionnaire evaluating demographic data, socioeconomic status, and CPAP knowledge and adherence participated in the study.Results. Seventy-nine patients (26 males;53±11 yrs; body mass index(BMI)=45±9 kg/m2) with apnea-hypopnea index (AHI)33±30events/hr completed the study. Included were 25 Hispanics, 39 African Americans, and 15 Caucasians, with no difference in age, AHI, CPAP use, or BMI between the groups. While there was a difference in educational level (P=0.006), income level (P<0.001), and employment status (P=0.03) between the groups, these did not influence CPAP adherence. Instead, overall improvement in quality of life and health status and perceived benefit from CPAP influenced adherence, both for the group as a whole (P=0.03,P=0.004, andP=0.001, resp.), as well as in Hispanics (P=0.02,P=0.02,P=0.03, resp.).Conclusion. In Hispanic patients with OSA, perceived benefit with therapy, rather than socioeconomic status or a language barrier, appears to be the most important factor in determining CPAP adherence.

scholarly journals The Prevalence of High Risk of Obstructive Sleep Apnea and its Association with Sociodemographic Factors among Adults in Taman Dato' Rashid Salleh, Indera Mahkota, Kuantan

2020 ◽  
Vol 18 (2) ◽  
Author(s):  
Rawahah Husna Ramli ◽  
Artika Hassan ◽  
Jamalludin Abd Rahman ◽  
Razman Mohd Rus ◽  
Hafizah Pasi ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
High Risk ◽  
Demographic Data ◽  
Adult Population ◽  
Neck Circumference ◽  
P Value ◽  
Berlin Questionnaire ◽  
Obstructive Sleep ◽  
Increased Risk

Introduction: Obstructive sleep apnea (OSA) is an insidious sleep breathing disorder, with cardinal manifestations of snoring, witnessed breathing pause during sleep and excessive daytime sleepiness. The aim of the study was to estimate the prevalence of OSA and its associated factors among adult population in Taman Dato’ Rashid Salleh, Kuantan. Materials and  method: A cross-sectional study was carried out among 157 participants who lived in Taman Dato’ Rashid Salleh from May 2018 to June 2018. Obstructive sleep apnea was quantified using the self-administered Malaynvalidated Berlin questionnaire which apart from the demographic data included three categories (10 questions) designed to elicit information regarding snoring (category 1), daytime somnolence (category 2) and the presence of obesity and/or hypertension (category 3). The respondents were considered as high risk of OSA if two or more categories were positive. Weight, height and neck circumference were measured by using Secca© weight scales, Secca© stadiometer and non-elastic plastic tape, respectively. Descriptive statistics was used to measure the prevalence, while chi-square test was used to explore the association of OSA and its background variables. Results: Out of 157 respondents, female and Malay were dominant with the 56.7% and 91.0 %, respectively. The mean age of the respondents was 36.7 (12.2) years old. The prevalence of high risk of OSA in was 18.5%. There was no association between gender, age, race, smoking and neck circumference with risk of OSA while Body Mass Index (BMI) and hypertension were significantly related to an increased risk for developing OSA (p-value < 0.001 and p=0.001, respectively).  Conclusions: Two in every 10 adults in Taman Dato’ Rashid Salleh, Kuantan were at high risk of OSA. It is recommended that appropriate health promotion should be targeted to this community to instill awareness and increase the level of understanding of the public on OSA.

scholarly journals Comparison of Cortical Autonomic Network-Linked Sympathetic Excitation by Mueller Maneuvers and Breath-Holds in Subjects With and Without Obstructive Sleep Apnea

2021 ◽  
Vol 12 ◽  
Author(s):  
Keri S. Taylor ◽  
Daniel A. Keir ◽  
Nobuhiko Haruki ◽  
Derek S. Kimmerly ◽  
Philip J. Millar ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Central Sleep Apnea ◽  
Blood Oxygen Level Dependent ◽  
Apnea Hypopnea Index ◽  
Bold Signal ◽  
Blood Oxygen Level ◽  
Efferent Nerve ◽  
Obstructive Sleep ◽  
The Right

In healthy young volunteers, acquisition of blood oxygen level-dependent (BOLD) magnetic resonance (MR) and muscle sympathetic nerve (MSNA) signals during simulation of obstructive or central sleep apnea identified cortical cardiovascular autonomic regions in which the BOLD signal changed synchronously with acute noradrenergic excitation. In the present work, we tested the hypothesis that such Mueller maneuvers (MM) and breath-holds (BH) would elicit greater concomitant changes in mean efferent nerve firing and BOLD signal intensity in patients with moderate to severe obstructive sleep apnea (OSA) relative to age- and sex-matched individuals with no or only mild OSA (Apnea Hypopnea Index, AHI, &lt;15 events/h). Forty-six participants, 24 with OSA [59 ± 8 years; AHI 31 ± 18 events/h (mean ± SD); seven women] and 22 without (58 ± 11 years; AHI 7 ± 4; nine women), performed a series of three MM and three BH, in randomly assigned order, twice: during continuous recording of MSNA from the right fibular nerve and, on a separate day, during T2∗-weighted echo planar functional MR imaging. MSNA at rest was greater in those with OSA (65 ± 19 vs. 48 ± 17 bursts per 100 heart beats; p &lt; 0.01). MM and BH elicited similar heart rate, blood pressure, and MSNA responses in the two cohorts; group mean BOLD data were concordant, detecting no between-group differences in cortical autonomic region signal activities. The present findings do not support the concept that recurring episodes of cyclical apnea during sleep alter cortical or peripheral neural responsiveness to their simulation during wakefulness by volitional Mueller maneuvers or breath-holds.

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