0131 Planes, Trains And Automobiles: Traffic Noise And Its Impact On Sleep Depth Measured By Odds Ratio Product

Abstract Introduction The odds ratio product (ORP) is a new highly-validated electroencephalogram biomarker of sleep depth. ORP has been validated as such by several studies investigating the effect of sleep disorders, responses to sleep deprivation and traffic noise. ORP during REM sleep varies considerably among individuals. Whether ORP reflects sleep depth also in REM sleep is unknown. We hypothesized that subjects with high REM ORP are more prone to REM sleep fragmentation. Methods Using data from the baseline (SHHS1; N=5,537) and follow-up (SHHS2; N=2,595) visits of the Sleep Heart Health Study, we calculated and summarized ORP in 30-second intervals corresponding to manually scored sleep stage epochs. We developed a heuristic to identify REM periods, defined as sequences of REM sleep epochs separated by no more than 10 minutes of other sleep stages or wake epochs. Using general linear models adjusted by age, sex, body mass index, race and ethnicity, we evaluated the relationship between REM ORP and total REM duration, number of awakening episodes per REM period and arousal index during REM sleep. Results Higher REM ORP was correlated with shorter total REM duration (ρ SHHS1=-0.12; p &lt 0.001, ρ SHHS2=-0.07; p &lt 0.001), more awakening episodes (ρ SHHS1=0.26; p<0.001, ρ SHHS2=0.30; p &lt 0.001) and higher arousal index (ρ SHHS1=0.18; p &lt 0.001, ρ SHHS2=0.16; p &lt < 0.001) during identified REM periods. In adjusted analyses, one-unit increase in REM ORP was associated, on average, with a 7 minute decrease in total REM duration (β=-7.10; p &lt 0.001), 1 more awakening episode per REM period (β=1.29; p &lt 0.001) and an increase of 6 arousals/hour (β=6.16; p &lt 0.001) during REM sleep periods. Conclusion We found that higher REM ORP was associated with shorter REM periods, higher proportion of awake during REM periods and higher REM arousal index. Although small, these differences suggest that ORP is consistent with the concept of sleep depth also during REM sleep. Support None

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The Odds Ratio Product (An Objective Sleep Depth Measure): Normal Values, Repeatability, and Change With CPAP in Patients With OSA

Journal of Clinical Sleep Medicine ◽

10.5664/jcsm.7812 ◽

2019 ◽

Vol 15 (08) ◽

pp. 1155-1163 ◽

Cited By ~ 1

Author(s):

Charles Gerhard Penner ◽

Bethany Gerardy ◽

Rob Ryan ◽

Mark Williams

Keyword(s):

Odds Ratio ◽

Normal Values ◽

Sleep Depth

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0009 A Comparison of the Effects of Gaboxadol and Sleep Restriction on Sleep Depth Assessed by the Odds-Ratio-Product

SLEEP ◽

10.1093/sleep/zsy061.008 ◽

2018 ◽

Vol 41 (suppl_1) ◽

pp. A3-A4

Author(s):

J K Walsh ◽

P K Schweitzer ◽

K S Griffin ◽

M Younes

Keyword(s):

Odds Ratio ◽

Sleep Restriction ◽

Sleep Depth

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0317 Normal Values and Repeatability of a Novel Sleep Depth Scale; The Odds Ratio Product

SLEEP ◽

10.1093/sleep/zsy061.316 ◽

2018 ◽

Vol 41 (suppl_1) ◽

pp. A121-A122

Author(s):

C Penner ◽

B Gerardy ◽

M Williams

Keyword(s):

Odds Ratio ◽

Normal Values ◽

Sleep Depth ◽

Depth Scale

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0691 Comparison Of Odds Ratio Product And Other Polysomnographic Metrics Among Responders And Non-responders To Upper Airway Stimulation Treatment Of Obstructive Sleep Apnea

SLEEP ◽

10.1093/sleep/zsaa056.687 ◽

2020 ◽

Vol 43 (Supplement_1) ◽

pp. A263-A264

Author(s):

J L Yu ◽

B T Keenan ◽

S T Kuna ◽

M Younes

Keyword(s):

Obstructive Sleep Apnea ◽

Sleep Apnea ◽

Odds Ratio ◽

Statistical Significance ◽

Upper Airway ◽

Research Society ◽

Apnea Hypopnea Index ◽

Upper Airway Stimulation ◽

Sleep Depth ◽

Obstructive Sleep

Abstract Introduction Upper airway stimulation (UAS) is a surgical method of treating obstructive sleep apnea (OSA). UAS involves an implantable neuro-stimulator that stimulates the hypoglossal nerve to protrude the tongue during sleep. OSA fails to improve in 22% of patients who receive UAS as defined by a > 50% reduction in Apnea-Hypopnea Index (AHI) and an AHI <20 events/hour. Light sleep may predict UAS failure in that it may limit the stimulus strength that can be applied. The odds ratio product (ORP) is a novel polysomnographic (PSG) metric of sleep depth. We hypothesized that ORP values prior to surgery will be higher (lighter sleep) in non-responders. Having markers that predict surgical success can help reduce unnecessary surgeries. Methods This is a retrospective cohort study of 126 patients (83 responders vs. 43 non-responders) who received UAS implantation for the treatment of OSA. PSG data was obtained from the Stimulation for Apnea Reduction (STAR) trial. Raw baseline PSG data were analyzed and ORP values calculated using Michele Sleep Scoring Software (Cerebra Medical, Winnipeg, CA). In addition, 13 PSG metrics that were considered possibly relevant to surgical outcome were calculated as an exploratory analysis. The measurements included: spindle density, spindle power, spindle frequency, alpha intrusion, Right/Left sleep depth correlation coefficient, respiratory duty cycle, respiratory flow limitation, and arousal intensity. Statistical Analysis: Comparisons between responders and non-responders used parametric t-tests for continuous data and chi-squared or Fisher’s exact tests for categorical data. Statistical significance was based on a Bonferroni-corrected p<0.00357. Results Differences in ORP values and other PSG metrics between responders and non-responders were not statistically significant. Of all PSG metrics only differences in spindle density approached statistical significance (Responders = 2.33 spindles/minute vs Non-Responders = 1.39 spindles/minute, p=0.00360). Conclusion The findings suggest that differences in sleep depth and several other sleep characteristics do not play a significant role in determining response to UAS therapy. Support This project was supported by a Sleep Research Society Career Development Award #023-JP-19

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0282 Correlation Between Sleep Depth in the Right and Left Cerebral Hemispheres Following Sleep Deprivation, Restriction or Noise Exposure

SLEEP ◽

10.1093/sleep/zsaa056.280 ◽

2020 ◽

Vol 43 (Supplement_1) ◽

pp. A107-A107

Author(s):

M Younes ◽

S T Kuna ◽

A I Pack ◽

P K Schweitzer ◽

J K Walsh ◽

...

Keyword(s):

Sleep Deprivation ◽

Noise Exposure ◽

Traffic Noise ◽

Sleep Loss ◽

Sleep Stages ◽

Depth Range ◽

Sleep State ◽

Sleep Depth ◽

High Prevalence ◽

The Right

Abstract Introduction The Odds-Ratio-Product (ORP) is a highly-validated continuous index of sleep depth (range 0=deep sleep; 2.5=full wakefulness). ORP values fluctuate within this range as sleep state changes between wake and different sleep stages. In healthy non-sleep deprived adults, intra-class correlation coefficient of concurrent right vs. left ORP values (R / L coefficient) is typically >0.80. In a recent study R / L coefficient was markedly reduced in many critically-ill patients and these patients failed to be weaned from mechanical ventilation. Given the high prevalence of sleep loss in such patients we hypothesized that reduction in R/L coefficient might result from sleep loss. This retrospective EEG analysis of data from 3 independent research studies investigated if R / L coefficient decreases in pure models of sleep deprivation, restriction or noise exposure during sleep in healthy subjects. Methods Polysomnograms were obtained from three studies: A) 200 subjects who underwent 36 hours of total sleep deprivation; B) 21 subjects who underwent 4 consecutive nights of sleep restriction (5 hrs. / night); C) 72 subjects who were exposed to intermittent traffic noise events with maximum sound pressure levels ranging from 45–65 dB(A) for 10 consecutive nights. For study A, R / L coefficient was calculated from pre- and post-deprivation sleep studies and the two values were compared. For study B, coefficient was calculated at baseline and in each restriction night. For study C, the coefficient was calculated in each of the 10 exposure nights and the slope of the change was calculated. Results In study A, the coefficient decreased from 0.82±0.12 at baseline to 0.74±0.16 after sleep deprivation (p &lt 0.0001). In study B, the coefficient decreased from 0.83±0.11 at baseline to 0.75±0.15 on the 4th restriction night (p &lt 0.01). In study C, coefficient decreased at a rate of 0.003±0.001 per exposure night (p &lt 0.001). Conclusion The correlation between sleep depth in the right and left hemispheres deteriorates following sleep deprivation, restriction or noise-induced sleep fragmentation. Support NIH P50 HL060287

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0148 Assessment of Sleep Depth and Propensity during Sleep Restriction using the Odds-Ratio-Product

SLEEP ◽

10.1093/sleep/zsy061.147 ◽

2018 ◽

Vol 41 (suppl_1) ◽

pp. A57-A58 ◽

Cited By ~ 2

Author(s):

P K Schweitzer ◽

K S Griffin ◽

M Younes ◽

J K Walsh

Keyword(s):

Odds Ratio ◽

Sleep Restriction ◽

Sleep Depth

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Association of a Novel EEG Metric of Sleep Depth/Intensity with Attention-Deficit/Hyperactivity, Learning and Internalizing Disorders and their Pharmacotherapy in Adolescence

SLEEP ◽

10.1093/sleep/zsab287 ◽

2021 ◽

Author(s):

Anna Ricci ◽

Susan L Calhoun ◽

Fan He ◽

Jidong Fang ◽

Alexandros N Vgontzas ◽

...

Keyword(s):

Rem Sleep ◽

Attention Deficit ◽

Odds Ratio ◽

Sleep Disturbances ◽

Primary Outcome ◽

Nrem Sleep ◽

Learning Disorders ◽

Typically Developing ◽

Sleep Depth ◽

Youth With Adhd

Abstract Study Objectives Psychiatric/learning disorders are associated with sleep disturbances, including those arising from abnormal cortical activity. The odds ratio product (ORP) is a standardized electroencephalogram metric of sleep depth/intensity validated in adults, while ORP data in youth are lacking. We tested ORP as a measure of sleep depth/intensity in adolescents with and without psychiatric/learning disorders. Methods 418 adolescents (median 16y) underwent a 9-hour, in-lab polysomnography. Of them, 263 were typically developing (TD), 89 were unmedicated and 66 were medicated for disorders including attention-deficit/hyperactivity (ADHD), learning (LD) and internalizing (ID). Central ORP during non-rapid eye movement (NREM) sleep was the primary outcome. Secondary/exploratory outcomes included central and frontal ORP during NREM stages, in the 9-seconds following arousals (ORP-9), in first and second halves of the night, during REM sleep and wakefulness. Results Unmedicated youth with ADHD/LD had greater central ORP than TD during stage 3 and in central and frontal regions during stage 2 and the second half of the sleep period, while ORP in youth with ADHD/LD on stimulants did not significantly differ from TD. Unmedicated youth with ID did not significantly differ from TD in ORP, while youth with ID on antidepressants had greater central and frontal ORP than TD during NREM and REM sleep, and higher ORP-9. Conclusion The greater ORP in unmedicated youth with ADHD/LD, and normalized levels in those on stimulants, suggests ORP is a useful metric of decreased NREM sleep depth/intensity in ADHD/LD. Antidepressants are associated with greater ORP/ORP-9, suggesting these medications induce cortical arousability.

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