Respiratory Cycle-Related EEG Changes (RCREC) predict all-cause mortality in the Sleep Heart Health Study (SHHS)
Sleep-disordered breathing (SDB) is among the most prevalent sleep disturbances in adults and is associated with an increased risk of death. This analysis focused on data from a large cohort of adults to assess whether an SDB biomarker based on quantitative analysis of sleep EEG, namely Respiratory Cycle-Related EEG Changes (RCREC), may in comparison to the standard apnea-hypopnea index (AHI) improve prediction of all-cause mortality. The RCREC are thought to represent breath-to-breath, inspiratory microarousals associated with increased work of breathing.
Data were obtained from the Sleep Heart Health Study (SHHS), a multicenter longitudinal study focused on SDB and cardiovascular health of middle-aged to older adults. The RCREC values were computed in delta (0.5-4.5 Hz), theta (4.5-8.5 Hz), alpha (8.5-12.5 Hz), sigma (12.5-15.5 Hz), beta (15.5-30.5 Hz), and gamma (30.5-49.0 Hz) frequency bands. Sequential Cox Proportional Hazard models, adjusted for body-mass index, age, race, smoking status, and sex, were used to assess association with all-cause mortality.
Among adults with sufficient data quality (n=4427, mean age at baseline 62.8 ±10.9 (SD) years, 53% female), AHI and gamma RCREC separately showed associations with risk of mortality (adjusted OR 1.01 deaths per year per unit increase in AHI (pConclusion
Gamma RCREC as a biomarker of SDB may, in comparison to the AHI, better predict all-cause mortality in the SHHS. The reason for clinical utility of gamma as opposed to other-frequency RCREC is not clear, though the reported prominence among insomniacs of gamma EEG power, thought to represent cortical hyperactivation, allows speculation that chronic repetitive nightly exposure could shorten life.
Dunietz, G. L.,
O'Brien, L. M.
Respiratory Cycle-Related EEG Changes (RCREC) predict all-cause mortality in the Sleep Heart Health Study (SHHS).
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