0469 Respiratory Cycle-Related EEG Changes (RCREC) Predict All-Cause Mortality in the Sleep Heart Health Study (SHHS)

Document Type

Article

Publication Date

4-2019

Department

Department of Electrical and Computer Engineering

Abstract

Introduction

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. Methods

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. Results

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 (p<0.04); 1.02 per year per 0.1 increase in gamma RCREC (p<0.0001). In a model that included AHI, gamma RCREC, and the above covariates, gamma RCREC retained significance (p<0.0001), AHI did not (p=0.14), and addition of AHI had not improved the overall model significance (Wilks’ Theorem, p=0.15). The RCREC in other frequency bands were not similarly effective. Conclusion

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.

Publisher's Statement

© Sleep Research Society 2019. Publisher’s version of record: https://doi.org/10.1093/sleep/zsz067.468

Publication Title

Sleep

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