Format

Send to

Choose Destination
Sleep. 2015 Sep 1;38(9):1439-49. doi: 10.5665/sleep.4986.

Regional Cerebral Blood Flow during Wakeful Rest in Older Subjects with Mild to Severe Obstructive Sleep Apnea.

Author information

1
Center for Advanced Research in Sleep Medicine (CARSM), Hôpital du Sacré-Coeur de Montréal, Montreal, Quebec, Canada.
2
Université de Montréal, Department of Psychiatry, Montreal, Quebec, Canada.
3
Université du Québec à Montréal, Department of Psychology, Montreal, Quebec, Canada.
4
Université de Montréal, Department of Psychology, Montreal, Quebec, Canada.
5
McGill University, McConnell Brain Imaging Centre, Montreal, Quebec, Canada.

Abstract

OBJECTIVES:

To evaluate changes in regional cerebral blood flow (rCBF) during wakeful rest in older subjects with mild to severe obstructive sleep apnea (OSA) and healthy controls, and to identify markers of OSA severity that predict altered rCBF.

DESIGN:

High-resolution (99m)Tc-HMPAO SPECT imaging during wakeful rest.

SETTING:

Research sleep laboratory affiliated with a University hospital.

PARTICIPANTS:

Fifty untreated OSA patients aged between 55 and 85 years, divided into mild, moderate, and severe OSA, and 20 age-matched healthy controls.

INTERVENTIONS:

N/A.

MEASUREMENTS:

Using statistical parametric mapping, rCBF was compared between groups and correlated with clinical, respiratory, and sleep variables.

RESULTS:

Whereas no rCBF change was observed in mild and moderate groups, participants with severe OSA had reduced rCBF compared to controls in the left parietal lobules, left precentral gyrus, bilateral postcentral gyri, and right precuneus. Reduced rCBF in these regions and in areas of the bilateral frontal and left temporal cortex was associated with more hypopneas, snoring, hypoxemia, and sleepiness. Higher apnea, microarousal, and body mass indexes were correlated to increased rCBF in the basal ganglia, insula, and limbic system.

CONCLUSIONS:

While older individuals with severe obstructive sleep apnea (OSA) had hypoperfusion in the sensorimotor and parietal areas, respiratory variables and subjective sleepiness were correlated with extended regions of hypoperfusion in the lateral cortex. Interestingly, OSA severity, sleep fragmentation, and obesity correlated with increased perfusion in subcortical and medial cortical regions. Anomalies with such a distribution could result in cognitive deficits and reflect impaired vascular regulation, altered neuronal integrity, and/or undergoing neurodegenerative processes.

KEYWORDS:

SPECT; aging; cerebral perfusion; neuroimaging; obstructive sleep apnea; regional cerebral blood flow; snoring

PMID:
25761981
PMCID:
PMC4531412
DOI:
10.5665/sleep.4986
[Indexed for MEDLINE]
Free PMC Article

Supplemental Content

Full text links

Icon for Silverchair Information Systems Icon for PubMed Central
Loading ...
Support Center