P300 Latency: Abnormal in Sleep Apnea with Somnolence and Idiopathic Hypersomnia, but Normal in Narcolepsy
TL;DR: IH and profound OSA patients show cognitive evoked potential evidence of cognitive dysfunction and Narcolepsy patients do not show such evidence, and visual P300 latency differentiates among disorders of EDS.
Abstract: To evaluate cognitive abnormalities in excessive daytime sleepiness (EDS) using cognitive evoked potentials (P300), and to evaluate if P300 measures differentiate among disorders of EDS, a series of EDS subjects were administered a polysomnogram, auditory and visual P300 testing using 31 scalp electrodes, and a multiple sleep latency test. P300 variables were compared with those of normal subjects. Forty normal subjects ages 16 to 65 years, and 69 EDS patients ages 16 to 65 years were used. Of these, 39 had profound obstructive sleep apnea (OSA, Respiratory Disturbance Index or RDI > 80/h sleep) with severe somnolence (Mean Sleep Latency < 5 min). Twenty-two had idiopathic hypersomnia (IH). Eight had narcolepsy. The normals and the three EDS groups did not differ in age. IH and profound OSA patients had longer visual P300 latency than normals or narcolepsy patients (p < 0.05). (p < 0.05). IH and profound OSA patients had longer auditory P300 latency than normals. They had smaller auditory P300 amplitude than narcolepsy patients. There were visual P300 latency topographic differences between normals and profound OSA patients. In conclusion, IH and profound OSA patients show cognitive evoked potential evidence of cognitive dysfunction. Narcolepsy patients do not show such evidence. Visual P300 latency differentiates among disorders of EDS.
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15 Mar 2013TL;DR: In this paper, a processor-based system for analyzing physiologic data and medical care is provided wherein the patient data is analyzed to construct images that are representative of a patient's condition.
Abstract: A processor-based system for analyzing physiologic data and medical care is provided wherein the patient data is analyzed to construct images that are representative of a patient's condition. The processor provides a self-modulating analysis, which is responsive to the occurrence of additional data items to increase the information contained in the images. Identifications of modes of physiologic failure by the analysis of the generated images provides for earlier recognition and intervention and improved protocolization of testing and treatment.
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17 May 2002TL;DR: In this article, an object-based method of iterative relational processing waveform fragments in the time domain is described wherein each more complex waveform object inherits the characteristics of the waveform objects from which it is derived.
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232 citations
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13 Dec 2012TL;DR: In this article, an exemplary pulse oximeter comprises a probe that was adapted to be attached to a body part of a patient to create a signal indicative of an oxygen saturation of blood of the patient, and a processor that is adapted to receive the signal produced by the probe, to calculate an SPO2 value based on the signal, to detect a plurality of pattern types of SPO 2 indicative of pathophysiologic events, and to produce an output indicative of a detected one of the plurality of patterns types.
Abstract: The disclosed embodiments relate to pulse oximetry. An exemplary pulse oximeter comprises a probe that is adapted to be attached to a body part of a patient to create a signal indicative of an oxygen saturation of blood of the patient, and a processor that is adapted to receive the signal produced by the probe, to calculate an SPO2 value based on the signal, to detect a plurality of pattern types of SPO2 indicative of pathophysiologic events, and to produce an output indicative of a detected one of the plurality of pattern types.
160 citations
TL;DR: Averaged event-related potentials provide a rich tool to investigators interested in probing the nervous system to evaluate daytime functioning in the face of sleep disruption, the ability of the sleeping nervousSystem to monitor the external environment, and the ability to respond to stimuli in a manner consistent with the initiation or maintenance of sleep.
124 citations
TL;DR: This review summarizes studies of evoked potentials applied to the investigation of human sleep and of sleep disorders and reviews clinical application of EPs to the study of sleep/wake disorders.
123 citations
References
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TL;DR: This outstanding manual is more than an outline; it includes diagnostic criteria, clinical course, predisposing factors, prevalence, differential diagnosis, and a bibliography for each of the numerous disorders.
Abstract: I congratulate the American Sleep Disorders Association for this outstanding manual, modeled after DSM-111 and consistent in style with the ICD-9-CM Classification. Like the DSM-111, it is more than an outline; it includes diagnostic criteria, clinical course, predisposing factors, prevalence, differential diagnosis, and a bibliography for each of the numerous disorders. The book obviously is essential for polysomnographers, but all neurologists seeing patients with sleep disorders or sleep-related phenomena should have i t available.
4,004 citations
TL;DR: The P300 wave is a positive deflection in the human event-related potential that may represent the transfer of information to consciousness, a process that involves many different regions of the brain.
Abstract: SummaryThe P300 wave is a positive deflection in the human event-related potential. It is most commonly elicited in an “oddball” paradigm when a subject detects an occasional “target” stimulus in a regular train of standard stimuli. The P300 wave only occurs if the subject is actively engaged in the
1,768 citations
TL;DR: It is concluded that patients with obstructive sleep apnea have a significantly higher frequency of auto accidents than do subjects without apnea.
Abstract: Although patients with obstructive sleep apnea often report falling asleep while driving, the frequency of auto accidents involving these patients has not been rigorously studied. Therefore, we compared the driving records of 29 patients with obstructive sleep apnea with those of 35 subjects without sleep apnea. The patients with sleep apnea had a sevenfold greater rate of automobile accidents than did the subjects without apnea (p < 0.01). The percentage of persons with one or more accidents was also greater in the patients with apnea than in the control subjects without apnea (31% versus 6%, p < 0.01). The percentage of persons having one or more accidents in which they were at fault was also greater in the patients with apnea than in the control subjects (24% versus 3%, p < 0.02). The automobile accident rate of the patients with sleep apnea was 2.6 times the accident rate of all licensed drivers in the state of Virginia (p < 0.02). In addition, 24% of patients with sleep apnea reported falling asleep ...
596 citations
TL;DR: Patients with a wide variety of sleep disorders appear to be at increased risk for sleep-related accidents, and the severity and duration of hypersomnia are probably not the only factors that contribute to that risk.
Abstract: Sleep-related motor vehicle accidents are a serious safety hazard both for the driver who falls asleep and for others on the road. Sleep disorders may be significant contributing factor in some of these accidents. We reviewed data on sleep-related accidents from 70 control subjects and 424 adults with four categories of sleep disorders: sleep apnea, narcolepsy, other disorders of excessive sleepiness, and sleep disorders without excessive sleepiness. The proportion of individuals with sleep-related accidents was 1.5-4 times greater in the hypersomnolent patient groups than in the control group. In patients with hypersomnia, the incidence of sleep-related accidents per year of excessive sleepiness was 3-7%. Although the proportion of patients with sleep-related accidents was highest in narcoleptics, apneics were involved in more sleep-related accidents because of their greater number. Apneics and nacroleptics accounted for 71% of all sleep-related accidents. The proportion of severe apneics who had sleep-related accidents was almost twice that of patients with mild or moderate apnea. Mean sleep latency by Multiple Sleep Latency Test did not differ significantly in patients with accidents and those without. Patients with a wide variety of sleep disorders appear to be at increased risk for sleep-related accidents. The severity and duration of hypersomnia are probably not the only factors that contribute to that risk. These findings have implications for the management of patients with sleep disorders.
334 citations
TL;DR: The spline-Laplacian is demonstrated, a relatively new approach that can yield dramatic improvement in spatial resolution when average electrode spacing is less than about 3 cm.
Abstract: SummaryAn important goal of EEG research is to obtain practical methods to improve the spatial resolution of scalp-recorded potentials, i.e., to make surface data more accurately represent local underlying brain sources. This goal may be somewhat different from that of “localizing brain activity wit
313 citations