{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2023,10,3]],"date-time":"2023-10-03T05:42:13Z","timestamp":1696311733641},"reference-count":28,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2013,11,29]],"date-time":"2013-11-29T00:00:00Z","timestamp":1385683200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Journal of Sleep Research"],"published-print":{"date-parts":[[2014,6]]},"abstract":"<jats:title>Summary<\/jats:title><jats:p>Fluctuations in sleep\u2013wake state are thought to contribute to the respiratory instability of Cheyne\u2013Stokes respiration in patients with heart failure by promoting the rhythmic occurrence of central apnea and ventilatory overshoot. There are no data, however, on the relationship between vigilance state and respiratory events. In this study we used a novel method to detect the occurrence of state transitions (time resolution: 0.25\u00a0s, minimum duration of state changes: 2\u00a0s) and to assess their time relationship with apnoeic events. We also evaluated whether end\u2010apnoeic arousals are associated with a ventilatory overshoot. A polysomnographic, daytime laboratory recording (25\u00a0min) was performed during Cheyne\u2013Stokes respiration in 16 patients with heart failure. Automatic state classification included wakefulness and non\u2010rapid eye movement sleep stages 1\u20132. As a rule, wakefulness occurred during hyperpnoeic phases, and non\u2010rapid eye movement sleep occurred during apnoeic events. Ninety\u2010two percent of the observed central apneas (<jats:italic>N\u00a0<\/jats:italic>=<jats:italic>\u00a0<\/jats:italic>272) were associated with a concurrent wakefulness \u2192 non\u2010rapid eye movement sleep \u2192 wakefulness transition. The delay between wakefulness \u2192 non\u2010rapid eye movement sleep transitions and apnea onset was \u22120.3 [\u22123.1, 3.0]\u00a0s [median (lower quartile, upper quartile); <jats:italic>P\u00a0<\/jats:italic>=<jats:italic>\u00a0<\/jats:italic>0.99 testing the null hypothesis: median delay\u00a0=\u00a00], and the delay between non\u2010rapid eye movement sleep\u00a0\u2192\u00a0wakefulness transitions and apnea termination was 0.2 [\u22120.5, 1.2]\u00a0s (<jats:italic>P\u00a0<\/jats:italic>=<jats:italic>\u00a0<\/jats:italic>0.7). A positive\/negative delay indicates that the state transition occurred before\/after the onset or termination of apnea. Non\u2010rapid eye movement sleep\u00a0\u2192\u00a0wakefulness transitions synchronous with apnea termination were associated with a threefold increase in tidal volume and a twofold increase in ventilation (all <jats:italic>P\u00a0<\/jats:italic>&lt;<jats:italic>\u00a0<\/jats:italic>0.001), indicating ventilatory overshoot. These findings highlight that wakefulness\u00a0\u2192\u00a0non\u2010rapid eye movement sleep\u2005\u2192\u2005wakefulness transitions parallel apnoeic events during Cheyne\u2013Stokes respiration in patients with heart failure. The relationships between state changes and respiratory events are consistent with the notion that state fluctuations promote ventilatory instability.<\/jats:p>","DOI":"10.1111\/jsr.12109","type":"journal-article","created":{"date-parts":[[2013,11,29]],"date-time":"2013-11-29T12:56:57Z","timestamp":1385729817000},"page":"349-359","source":"Crossref","is-referenced-by-count":8,"title":["Sleep\u2013wake fluctuations and respiratory events during <scp>C<\/scp>heyne\u2013<scp>S<\/scp>tokes respiration in patients with heart failure"],"prefix":"10.1111","volume":"23","author":[{"given":"Gian","family":"Domenico Pinna","sequence":"first","affiliation":[{"name":"Department of Biomedical Engineering Fondazione S. Maugeri \u2013 IRCCS Montescano Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elena","family":"Robbi","sequence":"additional","affiliation":[{"name":"Sleep Laboratory Department of Pneumology Fondazione S. Maugeri \u2013 IRCCS Montescano Italy"},{"name":"Department of Cardiology Fondazione S. Maugeri \u2013 IRCCS Montescano Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fabio","family":"Pizza","sequence":"additional","affiliation":[{"name":"Department of Biomedical and Neuromotor Sciences (DIBINEM) University of Bologna Bologna Italy"},{"name":"Istituto delle Scienze Neurologiche di Bologna \u2013 IRCCS AUSL di Bologna Bologna Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Angelo","family":"Caporotondi","sequence":"additional","affiliation":[{"name":"Department of Cardiology Fondazione S. Maugeri \u2013 IRCCS Montescano Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria Teresa","family":"La Rovere","sequence":"additional","affiliation":[{"name":"Department of Cardiology Fondazione S. Maugeri \u2013 IRCCS Montescano Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Roberto","family":"Maestri","sequence":"additional","affiliation":[{"name":"Department of Biomedical Engineering Fondazione S. Maugeri \u2013 IRCCS Montescano Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2013,11,29]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1093\/sleep\/20.8.654"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehq327"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.200503-409OC"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1378\/chest.07-0121"},{"key":"e_1_2_9_6_1","first-page":"729","volume-title":"Handbook of Physiology, Section 3, The Respiratory System. Part II","author":"Cherniack N. 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