{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,20]],"date-time":"2026-05-20T17:23:29Z","timestamp":1779297809799,"version":"3.51.4"},"reference-count":44,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2025,2,3]],"date-time":"2025-02-03T00:00:00Z","timestamp":1738540800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Sleep Research"],"published-print":{"date-parts":[[2025,12]]},"abstract":"<jats:title>Summary<\/jats:title>\n                  <jats:p>\n                    The cyclic alternating pattern (CAP) is a cyclic variation of sleep electroencephalogram activity within non\u2010rapid eye movement (non\u2010REM) sleep and increased CAP is the marker of sleep instability. The present study aimed to examine the expression of cyclic alternating pattern in non\u2010REM sleep in patients with systemic sclerosis (SSc) and to compare these findings with the control group. Thirty\u2010one patients with SSc were compared with matched controls by age, gender, body mass index, and apnea\u2013hypopnea index (AHI). Sleep measurements were obtained by standard polysomnography with conventional sleep scoring. A CAP analysis was performed and verified by certified somnologists. The sleep parameters of the SSc and control groups were similar for sleep efficiency, sleep stage percents N1, N2, N3, sleep latency, and minimum oxygen saturation (\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.627,\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.693,\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.530,\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.736,\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.772, and\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.693, respectively). The SSc patients presented a higher arousal and periodic limb movement index. The CAP analyses showed that SSc patients had higher CAP numbers, phase A2 index, A3 duration, and lower A1 duration (\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.032,\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.016,\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.016, and\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.016, respectively). Overall the phase A2 index, A2 total time during non\u2010REM sleep were significantly higher and the A1 duration was significantly lower in SSc patients, although sleep efficiency and the distribution of sleep macro\u2010structure seem to be similar to the control group. This study emphasises that microstructure analysis performed with CAP provides information that would otherwise be lost if only macrostructure analysis were considered.\n                  <\/jats:p>","DOI":"10.1111\/jsr.14472","type":"journal-article","created":{"date-parts":[[2025,2,3]],"date-time":"2025-02-03T22:18:26Z","timestamp":1738621106000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Sleep microstructure in patients with systemic sclerosis: A cyclic alternating pattern analysis study"],"prefix":"10.1111","volume":"34","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0994-0325","authenticated-orcid":false,"given":"Duygu Kurt","family":"G\u00f6k","sequence":"first","affiliation":[{"name":"Department of Neurology Kayseri City Education and Training Hospital  Kayseri Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kezban","family":"Aslan\u2010Kara","sequence":"additional","affiliation":[{"name":"School of Medicine, Department of Neurology Cukurova University  Adana Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Burak","family":"Y\u0131ld\u0131z","sequence":"additional","affiliation":[{"name":"School of Medicine, Department of Neurology Cukurova University  Adana Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"\u0130pek","family":"T\u00fcrk","sequence":"additional","affiliation":[{"name":"School of Medicine, Department of Internal Medicine, Division of Rheumatology Cukurova University  Adana Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Didem","family":"Arslan","sequence":"additional","affiliation":[{"name":"School of Medicine, Department of Internal Medicine, Division of Rheumatology Cukurova University  Adana Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,2,3]]},"reference":[{"issue":"4","key":"e_1_2_9_2_1","first-page":"261","article-title":"Validity and reliability of the Epworth sleepiness scale","volume":"10","author":"A\u011farg\u00fcn M. Y.","year":"1999","journal-title":"T\u00fcrk Psikiyatri Dergisi"},{"issue":"2","key":"e_1_2_9_3_1","first-page":"107","article-title":"The validity and reliability of the Pittsburgh Sleep Quality Index","volume":"7","author":"A\u011farg\u00fcn M. Y.","year":"1996","journal-title":"T\u00fcrk Psikiyatri Dergisi"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.semarthrit.2013.05.002"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1159\/000056240"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.semarthrit.2023.152268"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/0165-1781(89)90047-4"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.46497\/ArchRheumatol.2021.8415"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.5664\/jcsm.9708"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9343(92)90043-b"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.reuma.2019.07.001"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1093\/sleep\/30.6.755"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1098\/rsta.2020.0248"},{"key":"e_1_2_9_14_1","volume-title":"IBM SPSS statistics for windows, version 26.0","author":"IBM Corp. Released","year":"2019"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1093\/sleep\/14.6.540"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.5301\/jsrd.5000231"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0304-3959(01)00409-2"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1590\/s0100-879x2008001000018"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.5606\/ArchRheumatol.2019.7111"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.1109\/IEMBS.2010.5626211"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00521-018-3474-5"},{"key":"e_1_2_9_22_1","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/ket223"},{"key":"e_1_2_9_23_1","doi-asserted-by":"publisher","DOI":"10.12871\/0003982920152344"},{"key":"e_1_2_9_24_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1756-185X.009.01453"},{"key":"e_1_2_9_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.smrv.2011.02.003"},{"key":"e_1_2_9_26_1","doi-asserted-by":"publisher","DOI":"10.1097\/MCP.0000000000000100"},{"key":"e_1_2_9_27_1","doi-asserted-by":"publisher","DOI":"10.3389\/fneur.2022.966659"},{"key":"e_1_2_9_28_1","doi-asserted-by":"publisher","DOI":"10.3389\/fneur.02.966659"},{"key":"e_1_2_9_29_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.smrv.2017.08.003"},{"key":"e_1_2_9_30_1","doi-asserted-by":"publisher","DOI":"10.1016\/s1388-2457(00)0040-4"},{"key":"e_1_2_9_31_1","doi-asserted-by":"publisher","DOI":"10.1016\/s1389-9457(02)00013-8"},{"issue":"3","key":"e_1_2_9_32_1","first-page":"74","article-title":"Influence of autonomic nervous system dysfunction in the genesis of sleep disorders in fibromyalgia patients","volume":"105","author":"Rizzi M.","year":"2017","journal-title":"Clinical and Experimental Rheumatology"},{"issue":"6","key":"e_1_2_9_33_1","first-page":"1193","article-title":"Cyclic alternating pattern: a new marker of sleep alteration in patients with fibromyalgia?","volume":"31","author":"Rizzi M.","year":"2004","journal-title":"The Journal of Rheumatology"},{"key":"e_1_2_9_34_1","doi-asserted-by":"publisher","DOI":"10.1136\/ard.2003.018283"},{"key":"e_1_2_9_35_1","doi-asserted-by":"publisher","DOI":"10.10117\/s00296-013-2680-9"},{"key":"e_1_2_9_36_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.neulet.2018.01.042"},{"key":"e_1_2_9_37_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.isci.2023.107840"},{"key":"e_1_2_9_38_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2589.1992.tb00035.x"},{"key":"e_1_2_9_39_1","doi-asserted-by":"publisher","DOI":"10.5114\/reum.2019.87619"},{"key":"e_1_2_9_40_1","doi-asserted-by":"publisher","DOI":"10.1002\/jcu.22552"},{"key":"e_1_2_9_41_1","doi-asserted-by":"publisher","DOI":"10.1053\/smrv.1999.0083"},{"key":"e_1_2_9_42_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1567-4231(09)70033-4"},{"key":"e_1_2_9_43_1","doi-asserted-by":"publisher","DOI":"10.1016\/s1389-9457(01)00149-6"},{"key":"e_1_2_9_44_1","volume-title":"The AASM manual for the scoring of sleep and associated events: rules, terminology and technical specifications. version 3","author":"Troester M. M.","year":"2023"},{"key":"e_1_2_9_45_1","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis\u20102013\u2010204424"}],"container-title":["Journal of Sleep Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jsr.14472","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,11,7]],"date-time":"2025-11-07T07:04:48Z","timestamp":1762499088000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/jsr.14472"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,2,3]]},"references-count":44,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2025,12]]}},"alternative-id":["10.1111\/jsr.14472"],"URL":"https:\/\/doi.org\/10.1111\/jsr.14472","archive":["Portico"],"relation":{},"ISSN":["0962-1105","1365-2869"],"issn-type":[{"value":"0962-1105","type":"print"},{"value":"1365-2869","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,2,3]]},"assertion":[{"value":"2024-09-09","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-01-20","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-02-03","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e14472"}}