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Sleep Disorders
Volume 2018, Article ID 8713409, 7 pages
Research Article

Cyclic Alternating Pattern in Obstructive Sleep Apnea Patients with versus without Excessive Sleepiness

1Department of Neurology, Istanbul Aydin University, Faculty of Medicine, Istanbul, Turkey
2Department of Neurology, Acibadem Kayseri Hospital, Kayseri, Turkey
3Department of Neurology, Acibadem Kayseri Hospital, Acibadem University Faculty of Medicine, Istanbul, Turkey
4Department of Neurology, Ankara Training and Research Hospital, Ankara, Turkey

Correspondence should be addressed to Selda Korkmaz; moc.liamg@87szamkrok

Received 6 November 2017; Accepted 10 April 2018; Published 16 May 2018

Academic Editor: Liborio Parrino

Copyright © 2018 Selda Korkmaz et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Background. One of the main hypotheses on the development of daytime sleepiness (ES) is increased arousal in obstructive sleep apnea (OSA). Cyclic alternating pattern (CAP) is considered to be the main expression of sleep microstructure rather than arousal. Therefore, we aimed to investigate whether there is any difference between OSA patients with versus without ES in terms of the parameters of sleep macro- and microstructure and which variables are associated with Epworth Sleepiness Scale (ESS) score. Methods. Thirty-eight male patients with moderate to severe OSA were divided into two subgroups by having been used to ESS as ES or non-ES. Results. There was no difference between two groups in clinical characteristics and macrostructure parameters of sleep. However, ES group had significantly higher CAP rate, CAP duration, number of CAP cycles, and duration and rate of the subtypes A2 (, 0.019, 0.013, and 0.019, respectively) and lower mean phase B duration compared with non-ES group. In correlation analysis, ESS score was not correlated with any CAP measure. Conclusions. OSA patients with ES have increased CAP measures rather than those without ES.