Sleep medicine · 2026
The sleep EEG spectral profile of narcolepsy with comorbid obstructive sleep apnea more closely resembles narcolepsy than obstructive sleep apnea.
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Xu Xing, Lu Xu-Jia, Gao Fan, Chen Jiong, Zhang Yu-Ting, Mao Cheng-Jie, Shen Yun, Liu Chun-Feng
Аннотация
BACKGROUND: Narcolepsy (NT) and obstructive sleep apnea (OSA) frequently coexist, yet the sleep electroencephalographic (EEG) spectral profile of narcolepsy with comorbid OSA (NT-OSA) remains unclear. We compared spectral power among NT-OSA, NT, and OSA across polysomnography (PSG) and Multiple Sleep Latency Test (MSLT).
METHODS: We retrospectively analyzed 224 treatment-naïve adults with excessive daytime sleepiness (37 NT-OSA, 77 NT, and 110 OSA); 39 subjectively sleepy controls (SSC) were included in a secondary analysis. Relative EEG spectral power was calculated in central and occipital regions and compared using age- and sex-adjusted linear models. Effect-size profile correlations were assessed using OSA and SSC as reference groups.
RESULTS: NT-OSA differed from OSA in multiple EEG spectral measures but rarely from NT. During PSG, NT-OSA showed higher occipital alpha and lower delta power than OSA in N1 and REM sleep. During MSLT, it showed higher central theta power (N1), lower sigma (N1) and lower beta (N2) power than OSA. The NT-OSA and NT effect-size profiles were strongly correlated using either OSA or SSC as the reference group (ρ = 0.76 and 0.78, respectively; both P < 0.001). After additional adjustment for apnea-hypopnea index and arousal index, PSG differences were no longer significant, whereas several MSLT differences remained significant.
CONCLUSION: NT-OSA exhibited a sleep EEG spectral profile more closely resembling that of NT than that of OSA across PSG and MSLT. These spectral patterns warrant further evaluation for their potential role in the assessment of coexisting NT in patients with OSA and EDS.
METHODS: We retrospectively analyzed 224 treatment-naïve adults with excessive daytime sleepiness (37 NT-OSA, 77 NT, and 110 OSA); 39 subjectively sleepy controls (SSC) were included in a secondary analysis. Relative EEG spectral power was calculated in central and occipital regions and compared using age- and sex-adjusted linear models. Effect-size profile correlations were assessed using OSA and SSC as reference groups.
RESULTS: NT-OSA differed from OSA in multiple EEG spectral measures but rarely from NT. During PSG, NT-OSA showed higher occipital alpha and lower delta power than OSA in N1 and REM sleep. During MSLT, it showed higher central theta power (N1), lower sigma (N1) and lower beta (N2) power than OSA. The NT-OSA and NT effect-size profiles were strongly correlated using either OSA or SSC as the reference group (ρ = 0.76 and 0.78, respectively; both P < 0.001). After additional adjustment for apnea-hypopnea index and arousal index, PSG differences were no longer significant, whereas several MSLT differences remained significant.
CONCLUSION: NT-OSA exhibited a sleep EEG spectral profile more closely resembling that of NT than that of OSA across PSG and MSLT. These spectral patterns warrant further evaluation for their potential role in the assessment of coexisting NT in patients with OSA and EDS.