Asymmetric sleep in apneic human patients

Abstract

Unilateral sleep in marine mammals has been considered to be a defense against airway obstruction, as a sentinel for pod maintenance, and as a thermoregulatory mechanism. Birds also show asymmetric sleep, probably to avoid predation. The variable function of asymmetric sleep suggests a general capability for independence between brain hemispheres. Patients with obstructive sleep apnea share similar problems with diving mammals, but their eventual sleep asymmetry has received little attention. The present report shows that human sleep apnea patients also present temporary interhemispheric variations in dominance during sleep, with significant differences when comparing periods of open and closed airways. The magnitude of squared coherence, an index of interhemispheric EEG interdependence in phase and amplitude, rises in the delta EEG range during apneic episodes, while the phase lag index, a measure of linear and nonlinear interhemispheric phase synchrony, drops to zero. The L index, which measures generalized nonlinear EEG interhemispheric synchronization, increases during apneic events. Thus, the three indexes show significant and congruent changes in interhemispheric symmetry depending on the state of the airways. In conclusion, when confronted with a respiratory challenge, sleeping humans undergo small, but significant, breathing-related oscillations in interhemispheric dominance, similar to those observed in marine mammals. The evidence points to a relationship between cetacean unihemispheric sleep and their respiratory challenges.