Research sheds new light on the underlying mechanism of poor sleep.
Excessive wake time is commonly viewed as a direct consequence of sleep apnea or periodic limb movements. A new study published in the Journal of Clinical Sleep Medicine challenges this, concluding that when excessive wake time occurs with apnea or periodic limb movements, it is in fact an independent disorder related to abnormal central control of sleep depth. The study findings provide quantifiable evidence for the hyper-arousal hypothesis for insomnia and opens up new areas of research into the treatment of sleep disorders. The study was conducted by the renowned sleep researcher Dr. Magdy Younes, Distinguished Professor Emeritus, University of Manitoba and Medical Founder of Cerebra Health Inc., and Dr. Eleni Giannouli, Director of the Misericordia Sleep Disorder Centre.
The study, which included 267 patients and used Cerebra’s clinically validated ORP Sleep Depth measurement, shows that a patient’s wake time is correlated with how fast the brain transitions from wakefulness to deep sleep. This rate is measured by a new variable called ORP-9 (Sleep Sensitivity), provided by Cerebra’s software, which is the sleep depth reached 9 seconds after the end of sleep disturbance. ORP-9 was quite high, indicating slow sleep progression, in patients who had excessive wake time whether or not they had OSA or abnormal movements. On the other hand, ORP-9 was significantly lower in patients with normal wake time, again whether or not they had OSA or abnormal movements. This indicates that when excessive wake time is present in patients with mild or moderate sleep apnea and/or periodic limb movements, the wake time is unrelated to these conditions. Rather, it is a separate sleep disorder in its own right related to slow sleep progression which should be addressed separately.
In an editorial accompanying the paper, Professor Danny Eckert, Director, Adelaide Institute for Sleep Health, stated “… the current novel findings are interesting and intriguing for several reasons. Indeed, they provide novel insight into the pathophysiology of common sleep disorders, new knowledge on the interaction between key, have potential implications for therapy and generate important questions in which to pursue in future research studies.”
Dr. Younes states “that over 1/3 of people suffering from sleep apnea and/or abnormal movements complain of insomnia and have excessive wake time during sleep. This type of insomnia, called Insomnia with Short Sleep Duration, is associated with significant psychiatric and medical complications. In patients with combined OSA and insomnia the general thinking is that it is the sleep apnea that disrupted sleep and caused insomnia, and treatment was primarily directed at the apnea. The current findings suggest that not only is OSA not responsible for the excessive wake time, but it is possible that the insomnia is contributing to the severity of OSA since light sleep, a characteristic of this type of insomnia, is now well known to be a risk factor for OSA. Thus, treating the insomnia may actually improve OSA.”
He adds, “It is commonly believed that failure to turn our mind off as we try to sleep is an important cause for failure to sleep. The finding that ORP-9 (sleep sensitivity) is abnormally high in patients with excessive wake time, regardless of whether OSA is present, suggests that failure to turn one’s mind off in such cases is the result, rather than the cause, of failure to sleep; when sleep progresses slowly, one remains in a light sleep state for a while. During this time minor stimuli would reverse the process and produce excessive wake time.”
Sleep apnea often causes individuals to wake briefly and repeatedly throughout the night. Without access to digital sleep analysis, doctors may incorrectly characterize this wake time as a direct result of the apnea. Cerebra is changing this by making ORP Sleep Depth and Sleep Sensitivity metrics available in their sleep testing service. For those who continue to struggle with poor sleep following treatment of a sleep disorder like apnea or periodic limb movement, this could provide insight into other treatment options.
New at-home sleep study is changing our understanding of sleep, right in our own homes
Cerebra is the first to provide a direct measurement of sleep quality in the home, through its COMPLETE diagnostic study and its new, simplified, 2-night SLEEP study. Using Cerebra’s unique technology and proprietary ORP metrics, both products bring a comprehensive assessment to the place where sleep happens, in your bed and home. Cerebra sleep studies offer those suffering from poor or insufficient sleep an in-depth look at their sleep profile, sleep sensitivity, night-to-night patterns and insights into the underlying causes of their sleeping issues.
Both of Cerebra’s sleep study products are available directly to customers online; the studies are easily completed at home, with personalized results available online within days. All studies are reviewed by a registered polysomnographic technologist and come with personal support by a clinical sleep health educator and direct access to Cerebra’s treatment network for clinical care.
This product is now available to purchase online outside of Quebec at cerebra.health
For more information or to schedule an interview contact:
Mary Fearon or Lindsay Glasspoole
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Cerebra Health Inc. (Cerebra) is a Manitoba-based, digital health company focused on improving access to advanced digital sleep analysis and diagnostic technology for sleep assessment and diagnosis of sleep disorders.
Cerebra Medical, a wholly-owned subsidiary of Cerebra Health, operates an ISO 13485:2016 certified Quality Management System for the design, development, and manufacture of EEG sleep monitoring systems and medical device software for collection and analysis of physiological data recorded during sleep. Cerebra Medical holds an MDSAP certificate in conformance with the requirements of Health Canada and FDA.
Cerebra’s technology provides unmatched capabilities for in-home sleep analysis, with a focus on improved user experience, state-of-the-art technology, and increased operational efficiency. Cerebra is also working in partnership with leading sleep scientists and researchers to revolutionize clinical sleep medicine by leveraging its core capabilities in digital sleep analysis.
Prodigy DSA is a collection of software applications intended for use as an aid for the evaluation of sleep and the diagnosis of sleep disorders. Prodigy DSA is intended to be used for scoring, viewing, and editing digital data collected from adult, human subjects during sleep, and generating graphs and variables for viewable reports typically used to evaluate sleep and sleep disorders.
Using Prodigy DSA to guide treatment of sleep disorders has not been evaluated by Health Canada and is not part of the indications for use.