Recordings were made at the University of Wisconsin (Wisconsin Institute for Sleep and Consciousness) using a 256‐channel hdEEG system (Electrical Geodesics, Inc., Eugene, OR) combined with Alice Sleepware (Philips Respironics, Murrysville, PA). Additional polysomnography channels were used to record and monitor eye movements and submental electromyography during sleep. Sleep scoring was performed over 30 s epochs according to standard criteria (Iber, Ancoli‐Israel, Chesson, & Quan, 2007 ).
Alice sleepware
Manufactured by Philips
Sourced in United States
The Alice Sleepware is a lab equipment product designed for sleep studies. It is used to monitor and record various physiological parameters during sleep, including brain activity, eye movements, and breathing patterns.
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Lab products found in correlation
13 protocols using alice sleepware
1
Sleep-Recordings using hdEEG and PSG
2
Overnight Polysomnography for Sleep Assessment
3
Comprehensive Sleep Study Protocol
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All participants underwent an overnight in-laboratory hdEEG recording (256 channels; Electrical Geodesics Inc., Eugene, OR; sampling rate 500 Hz) coupled with standard monitoring with electrooculogram (EOG), submental EMG, ECG, bilateral tibial EMG, respiratory inductance plethysmography, pulse oximetry and a position sensor. Timings of recordings were based on participants’ typical sleep schedule. Lights were switched off within 1 h of their usual bedtime.
Sleep staging was performed by a registered polysomnographic technician in 30-s epochs according to standard criteria50 using Alice Sleepware (Philips Respironics, Murrysville, PA) based on EOG, submental EMG and 6 hdEEG channels at the approximate 10–20 locations (F3, F4, C3, C4, O1, O2) re-referenced to the mastoids. All staging and scoring were reviewed by a board-certified sleep physician.
Sleep staging was performed by a registered polysomnographic technician in 30-s epochs according to standard criteria50 using Alice Sleepware (Philips Respironics, Murrysville, PA) based on EOG, submental EMG and 6 hdEEG channels at the approximate 10–20 locations (F3, F4, C3, C4, O1, O2) re-referenced to the mastoids. All staging and scoring were reviewed by a board-certified sleep physician.
4
Polysomnographic Diagnosis of Obstructive Sleep Apnea
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The diagnosis of OSA was based on polysomnographic study (Alice Sleepware; Philips Respironics, Inc., Murrysville, Pa., USA). All variables were recorded on a commercially available computer system, including electroencephalography (F3M2, F4M1, C3M2, C4M1, O1M2 and O2M1), bilateral electrooculography, submental electromyography, thoracic and abdominal movements measured by uncalibrated inductive plethysmography, saturation of oxyhemoglobin (SaO2) using a finger oximeter, airflow through the nose and mouth recorded by thermistors, 2 contiguous ECG leads, a snoring microphone and video monitoring with an infrared video camera. The entire recording was observed by an experienced sleep technician. Apnea was defined as the continuous cessation of airflow for >10 s, and hypopnea was defined as a reduction in airflow of ≥30% lasting for ≥10 s accompanied by a decrease in oxygen saturation (SpO2) of at least 4% [18 (link)]. The length of time SpO2 was <90% during sleep and the minimum SaO2 for each patient was calculated. Apnea-hypopnea index (AHI) values were calculated as the number of episodes of apnea and hypopnea per hour over the total sleep time. Patients with an AHI ≥5 were considered to have OSA. The severity of OSA was classified according to the AHI (mild: ≥5 and <15, moderate: ≥15 and <30 and severe: ≥30) [19 (link)].
5
Comprehensive Sleep Evaluation with High-Density EEG
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Sleep was evaluated in all participants with standard PSG monitoring including electrooculogram (EOG), sub-mental electromyogram (EMG), electrocardiogram (ECG), bilateral tibial EMG, respiratory inductance plethysmography, pulse oximetry and a position sensor using a customized Alice 5 System (Philips Respironics, Murrysville, PA). Simultaneously, high density electroencephalography (hdEEG) was recorded from 256 channels with vertex referencing using NetStation software (Electrical Geodesics Inc., Eugene, OR). Sleep was scored by a registered sleep technologist according to AASM scoring guidelines [39 ] using Alice® Sleepware (Philips Respironics, Murrysville, PA) and then reviewed by a Sleep Medicine physician certified by the American Board of Medical Specialties (RMB). Sleep staging was performed using 6 hdEEG channels located at approximate 10–20 locations (F3, F4, C3, C4, O1, O2), re-referenced to the mastoids.
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High-Density EEG Sleep Scoring
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Polysomnography and Actigraphy Data Synchronization
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Polysomnography recordings were performed using an Alice-5 system (Respironics Inc., Murrysville, PA, USA) with the following set of measurements: four-electrode scalp-encephalography (C3–A2, C4–A1, O1–A2, and O2–A1), two-electrode electrooculography (placed near edge of the eyes), electrocardiography, and electromyography, in addition to sensors for the detection of oral/nasal airflow, and chest/abdominal movements. PSG data were recorded online by Alice Sleepware (version 2.8, Respironics Inc., Murrysville, PA, USA). An experienced PSG specialist, who was blind to participants’ conditions, scored sleep stages visually.
In order to match the 30-s PSG epochs to the 2-min actigraphy epochs, the most frequent sleep stage scored by PSG within the corresponding 2-min actigraphy epoch was designated as the representative sleep stage of the 2-min epoch.
In order to match the 30-s PSG epochs to the 2-min actigraphy epochs, the most frequent sleep stage scored by PSG within the corresponding 2-min actigraphy epoch was designated as the representative sleep stage of the 2-min epoch.
8
Polysomnographic Evaluation of OSA
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All patients were involved in an extensive sleep study in the sleep laboratory of our hospital using a computer software (Alice Sleepware, Philips Respironics, Murrysville, PA, USA). Apnea was defined as a total cessation of airflow for ≥10 s. Hypopnea was defined as 30% or more reduction in the respiratory airflow lasting for >10 s accompanied by a decrease of >4% in oxygen saturation. The average number of apneas and hypopneas per hour of sleep was calculated as the apnea–hypopnea index (AHI). Patients who experienced AHI events ≥5 per hour were diagnosed as having OSA. Oxygen desaturation index (ODI), cumulative time percentage with SpO2 90%, lowest and average SpO2 were extracted from the oximetry data.
9
High-Density EEG Sleep Staging
10
Polysomnography-based Diagnosis of OSA
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The diagnosis of OSA was based on attended full night polysomnography. All polysomnographic variables were recorded on a computer system (ALICE Sleepware, Philips Respironics, Inc, Murrysville, PA, USA), including electroencephalography (F3M2, F4M1, C3M2, C4M1, O1M2, O2M1), bilateral electrooculography, submental electromyography, thoracic and abdominal movements (by inductive plethysmography), oxyhemoglobin saturation (using a pulse oximeter), oronasal airflow (recorded by thermistors and nasal canulla), electrocardiography, snoring microphone, and video monitoring using an infrared video camera. OSA was diagnosed and classified according to the International Classification of Sleep Disorders (19) . Patients with an apneahypopnea index (AHI) ≥ 5 were considered to have OSA and patients with an AHI < 5 were considered as control.
Platelet indices (MPV, PDW, plateletcrit) were obtained from routine analysis of blood samples [in ethylenediaminetetraacetic acid (EDTA) tubes] using an automated blood cell counter (Beckman Coulter LH-750, Hematology Analyzer).
Platelet indices (MPV, PDW, plateletcrit) were obtained from routine analysis of blood samples [in ethylenediaminetetraacetic acid (EDTA) tubes] using an automated blood cell counter (Beckman Coulter LH-750, Hematology Analyzer).
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