26 Jul Normal Polysomnography Parameters in Healthy Adults
Normal Polysomnography Parameters in Healthy Adults: A systematic review and meta-analysis
This systematic review and meta-analysis is the largest analysis of published normative sleep data to date and provides robust control values for clinical use. Publish studies were searched of any design between Jan 1, 2007 – July 31, 2016, which included the criteria of:
- reported polysomnographic parameters scored using recent AASM criteria (207-2012)
- were collected during overnight level 1 in-laboratory sleep study in healthy controls
- Excluded studies of patients with conditions or subjected to treatments that might affect sleep and studies not available in English
- Study endpoints were the pooled estimates of 14 reported PSG parameters
- The study is registered with PROSPERO, number CRD42017074319
- Influence of age and sex were ascertained using multivariate mixed-effects meta-regressions
Of 3712 articles, 169 studies comprising of 5273 participants were eligible for inclusion and normative data is stratified by age and sex. The findings of the analysis demonstrate that with increasing age there is a decline in sleep duration, with more time spent in N1 sleep and a trend toward less time spent in stages N3 and REM sleep. It is suggested that with increasing age, the ability to maintain sleep rather than initiate sleep declines. Interestingly, wake after sleep onset increases by 9.7min per decade of age, which sleep latency only increased by 1.1min per decade of age. A decreased ability to maintain sleep may also manifest as age-related increases in percentage N1 of sleep. There was a non-statistically significant trend for less N2, SWS and REM sleep were not significant in this study. Parameters of arousal index, mean oxygen saturation and minimum oxygen desaturation, periodic limb movement index all increase with increasing age.
When looking at sex related trends through aging, for every 10% increase in the percentage of male participants males were associated with lower REM latency, decreasing by an average of 0.9min; and lower mean SaO2 by 0.1%. Males demonstrated increased symptoms of sleep disordered breathing with arousal index increasing by 0.3 events per hour, and AHI increasing by 0.2 events per hour. Women demonstrated prolonged sleep onset latency, which is suggested to be related to changes in estrogen and progesterone post menopause. Both sexes demonstrated significant decreases in sleep quality in the 50-64 year of age group; demonstrating decreased total sleep time and sleep efficiency, and with corresponding increases in wake after sleep onset, compared to the 18-34 years of age group.
Reference: Boulos, M. I., Jairam, T., Kendzerska, T., Im, J., Mekhael, A., & Murray, B. J. (2019). Normal polysomnography parameters in healthy adults: a systematic review and meta-analysis. The Lancet Respiratory Medicine, 7(6), 533-543.