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Updated: Sep 19, 2026

Drug-Induced Sleep Endoscopy (DISE) with Target Controlled Infusion (TCI) and Bispectral Analysis in Obstructive Sleep Apnea
Published on: December 6, 2016
The Association Between Obstructive Sleep Apnea and the Circadian Rest-Activity Rhythm: A Cross-sectional Analysis of
Adriano D S Targa1, Iván D Benítez1, Mario Henríquez-Beltrán2
1Translational Research in Respiratory Medicine, Hospital Universitari Arnau de Vilanova-Santa Maria, Biomedical Research Institute of Lleida (IRBLleida), Lleida, Spain; CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain.
Objectives:
To investigate the potential association between obstructive sleep apnea (OSA) and the circadian rest-activity rhythm.
Methods:
Active or retired employees aged 35-74 years from the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil) were eligible for inclusion. Participants underwent a standardized clinical evaluation, completed sleep questionnaires, performed a home sleep apnea test, and wore a wrist activity monitor for one week. The primary variables used to characterize the circadian rest-activity rhythm were intradaily variability (IV), interdaily stability (IS), relative amplitude (RA), and the circadian function index (CFI).
Results:
The cohort comprised 1828 participants (56.1% female), with a mean (SD) age of 49.1 (8.2) years. After adjustment for potential confounders, OSA showed no significant associations with any circadian-related variables. However, stratified analyses revealed that higher apnea-hypopnea index (AHI), treated as a continuous variable, was associated with decreased CFI exclusively in females and with decreased daytime activity in the oldest age tertile (-6.41 [-10.64 to -2.17]). Finally, integrative data analysis revealed that an OSA profile characterized by a higher percentage of time with oxygen saturation below 90%, reduced total sleep time, and daytime sleepiness was associated with a pattern of circadian disruption, marked by increased IV, reduced RA, and diminished IS.
Conclusions:
These findings suggest that the association between OSA and the circadian rest-activity rhythm is shaped by both patient-specific characteristics and disease-related factors, highlighting the importance of a patient-centered approach to managing potential circadian disruption in this context.
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