Electroencephalogram derived sleep microarchitecture in patients with interstitial lung disease and obstructive sleep apnea

Sleep Med. 2026 Aug 29;148:109244. doi: 10.1016/j.sleep.2026.109244. Online ahead of print.

ABSTRACT

INTRODUCTION: Sleep disturbances are common in patients with interstitial lung diseases (ILD) and are often compounded by comorbid obstructive sleep apnea (OSA). Conventional polysomnographic indices may not fully capture disease-specific neurophysiological alterations.

METHODOLOGY: We aimed to characterize EEG-derived sleep microarchitecture in ILD with comorbid OSA (ILD-OSA) and compare it with ILD without OSA and apnea hypopnea index matched non-ILD OSA (n = 20 in each group). Quantitative EEG analysis was performed using standardized preprocessing and data extraction protocols. Spectral power, slow wave and spindle metrics, and a novel measure of micro-continuity (Neuroloop gain), reflecting the brain’s propensity to generate and sustain sleep spindles and slow oscillations, were computed and compared across the groups.

RESULTS: Sleep macro and microarchitecture were similar between ILD with and without OSA. However, compared with non-ILD OSA, patients with ILD-OSA exhibited higher spindle amplitude and power, with preserved slow-wave characteristics. Notably, spindle neuroloop gain was significantly reduced in ILD-OSA.

CONCLUSIONS: Patients with ILD-OSA demonstrate differences in EEG-derived sleep microarchitecture compared with non-ILD OSA patients, particularly in spindle dynamics. These findings suggest that quantitative EEG may provide additional insights into sleep neurophysiology in ILD that warrant confirmation in larger prospective studies.

PMID:42669240 | DOI:10.1016/j.sleep.2026.109244