Obstructive sleep apnea related to rapid eye movement or non-rapid eye movement sleep: comparison of demographic, anthropometric and polysomnographic features
Özet
Objective: To determine whether there are significant differences between rapid-eyemovement
(REM)-related obstructive sleep apnea (OSA) and non-REM (NREM)-related
OSA, in terms of the demographic, anthropometric, and polysomnographic characteristics
of the subjects. Methods: This was a retrospective study of 110 patients (75 males) with
either REM-related OSA (n = 58) or NREM-related OSA (n = 52). To define REM-related
and NREM-related OSA, we used a previously established criterion, based on the apneahypopnea
index (AHI): AHI-REM/AHI-NREM ratio > 2 and ≤ 2, respectively. Results: The
mean age of the patients with REM-related OSA was 49.5 ± 11.9 years, whereas that of
the patients with NREM-related OSA was 49.2 ± 12.6 years. The overall mean AHI (all
sleep stages combined) was significantly higher in the NREM-related OSA group than
in the REM-related OSA group (38.6 ± 28.2 vs. 14.8 ± 9.2; p < 0.05). The mean AHI in
the supine position (s-AHI) was also significantly higher in the NREM-related OSA group
than in the REM-related OSA group (49.0 ± 34.3 vs. 18.8 ± 14.9; p < 0.0001). In the
NREM-related OSA group, the s-AHI was higher among the men. In both groups, oxygen
desaturation was more severe among the women. We found that REM-related OSA
was more common among the patients with mild-to-moderate OSA, whereas NREMrelated
OSA was more common among those with severe OSA. Conclusions: We found
that the severity of NREM-related OSA was associated mainly with s-AHI. Our findings
suggest that the s-AHI has a more significant effect on the severity of OSA than does the
AHI-REM. When interpreting OSA severity and choosing among treatment modalities,
physicians should take into consideration the sleep stage and the sleep posture
