Clinical Characteristics of Rapid Eye Movement-Related Obstructive Sleep Apnea: An Experience in a Tertiary Medical Center of Taiwan

• Published in: Nature and science of sleep Vol. 14; pp. 1521 - 1532
• Main Authors: Chiu, Hwa-Yen, Liu, Yung-Yang, Shiao, Tsu-Hui, Su, Kang-Cheng, Chou, Kun-Ta, Chen, Yuh-Min
• Format: Journal Article
• Language: English
• Published: Macclesfield Dove Medical Press Limited 30-09-2022; Taylor & Francis Ltd; Dove; Dove Medical Press
• Subjects: Airway management; Body mass index; Cardiovascular disease; Comorbidity; Diabetes; Eye movements; Gender; Health aspects; Hypertension; intermittent hypoxia; Medical centers; Metabolism; obstructive sleep apnea; Original Research; osa; Patients; Questionnaires; rapid eye movement; rem; Sleep apnea; Sleep apnea syndromes; Sleep disorders; sleep-disordered breathing; Statistical analysis; China; Taiwan; United States > US
• ISSN: 1179-1608; 1179-1608
• DOI: 10.2147/NSS.S368659

Purpose: Obstructive sleep apnea (OSA) is characterized by intermittent hypoxemia and sleep fragmentation. While apnea is pronounced with severe desaturation during rapid eye movement (REM) sleep, REM-related OSA is a distinct phenotype of OSA associated with respiratory disturbances predominantly during REM sleep. In this study, we investigated the clinical features of REM-related OSA in Taiwan. Patients and Methods: All patients diagnosed with OSA in the Taipei Veterans General Hospital from 2015 to 2017 were analyzed retrospectively and classified into REM-related OSA (REM-OSA) group, non-REM related OSA (NREM-OSA) group, and non-stage specific-OSA group. The clinical demographics, OSA-related symptoms, polysomnography results, and medical comorbidities of the three groups were analyzed. Results: Among 1331 patients with OSA, 414 (31.1%) were classified as REM-OSA, 808 (60.7%) as NREM-OSA, and 109 (8.2%) as non-stage specific-OSA. After being adjusted for OSA severity, the REM-OSA group was associated with less portion of males, longer desaturation duration, and lower nadir oxygen saturation (Sp[O.sub.2]) compared with the NREM-OSA group in mild and moderate OSA. In moderate OSA, the non-stage specific-OSA group featured more OSA severity and more desaturation compared with the other groups. The Epworth Sleepiness Scale scores and the prevalence of comorbidities did not vary among the REM-OSA, NREM-OSA, and non-stage specific-OSA groups. High REM-AHI/NREM-AHI ratio was associated with young age, female gender, high BMI, and low AHI. Conclusion: OSA patients with high REM-AHI/NREM-AHI ratio are related to young age, female gender, high BMI, and low AHI. Patients with REM-related OSA presented with longer desaturation duration and lower nadir Sp[O.sub.2] after being adjusted for OSA severity. Keywords: obstructive sleep apnea, OSA, rapid eye movement, REM, intermittent hypoxia, sleep-disordered breathing