Comparison of supine-only and REM-only obstructive sleep apnoea

Gillman, Andrew; Roebuck, Teanau; Ho, Sally; Braak, E. van; Naughton, Matthew T.

doi:10.1016/j.sleep.2012.01.016

Cited by 24 publications

(22 citation statements)

References 15 publications

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“…Our study showed roughly 5.5% of patients suffering from OSA presented a pure REM-dependent phenotype, while, some studies suggested that the prevalence of this phenotype might be higher, reaching up to 10% 21 . This lower prevalence of REM-OSA phenotype might be related to strict inclusion criteria for this group that we used.…”

Section: Discussionmentioning

confidence: 42%

Association between excessive daytime sleepiness, REM phenotype and severity of obstructive sleep apnea

Gabryelska

Białasiewicz

2020

Sci Rep

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the aim of the study was to compare ReM-dependent and ReM-independent, obstructive sleep apnea syndrome (oSA) patients in relation to their daily sleepiness assessed by epworth sleepiness scale (ESS). The study included 1863 consecutive patients, who were referred to a sleep centre with a presumed diagnosis of OSA. Following polysomnography, 292 patients fulfilled criteria for either ReM-dependent oSA (ReM-oSA, n = 102) or REM-independent OSA (nREM-OSA, n = 190). Both study groups were matched regarding sex and age. ReM-oSA group had two times lower median apnoeahypopnea index (AHi) compared to nReM-oSA (p < 0.001), yet daytime sleepiness measured by ESS was similar: median score 9.0 (6.0-11.0) and 8.0 (4.8-11.0), p = 0.109, respectively. Subsequent posthoc AncoVA analysis, with covariates (BMi, percent of total sleep time spent in ReM stage, percent of total sleep time spent in the supine position), has shown statistically significant difference between study groups regarding AHi (p < 0.001) and no difference regarding ESS score (p = 0.063). Despite two times lower AHi, patients with ReM-oSA present with similar daytime sleepiness as those with ReM independent OSA. Daily sleepiness may be stronger associated with apneas/hypopneas occurring in ReM than nReM sleep.

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Section: Discussionmentioning

confidence: 42%

Association between excessive daytime sleepiness, REM phenotype and severity of obstructive sleep apnea

Gabryelska

Białasiewicz

2020

Sci Rep

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“…Nevertheless, this study may have been susceptible to some population bias as the patients are of a single ethnic background with a high male to female ratio (6:1). Depending on the definition and the severity classification of POSA, previous studies have reported a male to female prevalence ratio of 2.5:1 vs. 5:1 (Vagiakis et al, 2006;Gillman et al, 2012;Joosten et al, 2012) and even up to 10.3:1 (O'Connor et al, 2000). Furthermore, PSG parameters can vary from night to night (Levendowski et al, 2009), nevertheless it is a common and acceptable practice to make treatment decisions based on the results of a single night PSG, as done in our study.…”

Section: Discussionmentioning

confidence: 72%

“…The inconsistency in definition criteria continues; for example, the prevalence of POSA has widely varied in different studies ranging from 23-30% to 9-60% depending on the definitions used (Cartwright et al, 1985;Mador et al, 2005;Mo et al, 2011;Gillman et al, 2012;Joosten et al, 2012;Teerapraipruk et al, 2012;Schiza et al, 2015). Therefore, more accurate characterization of subgroups of POSA may help developing a unified set of diagnostic criteria and thereby facilitating the development of optimized and targeted treatment strategies.…”

Section: Introductionmentioning

confidence: 99%

Two subtypes of positional obstructive sleep apnea: Supine-predominant and supine-isolated

Kim

Cho

Kim

et al. 2016

Clinical Neurophysiology

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“…It has been emphasized that AHI REM should be at least 2 times higher than AHI NREM ; however different values have been reported for AHI N-REM (AHI NREM <5 or <10) (11,14,15). In studies that used diagnostic criteria similar to ours, AHI have ranged between 10% and 13% (16,17 Because of differences in the definition criteria, in cases with REM-related OSAS, clinical characteristics also demonstrate differences. In many studies, a higher incidence of REM-related OSAS has been reported in women (3,6,12,13,19,20).…”

Section: Discussionmentioning

confidence: 74%

A Different Clinical Type of OSAS: REM-Related OSAS

Köseoğlu¹,

Kanbay²,

Demir³

2015

Eurasian J Pulmonol

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INTRODUCTIONObstructive sleep apnea syndrome (OSAS) is characterized by repetitive episodes of complete or partial upper airway obstruction during sleep. Repetitive episodes of airway obstruction lead to increasing respiratory efforts, intermittent arterial oxygen desaturation, systemic and pulmonary arterial blood pressure surges, and sleep disorders (1). We sleep occupies for nearly one-third of our life, and it is an essential and vital part of our life. Although it is perceived as a resting period for the body, during some stages of sleep, the brain and many bodily systems are extremely active. Sleep is evaluated in two stages as rapid eye movement (REM) and non-REM. The REM stage is named after REM during this phase. This stage is classified as tonic and phasic REM. During this stage, brain activity with mixed frequency, erection, thermoregulation loss, muscle twitching, cardiorespiratory disorder, respiratory control impairment, and irregular ventilation occur (2, 3). During REM, pharyngeal muscle activity decreases, and upper airway collapsibility increases as a result of the absence of excitatory, noradrenergic, and serotonergic stimuli in upper airway motor neurons (4). Therefore, in patients with OSAS during REM sleep, the number and duration of obstructive respiratory events increase with resultant serious oxygen desaturation. REM as a specific respiratory disorder was first described in 1996. From that day on, different expressions and diagnostic criteria have been used for the presence and definition of REM-related OSAS. Some authors have accepted this disorder as not a separate entity, but rather a component of an OSAS spectrum, and they indicated REM-related OSAS as an essentially early (baseline presentation) phase of classical OSAS, while others defined it as a different clinical type of OSAS (3,5,6). In the present study, we aimed to compare the clinical and polysomnographic findings of REM-related and non-REM-related OSAS patients to test whether REM-related OSAS is a different clinical type OSAS or the manifestation of early stage or the onset of OSAS. Methods:The study had a retrospective design. Patients with an initial diagnosis of sleep-related breathing disorders were later diagnosed to have OSAS based on an apnea-hypopnea index (AHI) of ≥5 and were divided into the following two groups: patients with AHINREM of <5 and AHIREM/AHINREM of >2 whose REM recordings were obtained for at least 30 min were defined as having "REM-related OSAS," and those who did not meet this description were defined as having "non-REM-related OSAS."Results: A total of 329 patients with a mean age of 51±10 years were included in the study. Thirty-five (10.6%) patients with OSAS were REM-related and 294 (89.4%) were non-REM-related. Age, body mass index, smoking status, and concomitant diseases were comparable between groups (p>0.05). In REM-related patients, AHI was lower, REM duration was longer, and mean oxygen saturations were comparatively higher (p<0.05). Conclusion:Similarities between groups in age, body ...

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Comparison of supine-only and REM-only obstructive sleep apnoea

Cited by 24 publications

References 15 publications

Association between excessive daytime sleepiness, REM phenotype and severity of obstructive sleep apnea

Association between excessive daytime sleepiness, REM phenotype and severity of obstructive sleep apnea

Two subtypes of positional obstructive sleep apnea: Supine-predominant and supine-isolated

A Different Clinical Type of OSAS: REM-Related OSAS

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