Clinical and Polysomnographic Features of Rapid Eye Movement–Specific Sleep-Disordered Breathing

Campos‐Rodríguez, Francisco; Fernández-Palacín, Ana; Reyes-Núñez, Nuria; Reina-González, Ángela

doi:10.1016/s1579-2129(09)72433-4

Cited by 24 publications

(29 citation statements)

References 18 publications

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“…The authors attributed the younger patient population in the REM-related OSAS group to its being the early phase presentation of classical OSAS. On the other hand, in various studies, authors could not detect any difference between the mean ages of patients with or without REM-related OSAS (3,11,24). Also, in our study, the mean ages of patients in both groups were found to be similar.…”

Section: Discussioncontrasting

confidence: 80%

“…However, some authors obtained similar incidence rates of sleepiness in patients with non-REM-related OSAS (3,24,25). Additionally, in our study, the mean ESSs were similar between both groups.…”

Section: Rem-related and Non-remrelated Osas (N=329)supporting

confidence: 76%

“…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). Higher AHI REM relative to AHI NREM in women suggest the protection of women from respiratory events in NREM sleep.…”

Section: Discussionmentioning

confidence: 94%

“…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.…”

Section: Introductionmentioning

confidence: 99%

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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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Section: Discussioncontrasting

confidence: 80%

Section: Rem-related and Non-remrelated Osas (N=329)supporting

confidence: 76%

Section: Discussionmentioning

confidence: 94%

Section: Introductionmentioning

confidence: 99%

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A Different Clinical Type of OSAS: REM-Related OSAS

Köseoğlu¹,

Kanbay²,

Demir³

2015

Eurasian J Pulmonol

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“…Campos Rodriguez ve arkadaşları benzer bir şekilde hafif, orta düzeydeki OUA hastalarında REM ile ilişkili OUA görülme sıklığının daha ağır hastalara göre daha fazla olduğunu belirtmişlerdir (Odds oranı 8.2) (14). Bizim çalışmamızda orta ve ağır OUA hastalarını almadığımızdan bu gruplardaki REM ile iliş-kili OUA sıklığı ve özellikleri hakkında yorum yapamadık.…”

unclassified

The frequency and properties of REM related obstructive sleep apnea among the patients with mild related obstructive sleep apnea

Özçelik

Akkoyunlu²,

Bostanlı³

et al. 2013

Tuberk Toraks

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ÖZET Hafif obstrüktif uyku apneli hastalarda REM ile ilişkili obstrüktif uyku apne sıklığı ve özellikleri GİRİŞObstrüktif uyku apne (OUA); üst hava yolunda tekrarlayan tıkanmalarla karakterize, erişkin popülasyonun %2-4'ünü etkileyen uykuyla ilişkili solunum hastalıkları-nın yaygın bir formudur. Uyku sırasında üst hava yolunda gelişen tıkanıklıkların hipoksemi, hiperkapni, otonomik sinir sistemi değişiklikleri ve uykuda bölünmeye yol açması OUA patofizyolojisinde belirleyicidir (1). REM ile ilişkili OUA ise apne ve hipopnelerin REM uykusu esnasında daha yoğun olduğu bir durumdur. REM ile ilişkili OUA prevalansının sınırlı sayıda yapılan klinik çalışma-larda tüm OUA'lı popülasyon içinde %10-36 arasında olduğu ve daha çok kadınlarda görüldüğü gösterilmiştir. Üst hava yolu tonusu non-REM uykuda azalır ve REM uykuda da azalmaya devam eder, böylece üst hava yolu rezistansında ve kollapsında artış meydana gelir. Ayrıca, uykunun REM evresinde hipoksi ve hiperkapniye meduller duyarlılık azalır ve tüm bunların sonucunda REM'de daha fazla solunumsal olayların yanında daha fazla oksijen desatürasyonu olur (2-5).REM ile ilişkili OUA, "Hafif ve orta OUA olgularında daha fazla görülmesi nedeniyle uykuda solunum bozuklukları spektrumunun erken bir işareti midir?" yoksa "Tamamen ayrı bir antite midir?"sorusu araştırmacıla-rın son zamanlarda oldukça dikkatini çekmektedir. Bu çalışmada, hafif OUA tanılı hastalar arasında REM ile ilişkili OUA hastalarının sıklığını ve diğer hafif OUA tanılı hastalardan farkını görmek; ayrıca REM ile ilişkili OUA hastalarında gündüz aşırı uykululuk ile AHİ ilişki-sini değerlendirmek amaçlanmıştır. MATERYAL ve METOD

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