<p>The Associations of Gender, Menopause, Age, and Asthma with REM-Predominant Obstructive Sleep Apnea: A Prospective Observational Study</p>

Abstract

The study sought to assess demographics, clinical features, comorbidities, and polysomnographic features of a large cohort of clinic-based patients with rapid eye movementpredominant obstructive sleep apnea (REM-predominant-OSA) in both genders, while assessing the relationship between REM-predominant OSA in one hand and menopausal status and age on the other. Methods: This prospective observational study was conducted between January 2003 and December 2017. REM-predominant OSA diagnostic criteria included an AHI of ≥5/h, with REM-AHI/non-REM-AHI of >2, a non-REM-AHI of <15/h, and a minimum of 15 min of REM sleep. Patients who had an AHI>5 events/h and did not meet the criteria for REMpredominant OSA were included in the non-stage-specific OSA group (NSS). Results: The study consisted of 1346 men and 823 women (total=2169). REM-predominant OSA was diagnosed in 17% (n=369). The prevalence of REM-predominant OSA in women was 25% compared with 12% in men. Several independent associations of REMpredominant OSA were identified in the whole group, including age (OR: 0.97 [0.95-0.98], p<0.01), female sex (OR: 6.95 [4.86-9.93], p>0.01), REM sleep duration (min) (OR: 1.02 [1.02-1.03], < 0.01), and time with SpO2 <90% (mins) (OR: 0.97 [0.95-0.99], < 0.01), hypertension (OR:0.67 [0.45-0.99], 0.04) and asthma (OR: 2.19 [1.56-3.07], < 0.01). The prevalence of REM-predominant OSA in premenopausal and postmenopausal women was 35% and 18.6% (p< 0.01), respectively. Among women, age was an independent correlate (OR: 0.97 [0.94-0.99], p=0.03; however, menopausal status was not. Conclusion: REM-predominant OSA is prevalent among clinic-based patients with OSA. A younger age and female sex were independent correlates of REM-predominant OSA. Among women, a younger age but not menopausal status was a correlate of REMpredominant OSA. Asthma was independently associated with REM-predominant OSA.

Characteristics of rapid eye movement-related obstructive sleep apnea in Thai patients

“…Likewise, the logistic regression confirmed that age < 60 years and female gender were independent correlates of REM-related OSA. These results are consistent with other studies 5 , 7 , 19 .…”

“…The association between REM-related OSA and asthma was interesting because a prospective observational study showed that asthma was independently associated with REM-related OSA 19 , which was consistent with a previous study in children with OSA 31 , while our results showed a negative relationship. However, the published pathophysiologic mechanisms that explain the association between asthma and OSA, especially REM-related OSA, are not well understood and are limited.…”

“…Therefore, although REM-AHI in non-stage specific OSA was significantly higher, both groups showed severe REM-AHI (REM-AHI ≥ 30 per hour) which could reflect similar symptoms. Oxygen desaturation during REM sleep might cause excessive daytime sleepiness 19 , but our data did not show any difference.…”

Rapid eye movement predominant obstructive sleep apnoea: prognostic relevance and clinical approach

“…A study attempted to determine whether REM-OSA is related to age or menopausal status in women. Premenopausal status and age were associated with REM-OSA among women in the univariate analysis model; however, only age remained an independent correlate of REM-OSA in the multivariable model [12 ▪▪ ].…”

Current Update on Clinically Relevant Sleep Issues in Parkinson’s Disease: A Narrative Review

“…In addition, it is important to note that dopaminergic treatment in PD may lead to an underestimation of RLS (dopamine agonists reduce RLS) or an overestimation of RLS (longterm treatment may cause augmentation and unmask subclinical RLS). In a study of 80 PD patients, 30 PD patients with RLS were older and had a longer duration of PD, higher nonmotor symptom scores (NMSQ), and a higher rate of impulse control disorders (50% vs. 26%), and RLS was an independent risk factor for impulse control disorders (odds ratio 5.9) after adjusting for confounding factors to younger age, female sex, asthma [160] and lateral positioning during sleep [161].…”