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Rapid Eye Movement-Related Obstructive Sleep Apnea (REM-OSA): Prevalence and Characteristics

Department of Pulmonary Medicine and Critical Care and Center for Sleep Disorders, The Cleveland Clinic Foundation, Cleveland, OH

PURPOSE: Little data are available regarding the prevalence and characteristics of REM-OSA.We describe the prevalence and characteristics of REM-OSA.

METHODS: We conducted a retrospective review of polysomnograms of patients diagnosed with obstructive sleep apnea at the Cleveland Clinic Foundation between July 1, 2000 and June 30, 2001. REM-OSA was defined as: overall apnea-hypopnea index (AHI) >5, REM-AHI >5, non REM-AHI (NREM-AHI) <5. We determined the prevalence and characteristics of REM-OSA. Correlation of REM-OSA with age, sex, body-mass index (BMI), Beck depression inventory (BDI), and Epworth sleepiness scale (ESS) was performed.

RESULTS: 1012 patients were diagnosed with OSA between July 1, 2000 and June 30, 2001. 104 patients satisfied our criteria for REM-OSA diagnosis (10.3%). The mean plus or minus standard deviation for the different characteristics were: age (47.6±13.4) years, BMI (33.3 ±7.8) Kg/m², ESS (10.9±5.1), BDI (9.6±8.1), REM-AHI (28.8±15.2), NREM-AHI (3.2±1.3), AHI (7.4±2.2). The percentage of women in the REM-OSA group was 46.2 versus 27.9 in the OSA group (p value < 0.001). A weak correlation was found between REM-AHI and BMI (r= 0.4), but none was detected between REM-AHI and any of the other characteristics.

CONCLUSIONS: REM-OSA represents a significant proportion of patients with OSA and appears to have a different gender predilection. It may represent a distinct subgroup with characteristics different from the ones established for OSA.

CLINICAL IMPLICATIONS: REM-OSA with its different gender predilection may be a distinct subgroup of OSA. This may have therapeutic implications (continuous positive airway pressure therapy versus REM-suppressant medications).

DISCLOSURE: G.S. Juvelekian, None.