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Updated: Jun 20, 2026

Drug-Induced Sleep Endoscopy (DISE) with Target Controlled Infusion (TCI) and Bispectral Analysis in Obstructive Sleep Apnea
Published on: December 6, 2016
Is obstructive sleep apnoea a rapid eye movement-predominant phenomenon?
1Department of Anaesthetics, Royal Prince Alfred Hospital, Camperdown NSW, Australia.
Obstructive sleep apnoea (OSA) is not predominantly worse during REM sleep, challenging previous assumptions. Respiratory disturbance during sleep is generally similar across REM and NREM stages for most patients.
Area of Science:
- Sleep Medicine
- Respiratory Physiology
Background:
- Obstructive sleep apnoea (OSA) is often considered more severe during Rapid Eye Movement (REM) sleep.
- Postoperative REM rebound may exacerbate OSA and increase cardio-respiratory risk.
- The hypothesis that OSA is a REM-predominant phenomenon requires further investigation.
Purpose of the Study:
- To investigate whether obstructive sleep apnoea (OSA) is a REM-predominant phenomenon.
- To compare the severity of respiratory disturbances during REM and Non-Rapid Eye Movement (NREM) sleep in OSA patients.
Main Methods:
- Retrospective analysis of sleep clinic records from 64 OSA patients.
- Comparison of Respiratory Disturbance Index (RDI) and minimum blood oxygen saturation (SpO2min) during REM and NREM sleep.
- Statistical analysis using the Wilcoxon signed rank test.
Main Results:
- Mean RDI was similar between NREM (36/hr) and REM (38/hr) sleep (P=0.96).
- 50% of patients had higher RDI in NREM, while 48% had higher RDI in REM.
- Mean SpO2min was similar between NREM (84%) and REM (82%) sleep (P=0.15), with no consistent pattern of desaturation predominance.
Conclusions:
- Respiratory disturbance in OSA is not significantly affected by sleep stage in most patients.
- Postoperative REM rebound may worsen OSA in a subset of patients, but not universally.
- The impact of postoperative sleep disturbances on cardio-respiratory risk is likely more complex than previously assumed.
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