Relationship between REM density, duty cycle, and obstructive sleep apnea in children

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Updated: Jul 13, 2026

Drug-Induced Sleep Endoscopy (DISE) with Target Controlled Infusion (TCI) and Bispectral Analysis in Obstructive Sleep Apnea
07:54

Drug-Induced Sleep Endoscopy (DISE) with Target Controlled Infusion (TCI) and Bispectral Analysis in Obstructive Sleep Apnea

Published on: December 6, 2016

Laurie Karamessinis1, Patricia Galster, Brian Schultz

  • 1The Sleep Center, The Children's Hospital ofPhiladelphia, University of Pennsylvania School of Medicine, Philadelphia, PA 19104, USA.

Sleep
|August 9, 2007
PubMed

Insights

Rapid eye movement (REM) density and REM cycle duration increase during sleep in children. However, increased REM density and duty cycle did not correlate with obstructive apnea severity in children with suspected OSAS.

Area of Science:

  • Pediatric Sleep Medicine
  • Respiratory Physiology

Background:

  • Rapid eye movement (REM) sleep patterns change with development, but REM density in children remains understudied.
  • Obstructive sleep apnea syndrome (OSAS) predominantly affects REM sleep, yet its link to REM density in pediatric populations is unclear.

Purpose of the Study:

  • To investigate changes in REM density and REM cycle duration throughout the night in children.
  • To examine the duty cycle's progression during REM sleep in children with suspected OSAS.
  • To determine if increased REM density correlates with obstructive apnea severity.

Main Methods:

  • Polysomnography was used to measure REM density and respiratory parameters in 76 children with suspected OSAS.
  • Sleep laboratory setting.
  • Data collected across multiple REM cycles per participant.

Main Results:

  • REM density and REM cycle duration increased across the night until the fifth REM cycle, then plateaued.
  • The inspiratory duty cycle progressively increased over the first six REM cycles.
  • The apnea-hypopnea index (AHI) did not change across REM cycles and was unaffected by REM density or duty cycle variations.

Conclusions:

  • The observed increase in duty cycle may represent a compensatory mechanism for heightened upper airway resistance during sleep.
  • Potential for ventilatory or upper airway muscle fatigue due to sustained compensatory efforts.
  • Further research is needed to clarify the relationship between REM sleep dynamics and OSAS severity in children.
Abstract

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