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Drug-Induced Sleep Endoscopy DISE with Target Controlled Infusion TCI and Bispectral Analysis in Obstructive Sleep Apnea
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Comparing REM- and NREM-Related Obstructive Sleep Apnea in Jordan: A Cross-Sectional Study.

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Obstructive sleep apnea (OSA) differs based on whether it occurs during REM or NREM sleep. Stricter definitions of REM-related OSA reveal milder clinical changes, impacting arousal and oxygen saturation.

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Area of Science:

  • Sleep Medicine
  • Respiratory Medicine
  • Clinical Polysomnography

Background:

  • Obstructive sleep apnea (OSA) involves upper airway obstruction during sleep, occurring in both REM and NREM phases.
  • Understanding the distinction between REM-related and NREM-related OSA is crucial for accurate diagnosis and management.

Purpose of the Study:

  • To evaluate demographic and polysomnographic differences between REM- and NREM-related OSA in a Jordanian population.
  • To compare the impact of broad versus strict definitions of REM-related OSA.

Main Methods:

  • Screened patients with suspected OSA undergoing sleep studies.
  • Included 478 OSA patients (AHI ≥ 5), classifying them based on REM/NREM AHI ratios.
  • Utilized broad (AHI_REM/AHI_NREM ≥ 2) and strict (AHI_REM > 5, AHI_NREM < 5, REM duration ≥ 30 min) definitions for REM-related OSA.

Main Results:

  • 18% (broad definition) vs. 2.7% (strict definition) of OSA patients had REM-related OSA.
  • Significant differences found in arousal index, duration of saturation < 90%, and saturation nadir between REM- and NREM-related OSA.
  • No significant differences in age, BMI, ESS, or snoring between groups.

Conclusions:

  • The definition used significantly impacts the classification of REM-related OSA.
  • Stricter definitions of REM-related OSA are associated with milder clinical manifestations.
  • Further research is needed to refine OSA classification and management strategies.