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Rapid eye movement related obstructive sleep apnea: Where do we stand?
Abdul Rehman Rishi1, Muhammad Adeel Rishi2
1Department of Internal Medicine, SSM Medical Group, Fenton, MO, USA.
Respiratory Investigation
|July 11, 2021
Summary
Rapid eye movement (REM) related obstructive sleep apnea (OSA) has variable prevalence and poorly defined clinical significance. Standardized definitions and treatment consensus are needed for this sleep disorder.
Area of Science:
- Sleep Medicine
- Respiratory Medicine
- Cardiology
Background:
- Obstructive sleep apnea (OSA) during Rapid Eye Movement (REM) sleep presents unique diagnostic and therapeutic challenges.
- Its prevalence varies based on diagnostic criteria, and its clinical significance is not fully established.
- REM-related OSA episodes are longer and cause greater oxygen desaturation than non-REM episodes.
Purpose of the Study:
- To review the epidemiology, clinical significance, and management of REM-related OSA.
- To highlight the need for standardized definitions and diagnostic criteria.
- To discuss the implications for treatment and further research.
Main Methods:
- Literature review of studies on REM-related obstructive sleep apnea.
- Analysis of epidemiological data, clinical associations, and treatment outcomes.
- Synthesis of current evidence regarding diagnostic challenges and therapeutic approaches.
Main Results:
- REM-related OSA is associated with more severe apneas and oxygen desaturation compared to non-REM OSA.
- It may be independently linked to hypertension and poor glycemic control.
- Current positive airway pressure (PAP) therapy may be insufficient for many patients with REM-related OSA.
Conclusions:
- Standardization of REM-related OSA definition and diagnosis is crucial.
- Consensus is needed on treatment thresholds, especially when the overall apnea-hypopnea index (AHI) is below the typical OSA diagnosis threshold.
- Further research is required to elucidate neurocognitive and cardiometabolic outcomes and guide optimal therapeutic strategies.
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