Sleep & breathing = Schlaf & Atmung · 2026
Glossopharyngeal airway collapse is the main factor leading REM-related oxygen desaturation in patients with obstructive sleep apnea: a pilot study.
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Zhou Yingqian, Yin Guoping, Xu Jinkun, Cao Xin, Ye Jingying
Аннотация
OBJECTIVE: This study aimed to determine the factors underlying rapid eye movement (REM) sleep-related oxygen desaturation (OD) in patients with obstructive sleep apnea (OSA).
METHODS: All subjects underwent overnight polysomnography with synchronous genioglossus electromyography using intraoral surface electrodes. For those subjects diagnosed with moderate or severe OSA (AHI > 15 events/h), we respectively calculated the average OD during rapid eye movement (REM-OD) and non-rapid eye movement sleep (NREM-OD). The ratio of REM-OD/NREM-OD ≥ 1.5 was defined as patients with REM-related OD. The upper airway anatomy was measured by three-dimensional computed tomography (3D-CT) in all subjects. The independent t test was used to analyze the difference between groups.
RESULTS: Thirty-three male OSA patients were recruited and divided into two groups, includingthe REM-related OD group (n = 15, AHI 68.01 ± 18.35 events/h) and the NREM-related OD group (n = 18, AHI 57.48 ± 28.81 events/h). The REM-related OD group had a more severe lowest oxygen saturation overnight (56.14 ± 7.06 vs. 70.92 ± 14.49, p = 0.009). GGEMG variables were similar between the two groups, except for apnea time in the REM period (p < 0.001). Parameters measured by 3D-CT of the UA showed that the REM-related OD group had a narrower glossopharyngeal airway, with a smaller minimal anteroposterior airway dimension (12.41 ± 2.99 vs. 17.58 ± 4.78, p = 0.020) and smaller minimal cross-sectional airway area (119.81 ± 30.94 vs. 199.78 ± 75.02, p = 0.005).
CONCLUSION: Glossopharyngeal airway narrowing is the leading factor of REM-related OD in paitients with moderate or severe OSA by the prolongation of apnea events during REM sleep.
METHODS: All subjects underwent overnight polysomnography with synchronous genioglossus electromyography using intraoral surface electrodes. For those subjects diagnosed with moderate or severe OSA (AHI > 15 events/h), we respectively calculated the average OD during rapid eye movement (REM-OD) and non-rapid eye movement sleep (NREM-OD). The ratio of REM-OD/NREM-OD ≥ 1.5 was defined as patients with REM-related OD. The upper airway anatomy was measured by three-dimensional computed tomography (3D-CT) in all subjects. The independent t test was used to analyze the difference between groups.
RESULTS: Thirty-three male OSA patients were recruited and divided into two groups, includingthe REM-related OD group (n = 15, AHI 68.01 ± 18.35 events/h) and the NREM-related OD group (n = 18, AHI 57.48 ± 28.81 events/h). The REM-related OD group had a more severe lowest oxygen saturation overnight (56.14 ± 7.06 vs. 70.92 ± 14.49, p = 0.009). GGEMG variables were similar between the two groups, except for apnea time in the REM period (p < 0.001). Parameters measured by 3D-CT of the UA showed that the REM-related OD group had a narrower glossopharyngeal airway, with a smaller minimal anteroposterior airway dimension (12.41 ± 2.99 vs. 17.58 ± 4.78, p = 0.020) and smaller minimal cross-sectional airway area (119.81 ± 30.94 vs. 199.78 ± 75.02, p = 0.005).
CONCLUSION: Glossopharyngeal airway narrowing is the leading factor of REM-related OD in paitients with moderate or severe OSA by the prolongation of apnea events during REM sleep.