Sleep & breathing = Schlaf & Atmung · 2026
REM-related obstructive sleep apnoea in neuromuscular diseases: A 10-year retrospective cohort study.
СтатьяНазвание и аннотация: Перевод в очереди
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Oguz Merve Sinem, Kiyan Esen, Pihtili Aylin, Altan Gokhan, Cakar Arman, Durmus Hacer
Аннотация
PURPOSE: Neuromuscular diseases (NMDs) are reported to have increased obstructive apnoea/hypopnoea during rapid eye movement (REM) sleep; however, the prevalence of REM-related obstructive sleep apnoea (OSA) and its clinical correlates in NMD remain undefined. We evaluated REM sleep, REM-related OSA frequency, and associated with demographic and clinical factors.
METHODS: We retrospectively evaluated patients with NMDs who underwent polysomnography (PSG) between 2015 and 2024. Demographic data, morning arterial blood gases, spirometry and PSG data were collected. REM-related OSA required AHI ≥ 5 events/hour, REM-to-non-REM (NREM) AHI ≥ 2, and REM ≥ 30 min; REM-isolated additionally required NREM AHI < 5 events/hour. Patients with OSA who did not meet the criteria for REM-related OSA were classified as having NREM-related OSA.
RESULTS: Among 290 patients, OSA was present in 87.6% (254/290). REM sleep duration was markedly reduced (11.8 ± 8.0%; 46.8 ± 32.2 min), and 30.0% of patients had REM duration < 30 min. Among OSA with REM ≥ 30 min (n = 182), 54.4% had REM-related OSA; 25.3% were REM-isolated. Compared with NREM-related OSA, the REM-related group exhibited more frequent female sex (p = 0.015), hypertension (p = 0.020), and depression (p = 0.025). In multivariable analysis, REM-related OSA was independently associated with morning hypercapnia (aOR 4.889; 95%CI 1.885-12.680), forced vital capacity (FVC) < 50% and/or ≥ 20% upright-to-supine decline (aOR 3.847; 95%CI 1.085-13.642), and mild OSA (aOR 3.461; 95%CI 1.509-7.937).
CONCLUSIONS: Despite the marked reduction in REM sleep in NMDs, OSA, and particularly REM-related OSA, is common. In the REM-related OSA group, morning hypercapnia and FVC decline were more frequent. These observations suggest that REM-stage characteristics may be predictive of subsequent chronic respiratory failure.
METHODS: We retrospectively evaluated patients with NMDs who underwent polysomnography (PSG) between 2015 and 2024. Demographic data, morning arterial blood gases, spirometry and PSG data were collected. REM-related OSA required AHI ≥ 5 events/hour, REM-to-non-REM (NREM) AHI ≥ 2, and REM ≥ 30 min; REM-isolated additionally required NREM AHI < 5 events/hour. Patients with OSA who did not meet the criteria for REM-related OSA were classified as having NREM-related OSA.
RESULTS: Among 290 patients, OSA was present in 87.6% (254/290). REM sleep duration was markedly reduced (11.8 ± 8.0%; 46.8 ± 32.2 min), and 30.0% of patients had REM duration < 30 min. Among OSA with REM ≥ 30 min (n = 182), 54.4% had REM-related OSA; 25.3% were REM-isolated. Compared with NREM-related OSA, the REM-related group exhibited more frequent female sex (p = 0.015), hypertension (p = 0.020), and depression (p = 0.025). In multivariable analysis, REM-related OSA was independently associated with morning hypercapnia (aOR 4.889; 95%CI 1.885-12.680), forced vital capacity (FVC) < 50% and/or ≥ 20% upright-to-supine decline (aOR 3.847; 95%CI 1.085-13.642), and mild OSA (aOR 3.461; 95%CI 1.509-7.937).
CONCLUSIONS: Despite the marked reduction in REM sleep in NMDs, OSA, and particularly REM-related OSA, is common. In the REM-related OSA group, morning hypercapnia and FVC decline were more frequent. These observations suggest that REM-stage characteristics may be predictive of subsequent chronic respiratory failure.