Clinical and Polysomnographic Features of Rapid Eye Movement–Specific Sleep-Disordered Breathing

Campos-Rodríguez, Francisco; Fernández-Palacín, Ana; Reyes-Núñez, Nuria; Reina-González, Ángela

doi:10.1016/S1579-2129(09)72433-4

Archivos de Bronconeumología

ISSN: 0300-2896

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Vol. 45. Issue 7.

Pages 330-334 (July 2009)

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Pages 330-334 (July 2009)

Original Article

DOI: 10.1016/S1579-2129(09)72433-4

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Clinical and Polysomnographic Features of Rapid Eye Movement–Specific Sleep-Disordered Breathing

Características clínicas y polisomnográficas del síndrome de apneas durante el sueño localizado en la fase REM

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Francisco Campos-Rodrígueza,

Corresponding author

fcamposr@telefonica.net

Corresponding author.

, Ana Fernández-Palacínb, Nuria Reyes-Núñeza, Ángela Reina-Gonzáleza

a Servicio de Neumología, Hospital Universitario de Valme, Sevilla, Spain

b Unidad de Investigación, Hospital Universitario de Valme, Sevilla, Spain

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Abstract

Objective

The aim of this study was to analyze the clinical and polysomnographic features of rapid eye movement (REM)–specific sleep disordered-breathing (SDB).

Patients and Methods

All cases of sleep apnea-hypopnea syndrome (SAHS) (apnea-hypopnea index [AHI] ≥ 10/h) diagnosed using over night polysomnography during the period 2004 to 2006 were analyzed retrospectively. Those cases in which the ratio of AHI during REM sleep to AHI during non-REM sleep was more than 2 were classified as REM-specific SDB. We recorded the following data: clinical signs and symptoms related to SAHS, PSG results, cardiovascular risk factors, and previous cardiovascular events. Logistic regression analysis was used to identify predictors of REM-specific SDB and to analyze the possible interactions between variables.

Results

A total of 419 patients were analyzed, of whom 138 (32.9%) presented REM-specific SDB. This condition was more common in patients with mild to moderate SAHS than in those with more severe cases (odds ratio, 8.21; 95% confidence interval, 4.83–14.03). The variables independently associated with REM-specific SDB in the logistic regression analysis were female sex, lower AHI, and higher body mass index. No interactions between the main variables studied were found. There were no differences between patients with REM-specific SDB and those with non-REM-specific SDB with regard to signs and symptoms related to SAHS, excessive daytime sleepiness, sleep architecture, cardiovascular risk factors, or history of cardiovascular episodes.

Keywords:

Sleep apnea syndrome

REM sleep

Excessive daytime sleepiness

Female sex

Resumen

Introducción

El objetivo de este estudio ha sido analizar las características clínicas y polisomnográficas del síndrome de apneas-hipopneas durante el sueño (SAHS) localizado en la fase REM (SAHS-REM).

Pacientes y métodos

Se han analizado retrospectivamente todos los casos de SAHS –índice de apneashipopneas (IAH) ≥ 10/h– diagnosticados mediante polisomnografía completa en el período 2004–2006. Se catalogaron como SAHS-REM aquellos en que la razón IAH-REM/IAH-no REM fue mayor de 2. De todos los pacientes se recogieron los siguientes datos: clínica de SAHS, resultados de la polisomnografía, factores de riesgo cardiovascular y eventos cardiovasculares previos. Se realizó un análisis de regresión logística para identificar las variables predictoras de SAHS-REM, así como para analizar posibles interacciones entre variables.

Resultados

Se analizaron en total 419 casos, de los que 138 (32,9%) presentaban SAHS-REM. Esta entidad fue más frecuente en pacientes con SAHS leve-moderado que en los casos graves (odds ratio = 8,21; intervalo de confianza del 95%, 4,83-14,03). En el análisis de regresión logística, las variables que se asociaron de forma independiente al SAHS-REM fueron el sexo femenino, un menor IAH y un mayor índice de masa corporal, y no se detectaron interacciones entre las principales variables estudiadas. No se encontraron diferencias entre los pacientes con SAHS-REM y SAHS-no REM en cuanto a la clínica del SAHS, hipersomnia diurna subjetiva, estructura de sueño, factores de riesgo cardiovascular o antecedentes de episodios cardiovasculares.

Conclusiones

El SAHS-REM podría considerarse un estadio inicial del SAHS, que acontece preferentemente en mujeres obesas con trastorno del sueño leve-moderado y que carece de características específicas en cuanto a presentación clínica, estructura de sueño o comorbilidad cardiovascular.

Palabras clave:

Síndrome de apneas del sueño

Sueño REM

Hipersomnia diurna

Sexo femenino

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