Multilevel surgery in patients with rapid eye movement-related obstructive sleep apnea.
OBJECTIVE
To compare the anatomic features and the results of a multilevel surgery in patients with rapid eye movement-related obstructive sleep apnea (REM OSA) and non-REM OSA.


METHODS
Cohort study of 90 consecutive mild or moderate OSA patients.


METHODS
The apnea-hypopnea index (AHI) was also calculated during REM sleep (AHI(REM)) and during non-REM sleep (AHI(NREM)), and patients were classified as having REM OSA if their AHI(REM)/AHI(NREM) ratio was >2, otherwise they were classified as non-REM OSA patients. All patients underwent concurrent uvulopalatopharyngoplasty and a radiofrequency tongue base reduction procedure.


RESULTS
A total of 31.1 percent patients were classified as REM OSA and 68.9 percent patients as non-REM OSA. There were no differences in the anatomical features between two groups. However, the AHI, HI, and arousal index were significantly higher in the non-REM OSA group than in the REM OSA group. When a successful outcome was defined as a postoperative AHI <20 with at least a 50 percent reduction from the preoperative level, 50 percent of the patients with REM OSA and 35.5 percent of the patients with non-REM OSA met the criteria for a successful outcome.


CONCLUSIONS
REM OSA patients had milder obstructive sleep apnea, and multilevel surgery might be more effective in REM OSA patients.
Eun
Young Gyu
YG
Department of Otorhinolaryngology, Head and Neck Surgery, School of Medicine, Kyunghee University, Dongdaemun-Gu, Seoul, Korea.
Kwon
Kee Hwan
KH
Shin
Seung Youp
SY
Lee
Kun Hee
KH
Byun
Jae Yong
JY
Kim
Sung Wan
SW