Sleepiness, quality of life, and sleep maintenance in REM versus non-REM sleep-disordered breathing.
BACKGROUND
The impact of REM-predominant sleep-disordered breathing (SDB) on sleepiness, quality of life (QOL), and sleep maintenance is uncertain.


OBJECTIVE
To evaluate the association of SDB during REM sleep with daytime sleepiness, health-related QOL, and difficulty maintaining sleep, in comparison to their association with SDB during non-REM sleep in a community-based cohort.


METHODS
Cross-sectional analysis of 5,649 Sleep Heart Health Study participants (mean age 62.5 [SD = 10.9], 52.6% women, 22.6% ethnic minorities). SDB during REM and non-REM sleep was quantified using polysomnographically derived apnea-hypopnea index in REM (AHI(REM)) and non-REM (AHI(NREM)) sleep. Sleepiness, sleep maintenance, and QOL were respectively quantified using the Epworth Sleepiness Scale (ESS), the Sleep Heart Health Study Sleep Habit Questionnaire, and the physical and mental composites scales of the Medical Outcomes Study Short Form (SF)-36.


RESULTS
AHI(REM) was not associated with the ESS scores or the physical and mental components scales scores of the SF-36 after adjusting for demographics, body mass index, and AHI(NREM) x AHI(REM) was not associated with frequent difficulty maintaining sleep or early awakening from sleep. AHI(NREM) was associated with the ESS score (beta = 0.25; 95% confidence interval [CI], 0.16 to 0.34) and the physical (beta = -0.12; 95% CI, -0.42 to -0.01) and mental (beta = -0.20; 95% CI, -0.20 to -0.01) components scores of the SF-36 adjusting for demographics, body mass index, and AHI(REM).


CONCLUSIONS
In a community-based sample of middle-aged and older adults, REM-predominant SDB is not independently associated with daytime sleepiness, impaired health-related QOL, or self-reported sleep disruption.
Chami
Hassan A
HA
The Pulmonary Center, Boston University School of Medicine, 72 East Concord Street, R-304, Boston, MA 02118, USA. hchami@bu.edu
Baldwin
Carol M
CM
Silverman
Angela
A
Zhang
Ying
Y
Rapoport
David
D
Punjabi
Naresh M
NM
Gottlieb
Daniel J
DJ
D000368:Aged; D006970:Disorders of Excessive Somnolence / Q000503:physiopathology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017286:Polysomnography; D011788:Quality of Life; D012890:Sleep / Q000502:physiology*; D012891:Sleep Apnea Syndromes / Q000150:complications*; D012895:Sleep, REM / Q000502:physiology*