[Rapid eye movement-related and none rapid eye movement-related classification in obstructive sleep apnea hypopnea syndrome].
OBJECTIVE
To study the value of a new measurement that divided obstructive sleep apnea-hypopnea syndrome (OSAHS) into rapid-eye-movement (REM) related and non-rapid-eye-movement (NREM) related subgroups.


METHODS
According to Siddiqui classification, 137 adult patients with OSHAS were diagnosed as REM-related OSAHS [REM apnea hypopnea index (AHI)/NREM AHI > 1] or NREM-related OSAHS (REM AHI/NREM AHI < 1). Polysomnographic data were compared and discussed.


RESULTS
(1) There were 72 cases defined as REM-related OSAHS (52.6%) and 65 cases defined as NREM-related OSAHS (47.4%). (2) In all cases, total AHI and NREM AHI in REM-related OSAHS were significantly lower than those in NREM-related OSAHS, while lowest arterial oxygen saturation (LSaO₂), REM LSaO₂ and NREM LSaO₂ were significantly higher than those in NREM-related OSAHS (t were -6.466, -7.638, 3.426, 2.472, 4.873 respectively, P < 0.05). No significance was found in sleep structure, REM AHI and REM LSaO₂ between REM-related and NREM-related OSAHS (P > 0.05). (3) Given the severity of OSHAS, the constituent ratio of REM-related OSAHS decreased (77.8%, 61.5%, 37.3%) from mild to severe OSAHS, while that of NREM-related OSAHS rose (22.7%, 38.5%, 62.7%; chi² = 16.996, P < 0.01). In mild and moderate groups, REM LSaO₂ of REM-related OSAHS was significantly lower than those in NREM-related OSAHS (t were -4.273 and -2.136, P < 0.05), while the differences of total AHI and LSaO₂, NREM LSaO₂ between these two types were not significant. In severe group, AHI in NREM-related OSAHS was significantly higher than that in REM-related OSAHS, while LSaO₂, REM LSaO₂ and NREM LSaO₂ was significantly lower than those in REM-related OASHS (t were -4.943, 2.574, 1.996, 3.571, P ≤ 0.05). (4) There was no significance in sleeping latency and efficiency between REM-related and NREM-related OSHAS.


CONCLUSIONS
REM-related OSHAS mainly exists in mild and moderate OSHAS, while NREM-related one mainly exists in severe OSHAS. NREM-related OSAHS may be more severe in AHI and hypoxia than REM-related one. Whenever obstructive apnea happened in REM or NREM period, its impacts on sleep structure, efficiency and latency have no difference.
Chai
Li-ping
LP
Department of Otorhinolaryngology, The First Affiliated Hospital of SUN Yat-sen University, Otorhinolaryngology Institute of SUN Yat-sen University, Guangzhou 510080, China. banana1212@163.com
Xie
Xuan
X
Zeng
Yu-hui
YH
Wang
Zhang-feng
ZF
Tu
Xiu-ping
XP
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017286:Polysomnography; D020181:Sleep Apnea, Obstructive / Q000145:classification* / Q000503:physiopathology; D012894:Sleep Stages; D012895:Sleep, REM; D055815:Young Adult