title: Amelioration of obstructive sleep apnea in REM sleep behavior disorder: implications for the neuromuscular control of OSA.
abstract: OBJECTIVE
  The relationship between REM sleep behavior disorder (RBD) and obstructive sleep apnea (OSA) remains unclear. We aimed to (1) explore the association of REM-related EMG activity (REMREEA) with OSA in RBD patients; (2) compare the severity of OSA between RBD patients with OSA (RBD-OSA) and their age-, sex-, AHI-, and BMI- matched OSA controls.
  
  
  METHODS
  a. Correlation study in consecutive RBD subjects and b. case-control study
  
  
  METHODS
  Sleep laboratory
  
  
  METHODS
  71 RBD patients in the correlation study and 55 subjects (28 RBD-OSA cases and 27 OSA controls) in the case-control study.
  
  
  METHODS
  N/A METHODS: Polysomnographic assessment to document the sleep architecture, sleep apnea related parameters, and REMREEA.
  
  
  RESULTS
  (1) In the correlation study, increased REMREEA was associated with lower severity of OSA in RBD patients, including total AHI (r = -0.263), NREM AHI (r = -0.242), obstructive AHI (r = -0.265), and mean apnea duration (r = -0.353) (P < 0.05). (2) In the case-control study, RBD-OSA patients had lesser severity of sleep apnea parameters than OSA controls in terms of higher nadir SpO(2) (85.7% ± 4.9% vs 80.8% ± 5.9%, P < 0.01), shorter maximum hypopnea duration (53.8 ± 16.7 vs 69.4 ± 22.4 seconds, P < 0.05), and maximum (45.8 ± 20.5 vs 60.8 ± 19.6 sec, P < 0.01) and mean apnea duration (22.3 ± 8.1 vs 26.3 ± 5.8 sec, P < 0.05). Significant interaction effects indicated that the usual REM sleep exacerbation of sleep apneas was seen only in OSA controls but not in RBD subjects.
  
  
  CONCLUSIONS
  This study demonstrated that excessive EMG activity in RBD might protect patients against severe OSA and suggests this may be a naturalistic model for understanding neuromuscular control of OSA.
authors: Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China.
authors: Jixiong
authors: J
authors: Huang
authors: Jihui
authors: J
authors: Zhang
authors: Siu Ping
authors: SP
authors: Lam
authors: Shirley Xin
authors: SX
authors: Li
authors: Crover Kwok Wah
authors: CK
authors: Ho
authors: Venny
authors: V
authors: Lam
authors: Mandy Wai Man
authors: MW
authors: Yu
authors: Yun-Kwok
authors: YK
authors: Wing
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D004576:Electromyography; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000503:physiopathology; D009420:Nervous System / Q000503:physiopathology; D012189:Retrospective Studies; D012720:Severity of Illness Index; D020181:Sleep Apnea, Obstructive / Q000150:complications* / Q000503:physiopathology; D020919:Sleep Disorders, Intrinsic / Q000150:complications*; D012895:Sleep, REM / Q000502:physiology*; D055815:Young Adult