title: Does obstructive sleep apnea worsen during REM sleep?
abstract: Although it is thought that obstructive sleep apnea (OSA) is worse during rapid eye movement (REM) sleep than in non-REM (NREM) sleep there are some uncertainties, especially about apnoe-hypopnoe-index (AHI). Several studies found no significant difference in AHI between both sleep stages. However, REM sleep is associated more with side sleeping compared to NREM sleep, which suggests that body position is a possible confounding factor. The main purpose of this study was to compare the AHI in REM and NREM sleep in both supine and lateral body position. A retrospective study was performed on 422 consecutive patients who underwent an overnight polysomnography. Women had higher AHI in REM sleep than NREM sleep in both supine (46.05+/-26.26 vs. 23.91+/-30.96, P<0.01) and lateral (18.16+/-27.68 vs. 11.30+/-21.09, P<0.01) body position. Men had higher AHI in REM sleep than NREM sleep in lateral body position (28.94+/-28.44 vs. 23.58+/-27.31, P<0.01), however, they did not reach statistical significance in supine position (49.12+/-32.03 in REM sleep vs. 45.78+/-34.02 in NREM sleep, P=0.50). In conclusion, our data suggest that REM sleep is a contributing factor for OSA in women as well as in men, at least in lateral position.
authors.affiliation: Department of Medical Physiology, Faculty of Medicine, P. J. Šafárik University, Košice, Slovakia. igor.peregrim@upjs.sk.
authors.forename: I
authors.initials: I
authors.lastname: Peregrim
authors.forename: S
authors.initials: S
authors.lastname: Grešová
authors.forename: M
authors.initials: M
authors.lastname: Pallayová
authors.forename: B L
authors.initials: BL
authors.lastname: Fulton
authors.forename: J
authors.initials: J
authors.lastname: Štimmelová
authors.forename: I
authors.initials: I
authors.lastname: Bačová
authors.forename: A
authors.initials: A
authors.lastname: Mikuľaková
authors.forename: Z
authors.initials: Z
authors.lastname: Tomori
authors.forename: V
authors.initials: V
authors.lastname: Donič
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D056888:Patient Positioning; D017286:Polysomnography; D012189:Retrospective Studies; D012307:Risk Factors; D012737:Sex Factors; D020181:Sleep Apnea, Obstructive / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology*; D012895:Sleep, REM; D016683:Supine Position