Abstract Details

Mild OSA is defined as apnea hypopnea index (AHI) of 5-15 events per hour of sleep, moderate as 15-30 & severe >30 events per hour of sleep. Patients with REM-predominant OSA tend to have an overall low AHI by virtue of the disproportionately lower percent of REM sleep as a function of total sleep duration. REM predominant OSA is classified as REM AHI >5 with a total REM sleep duration of at least 30 minutes. Compared with non-rapid eye movement (NREM) sleep, REM sleep is associated with higher autonomic nervous system & cardiorespiratory instability in healthy individuals & more so in patients with OSA. However, it is unknown whether there is any difference in prevalence of various comorbidities in mild vs moderate REM AHI.

To assess association between various comorbidities & mild vs moderate rapid eye movement (REM) predominant obstructive sleep apnea (OSA).

We conducted a single center cross-sectional retrospective study on patients aged >18 years who had REM AHI of 5-30. Patients were divided into two groups, those who have REM AHI 5-15 & 15-30. Statistical analysis (frequency & chi square test) was conducted using IBM-SPSS:24 with P<0.05 &  power of study > 80%.

A total of 533 patients with a mean age of 53.24±14.55 years were analyzed. Of those, 342 people had AHI of 5 -15 & 191 patients had AHI 15-30. Mild as well as moderate REM OSA were significantly associated with atrial fibrillation, Type-2 diabetes & Restless leg syndrome when adjusted for age & BMI (P<0.05). Additionally, they were significantly associated with pulmonary hypertension & mood disorder when adjusted for BMI only (p<0.05). There was no significant correlation between the comorbidities & REM AHI when adjusted for gender (p>0.05).

Even mild REM OSA demonstrated statistically significant association to comorbidities similar to moderate REM OSA. Further studies are needed to evaluate the clinical significance of mild REM OSA.