Breathtaking dreams: reduced REM phenotype in REM-related sleep apnea.

IF 2 4区医学 Q3 CLINICAL NEUROLOGY Sleep and Breathing Pub Date : 2025-01-22 DOI:10.1007/s11325-024-03236-5

Luca Cerina, Pedro Fonseca, Gabriele B Papini, Rik Vullings, Sebastiaan Overeem

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Abstract

Purpose: The expression of the respiratory events in OSA is influenced by different mechanisms. In particular, REM sleep can highly increase the occurrence of events in a subset of OSA patients, a condition dubbed REM-OSA (often defined as an AHI 2 times higher in REM than NREM sleep). However, a proper characterization of REM-OSA and its pathological sequelae is still inadequate, partly because of limitations in the current definitions.

Methods: We propose a new interpretation of the REM-OSA definition, extending it from a AHI-ratio to a two-dimensional space, considering both time and events ratios in REM over NREM separately. Within this space, we analyzed current definitions of REM-OSA in three large clinical dataset and identified the underlying sources of heterogeneity.

Results: We observed that REM-OSA and REM-independent-OSA subgroups exist. Some subgroups exhibited abnormal REM characteristics (e.g., REM-OSA with reduced time in REM). Others had OSA features that are intermediate between REM-independent-OSA participants and those with a clear disproportion of REM events.

Conclusion: We found that a time and events' ratio of REM and NREM allow a more precise characterization of REM-OSA subgroups. Our new interpretation can be used to bolster new research into REM-OSA pathophysiological mechanisms.

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惊心动魄的梦：快速眼动相关睡眠呼吸暂停的快速眼动表型减少。

目的：OSA患者呼吸事件的表达受不同机制的影响。特别是，快速眼动睡眠可以大大增加OSA患者的一部分事件的发生，这种情况被称为REM-OSA（通常定义为快速眼动睡眠的AHI比非快速眼动睡眠高2倍）。然而，由于目前定义的局限性，对REM-OSA及其病理后遗症的适当描述仍然不足。方法：我们对REM- osa的定义提出了新的解释，将其从ahi比率扩展到二维空间，分别考虑REM与NREM的时间和事件比率。在这一领域，我们分析了三个大型临床数据集中REM-OSA的当前定义，并确定了异质性的潜在来源。结果：我们观察到存在REM-OSA和rem独立- osa亚组。一些亚组表现出异常的REM特征（如REM- osa， REM时间减少）。其他人的OSA特征介于非快速眼动性OSA参与者和快速眼动事件明显失调的参与者之间。结论：我们发现快速眼动和非快速眼动的时间和事件比率可以更精确地表征快速眼动- osa亚组。我们的新解释可用于支持对REM-OSA病理生理机制的新研究。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Sleep and Breathing 医学-呼吸系统

CiteScore

5.20

自引率

4.00%

发文量

222

审稿时长

3-8 weeks

期刊介绍： The journal Sleep and Breathing aims to reflect the state of the art in the international science and practice of sleep medicine. The journal is based on the recognition that management of sleep disorders requires a multi-disciplinary approach and diverse perspectives. The initial focus of Sleep and Breathing is on timely and original studies that collect, intervene, or otherwise inform all clinicians and scientists in medicine, dentistry and oral surgery, otolaryngology, and epidemiology on the management of the upper airway during sleep. Furthermore, Sleep and Breathing endeavors to bring readers cutting edge information about all evolving aspects of common sleep disorders or disruptions, such as insomnia and shift work. The journal includes not only patient studies, but also studies that emphasize the principles of physiology and pathophysiology or illustrate potentially novel approaches to diagnosis and treatment. In addition, the journal features articles that describe patient-oriented and cost-benefit health outcomes research. Thus, with peer review by an international Editorial Board and prompt English-language publication, Sleep and Breathing provides rapid dissemination of clinical and clinically related scientific information. But it also does more: it is dedicated to making the most important developments in sleep disordered breathing easily accessible to clinicians who are treating sleep apnea by presenting well-chosen, well-written, and highly organized information that is useful for patient care.