한국 성인에서 렘수면의존폐쇄수면무호흡증 환자의임상양상
Clinical Characteristics of REM-Dependent Obstructive Sleep Apnea in Korean Adults
2
조회
0
다운로드
2
인용
0
참고문헌
키워드
초록
Background: Rapid-eye-movement-sleep-dependent obstructive sleep apnea (REM-OSA) is a sleep breathing abnormality in which apneas/hypopneas occur mainly during REM sleep periods. However, the clinical significance of REM-OSA compared to sleep-stage-non-dependent OSA (SND-OSA) has been controversial. This study evaluated differences in the clinical features, polysomnography (PSG) characteristics, and subjective symptoms between REM-OSA and SND-OSA. Methods: In total, 136 consecutive patients with mild-to-moderate OSA were enrolled. REM-OSA was defined as a rapid eye movement (REM):non-REM apnea-hypopnea index (AHI) ratio of ＞2 and a total duration of REM sleep exceeding 30 minutes. We compared the demographic, clinical, and PSG characteristics, and subject symptoms between REM-OSA and SND-OSA. Results: The REM-OSA group comprised 45 (33%) of the 136 subjects. The mean age and total AHI did not differ between the groups, but there was a significant female predominance (35.6% vs. 16.5%) in the REM-OSA group. In terms of PSG parameters, subjects with REM-OSA showed a lower percentage of light sleep and a lower AHI in a supine position despite spending more sleep time in that position. Subjective sleep complaints, depression, anxiety, and health-related quality of life did not differ between the two study groups. Conclusions: The female predominance and sleep architecture differed between REM-OSA and SND-OSA in this study. The AHI in subjects with SND-OSA was dependent on sleep position rather than sleep stage. Further study is needed to elucidate the pathomechanism and clinical significance of REM-OSA.
Abstract
Background: Rapid-eye-movement-sleep-dependent obstructive sleep apnea (REM-OSA) is a sleep breathing abnormality in which apneas/hypopneas occur mainly during REM sleep periods. However, the clinical significance of REM-OSA compared to sleep-stage-non-dependent OSA (SND-OSA) has been controversial. This study evaluated differences in the clinical features, polysomnography (PSG) characteristics, and subjective symptoms between REM-OSA and SND-OSA. Methods: In total, 136 consecutive patients with mild-to-moderate OSA were enrolled. REM-OSA was defined as a rapid eye movement (REM):non-REM apnea-hypopnea index (AHI) ratio of ＞2 and a total duration of REM sleep exceeding 30 minutes. We compared the demographic, clinical, and PSG characteristics, and subject symptoms between REM-OSA and SND-OSA. Results: The REM-OSA group comprised 45 (33%) of the 136 subjects. The mean age and total AHI did not differ between the groups, but there was a significant female predominance (35.6% vs. 16.5%) in the REM-OSA group. In terms of PSG parameters, subjects with REM-OSA showed a lower percentage of light sleep and a lower AHI in a supine position despite spending more sleep time in that position. Subjective sleep complaints, depression, anxiety, and health-related quality of life did not differ between the two study groups. Conclusions: The female predominance and sleep architecture differed between REM-OSA and SND-OSA in this study. The AHI in subjects with SND-OSA was dependent on sleep position rather than sleep stage. Further study is needed to elucidate the pathomechanism and clinical significance of REM-OSA.
참고문헌 (21)
- Sohn Ch, "Obstructive sleep apnea symptoms prevalence and sleep apnea-associated factors in Korean adult populations", Sleep Med Psychophysiol, 5, pp.88~102 (1998)
- Peppard PE, "Prospective study of the association between sleep-disordered breathing and hypertension", N Engl J Med, 342, pp.1378~1384 (2000)
- Malhotra A, "Obstructive sleep apnoea", Lancet, 360, pp.237~245 (2002)
- Findley LJ, "Apnea duration and hypoxemia during REM sleep in patients with obstructive sleep apnea", Chest, 87, pp.432~436 (1985)
- Becker HF, "Breathing during sleep in patients with nocturnal desaturation", Am J Respir Crit Care Med, 159, pp.112~118 (1999)
- Kass JE, "Rapid-eye-movementspecific sleep-disordered breathing: a possible cause of excessive daytime sleepiness", Am J Respir Crit Care Med, 154, pp.167~169 (1996)
- O'Connor C, "Gender differences in the polysomnographic features of obstructive sleep apnea", Am J Respir Crit Care Med, 161, pp.1465~1472 (2000)
- Campos-Rodriguez F, "Clinical and polysomnographic features of rapid-eyemovement-specific sleep-disordered breathing", Arch Bronconeumol, 45, pp.330~334 (2009)
- Park T, "Comparison of REM Sleep-Dependent Obstructive Sleep Apnea Syndrome with Sleep Stage Non-Dependent One in Women Patients", Sleep Med Psychophysiol, 15, pp.25~32 (2008)
- Iber C, "The AASM manual for the scoring of sleep and associated events: rules, terminology and techmical specifications", pp.45~47 (2007), IL
- Bastien CH, "Validation of the Insomnia Severity Index as an outcome measure for insomnia research", Sleep Med, 2, pp.297~307 (2001)
- Cho YW, "The reliability and validity of the Korean version of the Epworth sleepiness scale", Sleep Breath, 15, pp.377~384 (2011)
- Sohn SI, "The reliability and validity of the Korean version of the Pittsburgh Sleep Quality Index", Sleep Breath, 16, pp.803~812 (2012)
- Oh SM, "A study on the standardization of the hospital anxiety and depression scale for Koreans: a comparison of normal, depressed and anxious groups", J Korean Neuropsychiatr Assoc, 38, pp.289~296 (1999)
- Yook S, "A clinical study on the Korean version of Beck Anxiety Inventory: comparative study of patient and non-patient", Korean J Clin Psychol, 16, pp.185~197 (1997)
- Leger D, "SF-36:evaluation of quality of life in severe and mild insomniacs compared with good sleepers", Psychosom Med, 63, pp.49~55 (2001)
- Koo BB, "Rapid eye movement-related sleep-disordered breathing: influence of age and gender", Chest, 134, pp.1156~1161 (2008)
- Haba-Rubio J, "Rapid eye movementrelated disordered breathing: clinical and polysomnographic features", Chest, 128, pp.3350~3357 (2005)
- Oksenberg A, "REM-related obstructive sleep apnea: the effect of body position", J Clin Sleep Med, 6, pp.343~348 (2010)
- Chami HA, "Sleepiness, quality of life, and sleep maintenance in REM versus non-REM sleep-disordered breathing", Am J Respir Crit Care Med, 181, pp.997~1002 (2010)
- Lee YJ, "Clinical and Polysomnographic Characteristics of REM Sleep-Dependent Obstructive Sleep Apnea", Sleep Med Psychophysiol, 15, pp.77~81 (2008)