Prevalence, clinical features, and CPAP adherence in REM-related sleep-disordered breathing: a cross-sectional analysis of a large clinical population
Prevalence, clinical features, and CPAP adherence in REM-related sleep-disordered breathing: a cross-sectional analysis of a large clinical population
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DOI：
10.1007/s11325-011-0537-6
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发表时间：
2012-06-01
影响因子：
2.5
通讯作者：
Mokhlesi, Babak
中科院分区：
文献类型：
--
作者：
Conwell, Walter;Patel, Bhakti;Mokhlesi, Babak
由于文献中使用的定义不一致，快速眼动（REM）相关的睡眠呼吸障碍（SDB）的患病率变化很大，其临床意义仍不清楚。本研究旨在比较REM相关SDB的不同定义标准的患病率和临床特征。我们还调查了REM相关SDB患者推荐CPAP治疗的频率，以及与非阶段特异性SDB相比，CPAP依从性是否较低。REM相关SDB的患病率是根据文献中通常报道的“传统标准”和最小化非REM睡眠期间SDB贡献的“严格标准”计算的。REM相关SDB的患病率范围为13.5%至36.7%。REM相关SDB的严格定义与传统定义之间无临床显著差异。REM相关的SDB在女性、年轻人和非洲裔美国人中更为普遍。与非阶段特异性阻塞性睡眠呼吸暂停（OSA）相比，REM相关SDB患者的症状和嗜睡程度相同。推荐88%的REM相关SDB患者和94%的非阶段特异性OSA患者进行CPAP滴定（p < 0.001）。无论REM相关SDB如何定义，在我们的大型临床队列中，它都是非常普遍的。与非阶段特异性OSA相比，这些患者同样嗜睡并坚持CPAP治疗，尽管总体上OSA明显较轻。需要进一步的研究来更好地确定这些患者是否会从长期CPAP治疗中获益。
Due to inconsistent definitions used in the literature, the prevalence of rapid eye movement (REM)-related sleep-disordered breathing (SDB) has been quite variable and its clinical significance remains unclear. This study aimed to compare the prevalence of and clinical characteristics between various criteria for defining REM-related SDB. We also investigated how frequently CPAP therapy was recommended in patients with REM-related SDB and if they had lower CPAP adherence compared to non-stage-specific SDB.In this cross-sectional study, we evaluated 1,019 consecutive adults referred for a polysomnogram for suspicion of SDB. The prevalence of REM-related SDB was calculated based on "traditional criteria" commonly reported in the literature and a "strict criteria" that minimized the contribution of SDB during non-REM sleep.The prevalence of REM-related SDB ranged from 13.5% to 36.7%. There were no clinically significant differences between the strict definition and the traditional definition of REM-related SDB. REM-related SDB was more prevalent in women, younger individuals and African Americans. Compared to non-stage-specific obstructive sleep apnea (OSA), patients with REM-related SDB were equally symptomatic and hypersomnolent. CPAP titration was recommended in 88% of patients with REM-related SDB vs. 94% of patients with non-stage-specific OSA (p < 0.001). There was no significant difference in CPAP adherence between the two groups.Regardless of how REM-related SDB is defined, it was highly prevalent in our large clinical cohort. Compared to non-stage-specific OSA, these patients were equally hypersomnolent and adherent to CPAP therapy despite having overall significantly milder OSA. Further research is needed to better establish whether these patients will derive any benefit from long-term CPAP therapy.