Bahammam Rakan A, Al-Qahtani Khalid M, Aleissi Salih A, Olaish Awad H, Almeneessier Aljohara S, Bahammam Ahmed S
Department of Medicine, College of Medicine, The University Sleep Disorders Center, King Saud University, Riyadh, Saudi Arabia.
Family Medicine, College of Medicine, King Saud University, Riyadh, Saudi Arabia.
Nat Sci Sleep. 2020 Oct 13;12:721-735. doi: 10.2147/NSS.S275051. eCollection 2020.
The study sought to assess demographics, clinical features, comorbidities, and polysomnographic features of a large cohort of clinic-based patients with rapid eye movement-predominant obstructive sleep apnea (REM-predominant-OSA) in both genders, while assessing the relationship between REM-predominant OSA in one hand and menopausal status and age on the other.
This prospective observational study was conducted between January 2003 and December 2017. REM-predominant OSA diagnostic criteria included an AHI of ≥5/h, with REM-AHI/non-REM-AHI of >2, a non-REM-AHI of <15/h, and a minimum of 15 min of REM sleep. Patients who had an AHI>5 events/h and did not meet the criteria for REM-predominant OSA were included in the non-stage-specific OSA group (NSS).
The study consisted of 1346 men and 823 women (total=2169). REM-predominant OSA was diagnosed in 17% (n=369). The prevalence of REM-predominant OSA in women was 25% compared with 12% in men. Several independent associations of REM-predominant OSA were identified in the whole group, including age (OR: 0.97 [0.95-0.98], p<0.01), female sex (OR: 6.95 [4.86-9.93], p>0.01), REM sleep duration (min) (OR: 1.02 [1.02-1.03], < 0.01), and time with SpO2 <90% (mins) (OR: 0.97 [0.95-0.99], < 0.01), hypertension (OR:0.67 [0.45-0.99], 0.04) and asthma (OR: 2.19 [1.56-3.07], < 0.01). The prevalence of REM-predominant OSA in premenopausal and postmenopausal women was 35% and 18.6% (p< 0.01), respectively. Among women, age was an independent correlate (OR: 0.97 [0.94-0.99], p=0.03; however, menopausal status was not.
REM-predominant OSA is prevalent among clinic-based patients with OSA. A younger age and female sex were independent correlates of REM-predominant OSA. Among women, a younger age but not menopausal status was a correlate of REM-predominant OSA. Asthma was independently associated with REM-predominant OSA.
本研究旨在评估一大群以门诊为基础的快速眼动为主型阻塞性睡眠呼吸暂停（REM为主型OSA）患者的人口统计学、临床特征、合并症及多导睡眠图特征，同时评估REM为主型OSA与绝经状态及年龄之间的关系。
本前瞻性观察性研究于2003年1月至2017年12月进行。REM为主型OSA的诊断标准包括：呼吸暂停低通气指数（AHI）≥5次/小时，快速眼动期AHI/非快速眼动期AHI>2，非快速眼动期AHI<15次/小时，且快速眼动睡眠至少15分钟。AHI>5次/小时且不符合REM为主型OSA标准的患者被纳入非特定阶段OSA组（NSS）。
该研究共纳入1346名男性和823名女性（总计2169名）。诊断出REM为主型OSA的患者有17%（n = 369）。女性中REM为主型OSA的患病率为25%，而男性为12%。在整个研究组中确定了几个与REM为主型OSA独立相关的因素，包括年龄（比值比：0.97 [0.95 - 0.98]，p < 0.01）、女性性别（比值比：6.95 [4.86 - 9.93]，p > 0.01）、快速眼动睡眠时间（分钟）（比值比：1.02 [1.02 - 1.03]，< 0.01）、血氧饱和度<90%的时间（分钟）（比值比：0.97 [0.95 - 0.99]，< 0.01）、高血压（比值比：0.67 [0.45 - 0.99]，0.04）和哮喘（比值比：2.19 [1.56 - 3.07]，< 0.01）。绝经前和绝经后女性中REM为主型OSA的患病率分别为35%和18.6%（p < 0.01）。在女性中，年龄是一个独立相关因素（比值比：0.97 [0.94 - 0.99]，p = 0.03）；然而，绝经状态并非如此。
REM为主型OSA在以门诊为基础的OSA患者中普遍存在。年龄较小和女性性别是REM为主型OSA的独立相关因素。在女性中，年龄较小而非绝经状态是REM为主型OSA的相关因素。哮喘与REM为主型OSA独立相关。
