Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2026 Jan;40(1):39-45. doi: 10.13201/j.issn.2096-7993.2026.01.007.
ABSTRACT
Objective:This study aims to systematically explore the clinical characteristics of rapid eye movement（REM） -related obstructive sleep apnea（OSA） and objective polysomnography（PSG） indicators, and conduct an in-depth investigation into the specific manifestations of REM-OSA at different disease severity levels, and clarify the differences in clinical characteristics and PSG parameters between REM-OSA and non-rapid eye movement OSA（NREM-OSA）. It provides a scientific basis for optimizing the clinical diagnosis and treatment strategies of REM-OSA and improving patient prognosis. Methods:The clinical data of OSA patients who visited the Sleep Center of the Second Affiliated Hospital of Xian Jiaotong University from March 1, 2021, to April 1, 2025, completed all-night PSG, and met the inclusion criteria were retrospectively analyzed. OSA was classified into mild, moderate, and severe degrees according to the apnea-hypopnea index（AHI）, and grouped based on the REM-OSA diagnostic criteria. Sleep data were obtained through PSG monitoring, and demographic information, clinical symptoms, and comorbidity data were collected. In-depth exploration was carried out through different groupings to analyze the specific manifestations of REM-OSA at different disease stages. Results:The prevalence of REM-OSA was relatively high in mild and moderate OSA（49.4% and 36.2% respectively）, and only 3.9% in severe OSA. Demographic characteristics: The proportion of males with NREM-OSA was higher than that of REM-OSA in all degrees of OSA（mild: P=0.01; moderate: P=0.02; severe: P=0.01）. In severe OSA, the BMI, neck circumference, and waist circumference of NREM-OSA patients were significantly higher than those of REM-OSA patients（all P<0.01）. Clinical symptoms: In severe OSA, the Epworth Sleepiness Scale（ESS） scores of NREM-OSA patients were higher（P=0.01）. There were no significant differences in the incidence of memory decline, anxiety, and common comorbidities between the two groups. PSG parameters: The proportion of stage N1 in REM-OSA patients was lower than that in NREM-OSA patients in all degrees of OSA, while the proportions of stage N2 and REM were higher（taking severe cases as an example, all P<0.01）. In severe OSA, the number of respiratory events and total apnea index of NREM-OSA were higher（all P<0.01）, but the longest hypopnea duration of REM-OSA was longer（P=0.02）. In all degrees of OSA, the lowest oxygen saturation of REM-OSA was lower, and the time ratio of blood oxygen<90% was higher（taking severe cases as an example, all P<0.01）, while the sleep respiratory event-related arousal index of NREM-OSA was higher（taking severe cases as an example, P<0.01）. Conclusion:REM-OSA has unique clinical and PSG characteristics in mild and moderate OSA. Clinically, attention should be paid to REM phase monitoring to avoid missed diagnosis. In the treatment of severe OSA, airway management during the entire sleep period needs to be emphasized. Precise diagnosis and treatment strategies for OSA in different sleep phases are of great significance for improving the prognosis of patients.
PMID:41457028 | DOI:10.13201/j.issn.2096-7993.2026.01.007