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REM-Predominant Obstructive Sleep Apnea in Patients with Coronary Artery Disease

Balcan, Baran ; Celik, Yeliz ; Newitt, Jennifer ; Strollo, Patrick J. and Peker, Yüksel LU (2022) In Journal of Clinical Medicine 11(15).
Abstract

Obstructive sleep apnea (OSA) is common in adults with coronary artery disease (CAD). OSA that occurs predominantly during rapid-eye movement (REM) sleep has been identified as a specific phenotype (REM-predominant OSA) in sleep clinic cohorts. We aimed to examine the association of REM-predominant OSA with excessive sleepiness, functional outcomes, mood, and quality of life in a CAD cohort, of whom 286 OSA patients with total sleep time ≥ 240 min, and REM sleep ≥ 30 min, were included. REM-predominant OSA was defined as a REM-apnea-hypopnea-index (AHI) /non-REM (NREM) AHI ≥ 2. In all, 73 (25.5%) had REM-predominant OSA. They were more likely to be female (26.0% vs. 9.9%; p = 0.001), and more obese (42.5% vs. 24.4%; p = 0.003) but had... (More)

Obstructive sleep apnea (OSA) is common in adults with coronary artery disease (CAD). OSA that occurs predominantly during rapid-eye movement (REM) sleep has been identified as a specific phenotype (REM-predominant OSA) in sleep clinic cohorts. We aimed to examine the association of REM-predominant OSA with excessive sleepiness, functional outcomes, mood, and quality of life in a CAD cohort, of whom 286 OSA patients with total sleep time ≥ 240 min, and REM sleep ≥ 30 min, were included. REM-predominant OSA was defined as a REM-apnea-hypopnea-index (AHI) /non-REM (NREM) AHI ≥ 2. In all, 73 (25.5%) had REM-predominant OSA. They were more likely to be female (26.0% vs. 9.9%; p = 0.001), and more obese (42.5% vs. 24.4%; p = 0.003) but had less severe OSA in terms of AHI (median 22.6/h vs. 36.6/h; p < 0.001) compared to the patients with non-stage specific OSA. In adjusted logistic regression models, female sex (odds ratio [OR] 4.64, 95% confidence interval [CI] 1.85–11.64), body-mass-index (BMI; OR 1.17; 95% CI 1.07–1.28) and AHI (OR 0.93, 95% CI 0.91–0.95) were associated with REM-predominant OSA. In univariate linear regression models, there was a dose-response relationship between REM-AHI and Zung Self-rated Depression Scale but not excessive sleepiness, functional outcomes, and anxiety scores. Among the Short Form-36 subdomains, Vitality, Mental Health, and Mental Component Summary (MCS) scores were inversely correlated with REM-AHI. In multivariate linear models, only MCS remained significantly associated with REM-AHI after adjustment for age, BMI, and sex (β-coefficient −2.20, %95 CI [−0.56, −0.03]; p = 0.028). To conclude, female sex and BMI were related to REM-predominant OSA in this revascularized cohort. MCS was inversely associated with REM-AHI in the multivariate model.

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author
; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
coronary artery disease, depression, obstructive sleep apnea, quality of life, REM sleep
in
Journal of Clinical Medicine
volume
11
issue
15
article number
4402
publisher
MDPI AG
external identifiers
  • pmid:35956019
  • scopus:85136697287
ISSN
2077-0383
DOI
10.3390/jcm11154402
language
English
LU publication?
yes
id
8411bab3-8eb2-4053-8490-1b14bbd7c845
date added to LUP
2022-10-20 13:52:05
date last changed
2025-03-22 02:11:30
@article{8411bab3-8eb2-4053-8490-1b14bbd7c845,
  abstract     = {{<p>Obstructive sleep apnea (OSA) is common in adults with coronary artery disease (CAD). OSA that occurs predominantly during rapid-eye movement (REM) sleep has been identified as a specific phenotype (REM-predominant OSA) in sleep clinic cohorts. We aimed to examine the association of REM-predominant OSA with excessive sleepiness, functional outcomes, mood, and quality of life in a CAD cohort, of whom 286 OSA patients with total sleep time ≥ 240 min, and REM sleep ≥ 30 min, were included. REM-predominant OSA was defined as a REM-apnea-hypopnea-index (AHI) /non-REM (NREM) AHI ≥ 2. In all, 73 (25.5%) had REM-predominant OSA. They were more likely to be female (26.0% vs. 9.9%; p = 0.001), and more obese (42.5% vs. 24.4%; p = 0.003) but had less severe OSA in terms of AHI (median 22.6/h vs. 36.6/h; p &lt; 0.001) compared to the patients with non-stage specific OSA. In adjusted logistic regression models, female sex (odds ratio [OR] 4.64, 95% confidence interval [CI] 1.85–11.64), body-mass-index (BMI; OR 1.17; 95% CI 1.07–1.28) and AHI (OR 0.93, 95% CI 0.91–0.95) were associated with REM-predominant OSA. In univariate linear regression models, there was a dose-response relationship between REM-AHI and Zung Self-rated Depression Scale but not excessive sleepiness, functional outcomes, and anxiety scores. Among the Short Form-36 subdomains, Vitality, Mental Health, and Mental Component Summary (MCS) scores were inversely correlated with REM-AHI. In multivariate linear models, only MCS remained significantly associated with REM-AHI after adjustment for age, BMI, and sex (β-coefficient −2.20, %95 CI [−0.56, −0.03]; p = 0.028). To conclude, female sex and BMI were related to REM-predominant OSA in this revascularized cohort. MCS was inversely associated with REM-AHI in the multivariate model.</p>}},
  author       = {{Balcan, Baran and Celik, Yeliz and Newitt, Jennifer and Strollo, Patrick J. and Peker, Yüksel}},
  issn         = {{2077-0383}},
  keywords     = {{coronary artery disease; depression; obstructive sleep apnea; quality of life; REM sleep}},
  language     = {{eng}},
  month        = {{08}},
  number       = {{15}},
  publisher    = {{MDPI AG}},
  series       = {{Journal of Clinical Medicine}},
  title        = {{REM-Predominant Obstructive Sleep Apnea in Patients with Coronary Artery Disease}},
  url          = {{http://dx.doi.org/10.3390/jcm11154402}},
  doi          = {{10.3390/jcm11154402}},
  volume       = {{11}},
  year         = {{2022}},
}