Clinical Characteristics of Rapid Eye Movement-Related Obstructive Sleep Apnea: An Experience in a Tertiary Medical Center of Taiwan

Hwa-Yen Chiu,1– 4 Yung-Yang Liu,1,4 Tsu-Hui Shiao,1,4 Kang-Cheng Su,1,4 Kun-Ta Chou,1,4 Yuh-Min Chen1,4 1Chest Department, Taipei Veterans General Hospital, Taipei, 11217, Taiwan, Republic of China; 2Institute of Biophotonics, National Yang Ming Chiao Tung University, Taipei, 112, Taiwan, Republic of China; 3Division of Internal Medicine, Hsinchu Branch, Taipei Veterans General Hospital, Hsinchu, 31064, Taiwan, Republic of China; 4School of Medicine, Faculty of Medicine, National Yang Ming Chiao Tung University, Taipei, 112, Taiwan, Republic of ChinaCorrespondence: Yung-Yang Liu, Chest Department, Taipei Veterans General Hospital, No. 201, Sec. 2, Shipai Road, Beitou District, Taipei City, 11217, Taiwan, Republic of China, Tel +886-2-2871-2121 ext. 3071, Fax +886-2-2875-7858, Email yyliu1103@gmail.comPurpose: Obstructive sleep apnea (OSA) is characterized by intermittent hypoxemia and sleep fragmentation. While apnea is pronounced with severe desaturation during rapid eye movement (REM) sleep, REM-related OSA is a distinct phenotype of OSA associated with respiratory disturbances predominantly during REM sleep. In this study, we investigated the clinical features of REM-related OSA in Taiwan.Patients and Methods: All patients diagnosed with OSA in the Taipei Veterans General Hospital from 2015 to 2017 were analyzed retrospectively and classified into REM-related OSA (REM-OSA) group, non-REM related OSA (NREM-OSA) group, and non-stage specific-OSA group. The clinical demographics, OSA-related symptoms, polysomnography results, and medical comorbidities of the three groups were analyzed.Results: Among 1331 patients with OSA, 414 (31.1%) were classified as REM-OSA, 808 (60.7%) as NREM-OSA, and 109 (8.2%) as non-stage specific-OSA. After being adjusted for OSA severity, the REM-OSA group was associated with less portion of males, longer desaturation duration, and lower nadir oxygen saturation (SpO2) compared with the NREM-OSA group in mild and moderate OSA. In moderat