Türk Uyku Tıbbı Dergisi (Sep 2020)

Assessment of the Impact of Different Diagnostic Definitions on REM-related Obstructive Sleep Apnea: Board versus Restricted?

  • Burcu Oktay Arslan,
  • Özlem Yalnız,
  • Zeynep Zeren Uçar Hoşgör

DOI
https://doi.org/10.4274/jtsm.galenos.2020.70894
Journal volume & issue
Vol. 7, no. 3
pp. 124 – 130

Abstract

Read online

Objective:To evaluate the differences in demographic and polysomnographic (PSG) features between the board and restricted definitions of rapid eye movement (REM)-related obstructive sleep apnea (OSA), and whether different diagnostic criteria lead to different clinical classifications and treatment approaches.Materials and Methods:A total of 1096 patient files were screened for REM-related OSA. Patients with REM-related OSA were included in the study and classified into two groups according to the board and restricted definition of REM-related OSA. Demographic and PSG features and treatment approaches were compared between both groups.Results:This study Included a total of 154 patients: 33 (21.4%) were classified as restricted REM-related and 121 (78.6%) as board REM-related OSA. There were no differences between the two groups in terms of age (p=0.061), sex (p=0.274), Body Mass index (p=0.055), and co-morbidities (p=0.299). Significant differences were observed between the groups with regard to Epworth Sleepiness scale (p=0.033). The total Apne-hipopne index (AHI), AHIREM, and AHINREM in the board REM-related OSA group were significantly higher than those in the restricted REM-related OSA group (p<0.001). Treatment with only lifestyle interventions was recommended to fifty-one (35.1%) patients, whereas positive airway passage therapy was recommended to 100 (64.9%) patients. Forty-one (26.6%) patients refused PAP titration. Lifestyle interventions only were recommended more commonly to patients with restricted REM-related OSA than to those with board REM-related OSA (p=0.004).Conclusion:The restricted definition of REM-related OSA yields milder but sleepy patients compared with the board definition. Particular attention should be given to sleepy patients with milder REM-related OSA with regard to the treatment options. Not only lifestyle interventions, but also PAP therapy should be considered in the treatment of patients who are sleepier.

Keywords