REM-associated sleep apnoea: prevalence and clinical significance in the HypnoLaus cohort

Eur Respir J. 2018 Aug 16;52(2):1702484. doi: 10.1183/13993003.02484-2017. Print 2018 Aug.

Abstract

This study determined the prevalence of rapid eye movement (REM) related sleep-disordered breathing (REM-SDB) in the general population and investigated the associations of REM-SDB with hypertension, metabolic syndrome, diabetes and depression.Home polysomnography (PSG) recordings (n=2074) from the population-based HypnoLaus Sleep Cohort (48.3% men, 57±11 years old) were analysed. The apnoea-hypopnoea index was measured during REM and non-REM sleep (as REM-AHI and NREM-AHI, respectively). Regression models were used to explore the associations between REM-SDB and hypertension, diabetes, metabolic syndrome and depression in the entire cohort and in subgroups with NREM-AHI <10 events·h-1 and total AHI <10 events·h-1The prevalence of REM-AHI ≥20 events·h-1 was 40.8% in the entire cohort. An association between increasing REM-AHI and metabolic syndrome was found in the entire cohort and in both the NREM-AHI and AHI subgroups (p-trend=0.014, <0.0001 and 0.015, respectively). An association was also found between REM-AHI ≥20 events·h-1 and diabetes in both the NREM-AHI <10 events·h-1 (odds ratio (OR) 3.12 (95% CI 1.35-7.20)) and AHI <10 events·h-1 (OR 2.92 (95% CI 1.12-7.63)) subgroups. Systolic and diastolic blood pressure were positively associated with REM-AHI ≥20 events·h-1REM-SDB is highly prevalent in our middle-to-older age sample and is independently associated with metabolic syndrome and diabetes. These findings suggest that an increase in REM-AHI could be clinically relevant.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Blood Pressure
  • Cohort Studies
  • Depression / epidemiology*
  • Diabetes Mellitus / epidemiology*
  • Female
  • Humans
  • Hypertension / epidemiology*
  • Linear Models
  • Logistic Models
  • Male
  • Metabolic Syndrome / epidemiology*
  • Middle Aged
  • Polysomnography
  • Prevalence
  • Severity of Illness Index
  • Sleep Apnea Syndromes / diagnosis
  • Sleep Apnea Syndromes / epidemiology*
  • Sleep, REM*
  • Switzerland / epidemiology