Sleep and Breathing

, Volume 16, Issue 2, pp 519–526 | Cite as

Prevalence, clinical features, and CPAP adherence in REM-related sleep-disordered breathing: a cross-sectional analysis of a large clinical population

  • Walter Conwell
  • Bhakti Patel
  • Diana Doeing
  • Sushmita Pamidi
  • Kristen L. Knutson
  • Farbod Ghods
  • Babak MokhlesiEmail author
Original Article



Due to inconsistent definitions used in the literature, the prevalence of rapid eye movement (REM)-related sleep-disordered breathing (SDB) has been quite variable and its clinical significance remains unclear. This study aimed to compare the prevalence of and clinical characteristics between various criteria for defining REM-related SDB. We also investigated how frequently CPAP therapy was recommended in patients with REM-related SDB and if they had lower CPAP adherence compared to non-stage-specific SDB.


In this cross-sectional study, we evaluated 1,019 consecutive adults referred for a polysomnogram for suspicion of SDB. The prevalence of REM-related SDB was calculated based on “traditional criteria” commonly reported in the literature and a “strict criteria” that minimized the contribution of SDB during non-REM sleep.


The prevalence of REM-related SDB ranged from 13.5% to 36.7%. There were no clinically significant differences between the strict definition and the traditional definition of REM-related SDB. REM-related SDB was more prevalent in women, younger individuals and African Americans. Compared to non-stage-specific obstructive sleep apnea (OSA), patients with REM-related SDB were equally symptomatic and hypersomnolent. CPAP titration was recommended in 88% of patients with REM-related SDB vs. 94% of patients with non-stage-specific OSA (p < 0.001). There was no significant difference in CPAP adherence between the two groups.


Regardless of how REM-related SDB is defined, it was highly prevalent in our large clinical cohort. Compared to non-stage-specific OSA, these patients were equally hypersomnolent and adherent to CPAP therapy despite having overall significantly milder OSA. Further research is needed to better establish whether these patients will derive any benefit from long-term CPAP therapy.


Obstructive sleep apnea REM-related obstructive sleep apnea REM-related sleep-disordered breathing CPAP adherence 


Conflicts of interest

None of the authors have a conflict of interest to disclose.


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Copyright information

© Springer-Verlag 2011

Authors and Affiliations

  • Walter Conwell
    • 1
  • Bhakti Patel
    • 1
  • Diana Doeing
    • 1
    • 2
  • Sushmita Pamidi
    • 1
    • 2
  • Kristen L. Knutson
    • 1
    • 2
  • Farbod Ghods
    • 2
  • Babak Mokhlesi
    • 1
    • 2
    Email author
  1. 1.Department of MedicineUniversity of ChicagoChicagoUSA
  2. 2.Sleep Disorders Center, Section of Pulmonary and Critical Care, Department of MedicineUniversity of ChicagoChicagoUSA

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