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Association between REM-related mild obstructive sleep apnea and common cardiometabolic diseases

  • Sleep Breathing Physiology and Disorders • Original Article
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Abstract

Purpose

To explore the association between rapid eye movement-related obstructive sleep apnea (REM-OSA) and common cardiometabolic diseases (CMDs) in patients with mild OSA.

Methods

This retrospective study was conducted by reviewing the medical records and polysomnograms (PSGs) of patients at Siriraj Hospital. The PSGs of patients diagnosed with mild OSA who had ≥ 15 min of REM sleep were included. REM-OSA was defined if the apnea–hypopnea index (AHI) in REM was ≥ 2 times that of non-REM. Common CMDs included coronary artery disease, stroke, heart failure, diabetes mellitus, and hypertension.

Results

The data of 518 patients with a mean age of 48.3 years, 198 males, and mean AHI of 9.8 events/h were analyzed in this study. When compared with the control group, the REM-OSA group (308 patients) were predominantly female (72%), overweight (62%), and had more severe oxygen desaturation, p-value < 0.001. CMDs were significantly more common in the REM-OSA group than in the controls [odds ratio (OR) 1.52, 95% confidence interval 1.04–2.21, p-value = 0.029]. Patients with a REM AHI of ≥ 20 events/h were significantly associated with hypertension compared to those with a REM AHI of < 20 events/h, p-value = 0.001. However, these associations were found not to be statistically significant after controlling for age, sex, BMI, and prevalent coexisting CMD (OR = 1.13, 95% CI: 0.72–1.76, p-value = 0.605).

Conclusion

Common CMDs, particularly HT, tend to show an association with REM-OSA in patients with mild OSA, but this association did not reach statistically significant levels.

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Data availability

The datasets generated during and/or analysed during the current study are available from the corresponding author on reasonable request.

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Acknowledgements

This study was supported by the Faculty of Medicine, Siriraj Hospital, Mahidol University, Thailand. We appreciate the support of Miss Julaporn Pooliam, our consulting statistician, and Miss Jeerapa Kerdnoppakhun and Miss Ngamrat Treerassapanich for their assistance with manuscript preparation. We also would like to thank all the nurses and medical staff at the ENT Department and Siriraj Sleep Center for their kind cooperation in this study.

Funding

This study received no funding.

Author information

Authors and Affiliations

  1. Mahachai Prompathya Hospital, Ratchaburi, Thailand

    Titima Sangchan

  2. Department of Otorhinolaryngology, Faculty of Medicine Siriraj Hospital, Mahidol University, 2 Wanglang Road, Bangkoknoi, Bangkok, Thailand

    Wish Banhiran & Phawin Keskool

  3. Division of Neurology, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand

    Wattanachai Chotinaiwattarakul

  4. Siriraj Sleep Center, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand

    Sarin Rungmanee & Chawanont Pimolsri

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  1. Titima Sangchan
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  2. Wish Banhiran
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  4. Phawin Keskool
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Corresponding author

Correspondence to Wish Banhiran.

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Ethical approval

This retrospective study was conducted at the Faculty of Medicine Siriraj Hospital after being approved by the Institutional Review Board, Faculty of Medicine Siriraj Hospital, Mahidol University (COA. No. Si 147/2021). For this type of study formal consent is not required.

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The authors declare they have no conflicts of interest in this study.

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Sangchan, T., Banhiran, W., Chotinaiwattarakul, W. et al. Association between REM-related mild obstructive sleep apnea and common cardiometabolic diseases. Sleep Breath 27, 2265–2271 (2023). https://doi.org/10.1007/s11325-023-02821-4

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  • DOI: https://doi.org/10.1007/s11325-023-02821-4

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