Breathtaking dreams: reduced REM phenotype in REM-related sleep apnea

Luca Cerina; Pedro Fonseca; Gabriele B. Papini; Rik Vullings; Sebastiaan Overeem

doi:10.1007/s11325-024-03236-5

Breathtaking dreams: reduced REM phenotype in REM-related sleep apnea

Luca Cerina (Corresponding author), Pedro Fonseca, Gabriele B. Papini, Rik Vullings, Sebastiaan Overeem

Signal Processing Systems

Onderzoeksoutput: Bijdrage aan tijdschrift › Tijdschriftartikel › Academic › peer review

6 Downloads (Pure)

Samenvatting

PURPOSE: The expression of the respiratory events in OSA is influenced by different mechanisms. In particular, REM sleep can highly increase the occurrence of events in a subset of OSA patients, a condition dubbed REM-OSA (often defined as an AHI 2 times higher in REM than NREM sleep). However, a proper characterization of REM-OSA and its pathological sequelae is still inadequate, partly because of limitations in the current definitions.

METHODS: We propose a new interpretation of the REM-OSA definition, extending it from a AHI-ratio to a two-dimensional space, considering both time and events ratios in REM over NREM separately. Within this space, we analyzed current definitions of REM-OSA in three large clinical dataset and identified the underlying sources of heterogeneity.

RESULTS: We observed that REM-OSA and REM-independent-OSA subgroups exist. Some subgroups exhibited abnormal REM characteristics (e.g., REM-OSA with reduced time in REM). Others had OSA features that are intermediate between REM-independent-OSA participants and those with a clear disproportion of REM events.

CONCLUSION: We found that a time and events' ratio of REM and NREM allow a more precise characterization of REM-OSA subgroups. Our new interpretation can be used to bolster new research into REM-OSA pathophysiological mechanisms.

Originele taal-2	Engels
Artikelnummer	87
Aantal pagina's	16
Tijdschrift	Sleep & Breathing
Volume	29
Nummer van het tijdschrift	1
Vroegere onlinedatum	22 jan. 2025
DOI's	https://doi.org/10.1007/s11325-024-03236-5
Status	Gepubliceerd - mrt. 2025

Bibliografische nota

Financiering

This work was performed within the IMPULS framework of the Eindhoven MedTech Innovation Center (e/MTIC, incorporating Eindhoven University of Technology, Philips Research, and Sleep Medicine Center Kempenhaeghe), including a PPS-supplement from Dutch Ministry of Economic Affairs and Climate Policy. Additional support by STW/IWT in the context of the OSA + project (No. 14619). The sponsor had no role in the design or conduct of this research. All authors certify that they have no affiliations with or involvement in any organization or entity with any financial interest (such as honoraria; educational grants; participation in speakers' bureaus; membership, employment, consultancies, stock ownership, or other equity interest; and expert testimony or patent-licensing arrangements), or non-financial interest (such as personal or professional relationships, affiliations, knowledge or beliefs) in the subject matter or materials discussed in this manuscript. L.C., G.P., and P.F. were employed and/or affiliated with Royal Philips. R.V. is co-founder and shareholder of Nemo Healthcare BV. S.O. received an unrestricted research grant from UCB Pharma and participated in advisory boards for Jazz Pharmaceuticals, Bioprojet, and Abbvie. None of these companies had a role in the study design, decision to publish, or preparation of the manuscript.

Toegang tot document

10.1007/s11325-024-03236-5

pdfDefinitieve gepubliceerde versie, 2,33 MBLicentie: CC BY

Andere bestanden en links

Link naar publicatie in Scopus

Sleep Medicine
van Gilst, M. M. (Content manager) & van der Hout-van der Jagt, M. B. (Content manager)
Impact: Research Topic/Theme (at group level)

Citeer dit

@article{7cb8d53169a04ae69115c56bd62da68b,

title = "Breathtaking dreams: reduced REM phenotype in REM-related sleep apnea",

abstract = "PURPOSE: The expression of the respiratory events in OSA is influenced by different mechanisms. In particular, REM sleep can highly increase the occurrence of events in a subset of OSA patients, a condition dubbed REM-OSA (often defined as an AHI 2 times higher in REM than NREM sleep). However, a proper characterization of REM-OSA and its pathological sequelae is still inadequate, partly because of limitations in the current definitions.METHODS: We propose a new interpretation of the REM-OSA definition, extending it from a AHI-ratio to a two-dimensional space, considering both time and events ratios in REM over NREM separately. Within this space, we analyzed current definitions of REM-OSA in three large clinical dataset and identified the underlying sources of heterogeneity.RESULTS: We observed that REM-OSA and REM-independent-OSA subgroups exist. Some subgroups exhibited abnormal REM characteristics (e.g., REM-OSA with reduced time in REM). Others had OSA features that are intermediate between REM-independent-OSA participants and those with a clear disproportion of REM events.CONCLUSION: We found that a time and events' ratio of REM and NREM allow a more precise characterization of REM-OSA subgroups. Our new interpretation can be used to bolster new research into REM-OSA pathophysiological mechanisms.",

keywords = "Humans, Sleep, REM/physiology, Male, Sleep Apnea, Obstructive/physiopathology, Female, Polysomnography, Middle Aged, Adult, Dreams/physiology, Phenotype, Aged, Obstructive sleep apnea, Sleep-disordered breathing, REM sleep, Rapid eye movement, REM-related sleep apnea",

author = "Luca Cerina and Pedro Fonseca and Papini, \{Gabriele B.\} and Rik Vullings and Sebastiaan Overeem",

note = "{\textcopyright} 2025. The Author(s).",

year = "2025",

month = mar,

doi = "10.1007/s11325-024-03236-5",

language = "English",

volume = "29",

journal = "Sleep \& Breathing",

issn = "1520-9512",

publisher = "Springer",

number = "1",

}

TY - JOUR

T1 - Breathtaking dreams

T2 - reduced REM phenotype in REM-related sleep apnea

AU - Cerina, Luca

AU - Fonseca, Pedro

AU - Papini, Gabriele B.

AU - Vullings, Rik

AU - Overeem, Sebastiaan

PY - 2025/3

Y1 - 2025/3

N2 - PURPOSE: The expression of the respiratory events in OSA is influenced by different mechanisms. In particular, REM sleep can highly increase the occurrence of events in a subset of OSA patients, a condition dubbed REM-OSA (often defined as an AHI 2 times higher in REM than NREM sleep). However, a proper characterization of REM-OSA and its pathological sequelae is still inadequate, partly because of limitations in the current definitions.METHODS: We propose a new interpretation of the REM-OSA definition, extending it from a AHI-ratio to a two-dimensional space, considering both time and events ratios in REM over NREM separately. Within this space, we analyzed current definitions of REM-OSA in three large clinical dataset and identified the underlying sources of heterogeneity.RESULTS: We observed that REM-OSA and REM-independent-OSA subgroups exist. Some subgroups exhibited abnormal REM characteristics (e.g., REM-OSA with reduced time in REM). Others had OSA features that are intermediate between REM-independent-OSA participants and those with a clear disproportion of REM events.CONCLUSION: We found that a time and events' ratio of REM and NREM allow a more precise characterization of REM-OSA subgroups. Our new interpretation can be used to bolster new research into REM-OSA pathophysiological mechanisms.

AB - PURPOSE: The expression of the respiratory events in OSA is influenced by different mechanisms. In particular, REM sleep can highly increase the occurrence of events in a subset of OSA patients, a condition dubbed REM-OSA (often defined as an AHI 2 times higher in REM than NREM sleep). However, a proper characterization of REM-OSA and its pathological sequelae is still inadequate, partly because of limitations in the current definitions.METHODS: We propose a new interpretation of the REM-OSA definition, extending it from a AHI-ratio to a two-dimensional space, considering both time and events ratios in REM over NREM separately. Within this space, we analyzed current definitions of REM-OSA in three large clinical dataset and identified the underlying sources of heterogeneity.RESULTS: We observed that REM-OSA and REM-independent-OSA subgroups exist. Some subgroups exhibited abnormal REM characteristics (e.g., REM-OSA with reduced time in REM). Others had OSA features that are intermediate between REM-independent-OSA participants and those with a clear disproportion of REM events.CONCLUSION: We found that a time and events' ratio of REM and NREM allow a more precise characterization of REM-OSA subgroups. Our new interpretation can be used to bolster new research into REM-OSA pathophysiological mechanisms.

KW - Humans

KW - Sleep, REM/physiology

KW - Male

KW - Sleep Apnea, Obstructive/physiopathology

KW - Female

KW - Polysomnography

KW - Middle Aged

KW - Adult

KW - Dreams/physiology

KW - Phenotype

KW - Aged

KW - Obstructive sleep apnea

KW - Sleep-disordered breathing

KW - REM sleep

KW - Rapid eye movement

KW - REM-related sleep apnea

UR - http://www.scopus.com/inward/record.url?scp=85216608370&partnerID=8YFLogxK

U2 - 10.1007/s11325-024-03236-5

DO - 10.1007/s11325-024-03236-5

M3 - Article

C2 - 39843647

SN - 1520-9512

VL - 29

JO - Sleep & Breathing

JF - Sleep & Breathing

IS - 1

M1 - 87

ER -

Breathtaking dreams: reduced REM phenotype in REM-related sleep apnea

Samenvatting

Bibliografische nota

Financiering

Toegang tot document

Andere bestanden en links

Vingerafdruk

Impact

Sleep Medicine

Citeer dit