Assessment of the Impact of Different Diagnostic Definitions on REM-related Obstructive Sleep Apnea: Board versus Restricted?
Journal Title: Journal of Turkish Sleep Medicine - Year 2020, Vol 7, Issue 3
Abstract
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.
Authors and Affiliations
Burcu Oktay Arslan, Özlem Yalnız, Zeynep Zeren Uçar Hoşgör
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