Sleep Med Psychophysiol.  2005 Jun;12(1):68-71.

A Case of REM-Dependent Obstructive Sleep Apnea Syndrome

Affiliations
  • 1Division of Sleep Studies and Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Korea. jeongdu@snu.ac.kr
  • 2Department of Psychiatry and Behavioral Science, Seoul National University College of Medicine, and Division of Sleep Studies and Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Korea.

Abstract

We report a case of obstructive sleep apnea syndrome, which occurred primarily during the REM sleep stage. A 55-year-old female patient who complained of chronic insomnia on the initial visit turned out to have obstructive sleep apnea syndrome of a mild degree (respiratory disturbance index (RDI) of 13.8/hour, %time spent below 90% of SaO2=5.0%) on nocturnal polysomnography. Interestingly, apnea episodes and desaturations mainly occurred during REM sleep stage. And RDI and destaturations during REM sleep stage were found to be severe enough to classify as a severe degree of obstructive sleep apnea syndrome. These findings suggest that severe obstructive sleep apnea syndrome might be masked under the symptom of chronic insomnia and that apneas can be predominantly localized within REM sleep epochs. In terms of treatment, "REM sleep-dependent" apneas may call for different methods of treatment, especially REM sleep-specific pharmacological intervention.

Keyword

Obstructive sleep apnea; REM sleep; REM sleep-dependent apnea; Chronic insomnia
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