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Eur Respir J. 2018 Aug 16;52(2). pii: 1702484. doi: 10.1183/13993003.02484-2017. Print 2018 Aug.

REM-associated sleep apnoea: prevalence and clinical significance in the HypnoLaus cohort.

Author information

1
Center for Investigation and Research in Sleep (CIRS), University Hospital of Lausanne, Lausanne, Switzerland.
2
Pulmonary Dept, University Hospital Ramon y Cajal, Madrid, Spain.
3
P. Acosta-Castro and C. Hirotsu contributed equally to this study as co-first authors.
4
Institute of Social and Preventive Medicine, University Hospital of Lausanne, Lausanne, Switzerland.
5
Dept of Internal Medicine, University Hospital of Lausanne, Lausanne, Switzerland.
6
Psychiatry Dept, University Hospital of Lausanne, Lausanne, Switzerland.
7
J. Haba-Rubio and R. Heinzer contributed equally to this study as co-last authors.

Abstract

This study determined the prevalence of rapid eye movement (REM) related sleep-disordered breathing (REM-SDB) in the general population and investigated the associations of REM-SDB with hypertension, metabolic syndrome, diabetes and depression.Home polysomnography (PSG) recordings (n=2074) from the population-based HypnoLaus Sleep Cohort (48.3% men, 57±11 years old) were analysed. The apnoea-hypopnoea index was measured during REM and non-REM sleep (as REM-AHI and NREM-AHI, respectively). Regression models were used to explore the associations between REM-SDB and hypertension, diabetes, metabolic syndrome and depression in the entire cohort and in subgroups with NREM-AHI <10 events·h-1 and total AHI <10 events·h-1The prevalence of REM-AHI ≥20 events·h-1 was 40.8% in the entire cohort. An association between increasing REM-AHI and metabolic syndrome was found in the entire cohort and in both the NREM-AHI and AHI subgroups (p-trend=0.014, <0.0001 and 0.015, respectively). An association was also found between REM-AHI ≥20 events·h-1 and diabetes in both the NREM-AHI <10 events·h-1 (odds ratio (OR) 3.12 (95% CI 1.35-7.20)) and AHI <10 events·h-1 (OR 2.92 (95% CI 1.12-7.63)) subgroups. Systolic and diastolic blood pressure were positively associated with REM-AHI ≥20 events·h-1REM-SDB is highly prevalent in our middle-to-older age sample and is independently associated with metabolic syndrome and diabetes. These findings suggest that an increase in REM-AHI could be clinically relevant.

Conflict of interest statement

Conflict of interest: M. Preisig reports unrestricted research grants from the Swiss National Science Foundation and GlaxoSmithKline, during the conduct of the study. Conflict of interest: P. Vollenweider reports an unrestricted grant to build the CoLaus cohort, from GlaxoSmithKline, during the conduct of the study. Conflict of interest: R. Heinzer reports grants from the Swiss National Science Foundation (grants 3200B0-105993, 3200B0-118308, 33CSCO-122661, 33CS30-139468 and 33CS30-148401), the Leenaards Foundation, the Ligue Pulmonaire Vaudoise, GlaxoSmithKline and the Faculty of Biology and Medicine of Lausanne University, during the conduct of the study; and personal fees for medical advisory board work from Nightbalance, outside the submitted work.

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