REM相关阻塞性睡眠呼吸暂停的临床研究进展

张香侠; 厉雪艳; 陈贵海; 葛义俊

doi:10.13201/j.issn.2096-7993.2022.02.015

REM相关阻塞性睡眠呼吸暂停的临床研究进展

- 安徽医科大学附属巢湖医院睡眠障碍科(安徽巢湖，238000)
基金项目:
国家自然科学基金面上项目(No：81671316)；安徽高校自然科学研究项目(No：KJ2019A0270)

详细信息

通讯作者: 葛义俊，E-mail：geyijun1984@126.com

中图分类号: R766

收稿日期: 2021-03-02

刊出日期: 2022-02-03

Progress in clinical research of REM-related obstructive sleep apnea

More Information

Corresponding author: GE Yijun, E-mail: geyijun1984@126.com

Received Date: 02 March 2021

Publish Date: 03 February 2022

摘要

- 阻塞性睡眠呼吸暂停 /
- 快速眼球运动 /
- 呼吸暂停低通气指数
Abstract: REM-related obstructive sleep apnea (REM-OSA) refers to apneas and hypopneas in which most respiratory events occur during REM. The total AHI of REM-OSA is low compared to NREM-OSA, but the duration of apnea hypopnea events is longer and the oxygen saturation is lower. Only focusing on the total AHI value will miss the diagnosis of REM-OSA, and even some patients with severe hypoxemia cannot be effectively treated.REM-OSA may be an early manifestation of OSA, and active early recognition and intervention may benefit patients.The pathophysiology and mechanism of REM-OSA are still unclear. In this article, we reviewed the existing REM-OSA related research.
- obstructive sleep apnea /
- rapid eye movement /
- apnea-hypopnea index

HTML全文

参考文献(33)

[1]	中华医学会, 中华医学会杂志社, 中华医学会全科医学分会, 等. 成人阻塞性睡眠呼吸暂停基层诊疗指南(2018年)[J]. 中华全科医师杂志, 2019, 18(1): 21-21. doi: 10.3760/cma.j.issn.1671-7368.2019.01.007
[2]	陈贵海, 张立强, 高雪梅, 等. 成人阻塞性睡眠呼吸暂停多学科诊疗指南[J]. 中华医学杂志, 2018, 98(24): 1902-1914. doi: 10.3760/cma.j.issn.0376-2491.2018.24.003
[3]	Mokhlesi B, Finn LA, Hagen EW, et al. Obstructive sleep apnea during REM sleep and hypertension. results of the Wisconsin Sleep Cohort[J]. Am J Respir Crit Care Med, 2014, 190(10): 1158-1167. doi: 10.1164/rccm.201406-1136OC
[4]	厉雪艳, 何硕, 张香侠, 等. 快速动眼睡眠型和非快速动眼睡眠型阻塞性睡眠呼吸暂停综合征患者的临床特征分析[J]. 临床神经病学杂志, 2021, 34(2): 81-85. doi: 10.3969/j.issn.1004-1648.2021.02.001
[5]	Mokhlesi B, Punjabi NM. "REM-related" obstructive sleep apnea: an epiphenomenon or a clinically important entity?[J]. Sleep, 2012, 35(1): 5-7. doi: 10.5665/sleep.1570
[6]	Conwell W, Patel B, Doeing D, et al. Prevalence, clinical features, and CPAP adherence in REM-related sleep-disordered breathing: a cross-sectional analysis of a large clinical population[J]. Sleep Breath, 2012, 16(2): 519-526. doi: 10.1007/s11325-011-0537-6
[7]	Gupta R, Lahan V, Sindhwani G. Sleep-stage-independent obstructive sleep apnea: an unidentified group?[J]. Neurol Sci, 2013, 34(9): 1543-1550. doi: 10.1007/s10072-012-1281-9
[8]	叶京英, 韩德民, 李彦如, 等. 快动眼睡眠期相关阻塞性睡眠呼吸暂停综合征人群特征的研究[J]. 首都医科大学学报, 2009, 30(6): 746-751. doi: 10.3969/j.issn.1006-7795.2009.06.005
[9]	郑雪松, 后农生, 郝锐. 快动眼睡眠相关阻塞性睡眠呼吸暂停低通气综合征的睡眠监测特点[J]. 中国耳鼻咽喉头颈外科, 2010, 17(10): 543-545. https://www.cnki.com.cn/Article/CJFDTOTAL-EBYT201010019.htm
[10]	柴丽萍, 谢绚, 曾宇慧, 等. 阻塞性睡眠呼吸暂停低通气综合征快动眼与非快动眼分型的多道睡眠图分析[J]. 中华耳鼻咽喉头颈外科杂志, 2010, 45(2): 105-108. doi: 10.3760/cma.j.issn.1673-0860.2010.02.004
[11]	McSharry DG, Saboisky JP, Deyoung P, et al. Physiological mechanisms of upper airway hypotonia during REM sleep[J]. Sleep, 2014, 37(3): 561-569. doi: 10.5665/sleep.3498
[12]	Bahammam RA, Al-Qahtani KM, Aleissi SA, et al. The Associations of Gender, Menopause, Age, and Asthma with REM-Predominant Obstructive Sleep Apnea: A Prospective Observational Study[J]. Nat Sci Sleep, 2020, 12: 721-735. doi: 10.2147/NSS.S275051
[13]	Zinchuk AV, Gentry MJ, Concato J, et al. Phenotypes in obstructive sleep apnea: A definition, examples and evolution of approaches[J]. Sleep Med Rev, 2017, 35: 113-123. doi: 10.1016/j.smrv.2016.10.002
[14]	Koo BB, Patel SR, Strohl K, et al. Rapid eye movement-related sleep-disordered breathing: influence of age and gender[J]. Chest, 2008, 134(6): 1156-1161. doi: 10.1378/chest.08-1311
[15]	Koo P, Gartman EJ, Sethi JM, et al. End-expiratory lung volume decreases during REM sleep despite continuous positive airway pressure[J]. Sleep Breath, 2020, 24(1): 119-125. doi: 10.1007/s11325-019-01857-9
[16]	Penzel T, Wessel N, Riedl M, et al. Cardiovascular and respiratory dynamics during normal and pathological sleep[J]. Chaos, 2007, 17(1): 015116. doi: 10.1063/1.2711282
[17]	Imadojemu VA, Mawji Z, Kunselman A, et al. Sympathetic chemoreflex responses in obstructive sleep apnea and effects of continuous positive airway pressure therapy[J]. Chest, 2007, 131(5): 1406-1413. doi: 10.1378/chest.06-2580
[18]	Goodfriend TL, Calhoun DA. Resistant hypertension, obesity, sleep apnea, and aldosterone: theory and therapy[J]. Hypertension, 2004, 43(3): 518-524. doi: 10.1161/01.HYP.0000116223.97436.e5
[19]	Chami HA, Gottlieb DJ, Redline S, et al. Association between Glucose Metabolism and Sleep-disordered Breathing during REM Sleep[J]. Am J Respir Crit Care Med, 2015, 192(9): 1118-1126. doi: 10.1164/rccm.201501-0046OC
[20]	Mokhlesi B, Grimaldi D, Van Cauter E. Response to comment on Grimaldi et al. Association of obstructive sleep apnea in rapid eye movement sleep with reduced glycemic control in type 2 diabetes: therapeutic implications. Diabetes Care 2014;37: 355-363[J]. Diabetes Care, 2014, 37(3): e60-61. doi: 10.2337/dc13-2662
[21]	Shpirer I, Elizur A, Shorer R, et al. Hypoxemia correlates with attentional dysfunction in patients with obstructive sleep apnea[J]. Sleep Breath, 2012, 16(3): 821-827. doi: 10.1007/s11325-011-0582-1
[22]	Scarpina F, Bastoni I, Cappelli S, et al. Psychological Well-Being in Obstructive Sleep Apnea Syndrome Associated With Obesity: The Relationship With Personality, Cognitive Functioning, and Subjective and Objective Sleep Quality[J]. Front Psychol, 2021, 12: 588767. doi: 10.3389/fpsyg.2021.588767
[23]	Aleisa AM, Alzoubi KH, Alkadhi KA. Post-learning REM sleep deprivation impairs long-term memory: reversal by acute nicotine treatment[J]. Neurosci Lett, 2011, 499(1): 28-31. doi: 10.1016/j.neulet.2011.05.025
[24]	Gupta R, Lahan V, Sindhwani G. Sleep-stage-independent obstructive sleep apnea: an unidentified group?[J]. Neurol Sci, 2013, 34(9): 1543-1550. doi: 10.1007/s10072-012-1281-9
[25]	Kryger MH, Roth T, Dement W. Principles and Practice of Sleep Medicine[M]. 6th ed. Philadelphia: Elsevier, 2017: 1-10.
[26]	Loadsman JA. Half of patients with obstructive sleep apnea have a higher NREM AHI than REM AHI[J]. Sleep Med, 2008, 9(4): 466-467. doi: 10.1016/j.sleep.2007.07.005
[27]	周静, 吴效明. 基于样本熵的睡眠呼吸暂停综合征脑电研究[J]. 中国医学物理学杂志, 2016, 33(7): 722-725. doi: 10.3969/j.issn.1005-202X.2016.07.017
[28]	周静, 吴效明. 睡眠呼吸暂停综合征患者脑电的去趋势波动分析[J]. 生物医学工程学杂志, 2016, 33(5): 842-846. https://www.cnki.com.cn/Article/CJFDTOTAL-SWGC201605004.htm
[29]	Koo BB, Dostal J, Ioachimescu O, et al. The effects of gender and age on REM-related sleep-disordered breathing[J]. Sleep Breath, 2008, 12(3): 259-264. doi: 10.1007/s11325-007-0161-7
[30]	Al Oweidat K, AlRyalat SA, Al-Essa M, et al. Comparing REM-and NREM-Related Obstructive Sleep Apnea in Jordan: A Cross-Sectional Study[J]. Can Respir J, 2018, 2018: 9270329.
[31]	BaHammam AS, Al-Shimemeri SA, Salama RI, et al. Clinical and polysomnographic characteristics and response to continuous positive airway pressure therapy in obstructive sleep apnea patients with nightmares[J]. Sleep Med, 2013, 14(2): 149-154. doi: 10.1016/j.sleep.2012.07.007
[32]	Carrasco E, Santamaria J, Iranzo A, et al. Changes in dreaming induced by CPAP in severe obstructive sleep apnea syndrome patients[J]. J Sleep Res, 2006, 15(4): 430-436. doi: 10.1111/j.1365-2869.2006.00553.x
[33]	Carley DW, Prasad B, Reid KJ, et al. Pharmacotherapy of apnea by cannabimimetic enhancement, the PACE clinical trial: effects of dronabinol in obstructive sleep apnea[J]. Sleep, 2018, 41(1): zsx184.