Continuous positive airway pressure in patients with rapid eye movement (REM)-specific obstructive sleep apnea, a retrospective match-controlled chart review

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Background: Rapid eye movement (REM) obstructive sleep apnea (OSA) represents 13 to 35% of all OSA cases and is more common in women. Continuous positive airway pressure (CPAP) is the gold standard for treatment of all forms of OSA but we do not know if patients with REM OSA have different pressure requirements than those with non-stage dependent OSA. Methods: This was a retrospective case control study. We first identified individuals with REM OSA and then tried to identify apnea hypopnea index (AHI), gender, and body mass index (BMI) matching controls that had non-stage specific OSA. Individuals were considered to have REM OSA if the REM AHI was greater than 5 events/hour, and the ratio of REM AHI / non-rapid eye movement (NREM) AHI was greater than 2. Demographic variables and the recommended CPAP pressure were analyzed using paired Student’s T-Tests. Results: Our study included a total of 16 individuals with REM OSA and equal number of AHI, gender, and BMI matching controls. Both groups had similar demographic and polysomnographic characteristics. Individuals with REM OSA required similar CPAP pressures as controls (7.5 cm H 2O vs 7.4 cm H 2O p=0.78). Conclusion: Individuals with REM might require similar CPAP pressures as their AHI, gender, and BMI matching controls.