Multilevel surgery in patients with rapid eye movement–related obstructive sleep apnea

Abstract

To compare the anatomic features and the results of a multilevel surgery in patients with rapid eye movement-related obstructive sleep apnea (REM OSA) and non-REM OSA. Cohort study of 90 consecutive mild or moderate OSA patients. The apnea-hypopnea index (AHI) was also calculated during REM sleep (AHI(REM)) and during non-REM sleep (AHI(NREM)), and patients were classified as having REM OSA if their AHI(REM)/AHI(NREM) ratio was >2, otherwise they were classified as non-REM OSA patients. All patients underwent concurrent uvulopalatopharyngoplasty and a radiofrequency tongue base reduction procedure. A total of 31.1 percent patients were classified as REM OSA and 68.9 percent patients as non-REM OSA. There were no differences in the anatomical features between two groups. However, the AHI, HI, and arousal index were significantly higher in the non-REM OSA group than in the REM OSA group. When a successful outcome was defined as a postoperative AHI <20 with at least a 50 percent reduction from the preoperative level, 50 percent of the patients with REM OSA and 35.5 percent of the patients with non-REM OSA met the criteria for a successful outcome. REM OSA patients had milder obstructive sleep apnea, and multilevel surgery might be more effective in REM OSA patients.