The effects of gender and age on REM-related sleep-disordered breathing

Division of Sleep Medicine, Cleveland Clinic Foundation, Cleveland, OH 44106, USA.
Sleep And Breathing (Impact Factor: 2.48). 09/2008; 12(3):259-64. DOI: 10.1007/s11325-007-0161-7
Source: PubMed


Sleep disordered breathing occurring predominantly in rapid eye movement REM sleep (rapid-eye-movement-related sleep-disordered breathing, REM SDB) is present in 10 to 36% of patients undergoing polysomnography (PSG) for suspected obstructive sleep apnea (O'Connor et al. in Am J Respir Crit Care Med 161:1465-1472, 2000; Resta et al. in J Respir Medicine 99:91-96, 2005; Haba-Rubio et al. in Chest 128:3350-3357, 2005; Juvelekian and Golish, American Academy of Sleep Medicine, abstract, 2004). We hypothesize that REM SDB is an age-related condition in women and, additionally, more prevalent in women than in men. Subjects with REM SDB were identified retrospectively among 1,540 obstructive sleep apnea (OSA) patients with an apnea-hypopnea index (AHI) >or= 5. Inclusion criteria for REM SDB were age >18, AHI >or= 5, NREM AHI < 15, and REM AHI/NREM AHI > 2. PSG data included sleep latency, REM latency, total sleep time (TST), AHI, REM AHI, NREM AHI, and sleep stage percentages. Demographic data and medical and psychiatric histories were also obtained. Statistical comparisons were made between men and women and women older and younger than 55 years, a marker for menopausal status. Two hundred twenty-one subjects fulfilled the criteria for REM SDB, yielding a prevalence of 14.4%. Overall, female apneics had a significantly higher prevalence of REM SDB than did men (24.5 vs 7.9%; p < 0.001). Younger women had a significantly higher prevalence than did older women (27.2 vs 18.6%; p = 0.008); younger men had a significantly higher prevalence of REM SDB than did older men (9.9 vs 4.5%; p = 0.002). Women were significantly older and more obese than were men. Younger women were more likely to be depressed and were significantly more obese than were older women. REM SDB is more prevalent in women than in men and more prevalent in men and women younger than 55 than those older than 55. In this population, women are more obese and older than men, while younger women were more obese than older women. These descriptive distinctions suggest differences in mechanism which may depend on gender and age.

21 Reads
  • [Show abstract] [Hide abstract]
    ABSTRACT: The article first gives a brief introduction to the basic concepts of the TMT (Trustworthy Machine Translation) and S4 systems. A small TMT prototype is being built up in SIA which is funded by CAS. The author presents the safest way to transform some natural language which is called the duality-derived-equivalent formula; it uses unambiguous natural language-type 4th class symbols and is derived based on duality principles. Duality-derived-equivalent formulae are of absolute correctness that need not consider the context, so they can be used in TMT to guarantee the correctness of MT
    Systems, Man, and Cybernetics, 2001 IEEE International Conference on; 02/2001
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Obstructive sleep apnea syndrome (OSAS) is a relatively common disorder characterized by recurrent episodes of upper airway collapse and obstruction during sleep. It results in apneic events (or in the case of partial obstruction, hypopneic events) that lead to loud snoring, hypoxia, and arousals that interrupt the normal sleep cycle. Typically, these nocturnal arousals cause patients to complain of excessive daytime sleepiness, which may interfere with routine daily activities. More importantly, when moderate to severe, OSAS can lead to a wide variety of medical complications, some of which can result in severe consequences or even death.
    Dental Clinics of North America 11/2008; 52(4):891-915, viii. DOI:10.1016/j.cden.2008.06.002
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Relationship of obstructive sleep apnea (OSA) with insulin resistance and type 2 diabetes in Caucasians has been studied, but this association has not been investigated in Hispanic and African-Americans. The objective of this study is to determine the prevalence of type 2 diabetes in patients evaluated for OSA in a predominantly African American and Hispanic sample. The secondary objective is to evaluate the relationship of REM related OSA and type 2 diabetes. 1008 consecutive patients who had a comprehensive polysomnography were evaluated. OSA was defined as an obstructive apnea-hypopnea index (AHI) of > or = 5 per hour. REM AHI of > or = 10 was considered to indicate REM related OSA. The prevalence of type 2 diabetes was 30.1% in the group with OSA compared to 18.6% in those without OSA. The subjects with OSA had significantly increased odds of type 2 diabetes compared with those without OSA (odds ratio = 1.8, 95% confidence interval: 1.3-2.6) but this association became non-significant when controlled for confounding variables and covariates (odds ratio = 1.3, 95% confidence interval: 0.9-2.0). Middle-aged participants with OSA had 2.8 times higher odds for type 2 diabetes, when compared to younger or middle aged without OSA, controlling for covariates. Finally, the odds of type 2 diabetes were 2.0 times higher in patients with REM AHI of > or = 10/h independent of confounding variables. OSA is not independently associated with type 2 diabetes in a predominantly African American and Hispanic sample. However, the relationship of REM related OSAwith type 2 diabetes may be statistically significant.
    Journal of clinical sleep medicine: JCSM: official publication of the American Academy of Sleep Medicine 06/2009; 5(3):215-21. · 3.05 Impact Factor
Show more

Similar Publications