Turning Dreams into Nightmares: Different Metabolic Effects of Obstructive Events in Rapid Eye Movement versus Non-Rapid Eye Movement Sleep

摘要

Rapid eye movement (REM) sleep constitutes approximately a quarter of sleep time and is associated with desynchronization of the electroencephalogram, low muscle tone, cardiorespiratory variation, and dreaming. Because only a minority of sleep time consists of REM sleep, obstructive sleep apnea (OSA) during REM usually contributes less to the overall apnea-hypopnea index (AHI) than non-REM (NREM) OSA. However, events in REM tend to be longer and associated with more desaturation and sympathetic activation, and they may thus have a disproportionate effect on health. Indeed, in a recent report, AHI in REM sleep had a greater association with incident hypertension than the AHI in NREM sleep. There is also growing evidence that REM-related OSA may have an effect on glucose metabolism independent and different from NREM OSA.