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Clinical and polysomnographic determinants of REM predominant obstructive sleep apnoea and response to treatment in a revascularized coronary artery disease cohort

Baran Balcan, Jennifer Newitt, Seyed M Nouraie, Patrick J Strollo, Erik Thunström, Yuksel Peker
European Respiratory Journal 2020 56: 4994; DOI: 10.1183/13993003.congress-2020.4994
Baran Balcan
1Marmara University, Istanbul, Turkey
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  • For correspondence: drbaranbalcan@gmail.com
Jennifer Newitt
2University of Pittsburgh, Pittsburgh, United States of America
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Seyed M Nouraie
2University of Pittsburgh, Pittsburgh, United States of America
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Patrick J Strollo
2University of Pittsburgh, Pittsburgh, United States of America
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Erik Thunström
3University of Gothenburg, Gothenburg, Sweden
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Yuksel Peker
4Koc University, Istanbul, Turkey
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Abstract

Background: Obstructive sleep apnoea (OSA) is common in patients with coronary artery disease (CAD). OSA occurring predominantly during rapid-eye movement (REM) sleep has been associated with increased cardiovascular morbidity. Clinical features of this phenotype among CAD patients is unknown.

Aims and Objective: We addressed the determinants of REM-predominant OSA and its association with cardiovascular outcomes in a CAD cohort.

Methods: The current study was a secondary analysis of the RICCADSA trial, conducted in Sweden between 2005 and 2013. Out of 511 patients, 399 had OSA, based on an Apnoea-Hypopnoea-Index (AHI)≥15/hr on home-sleep apnoea testing. Polysomnography was conducted in the OSA group, of whom 286 with total sleep time≥240 min, and REM sleep≥30 min, were included in the current protocol. REM- predominant OSA was defined as an REM-AHI/non-REM AHI≥2.

Results: In all, 73 (25.5%) had REM-predominant OSA. They were more likely to be female (26.0% vs 9.9%; p=0.001), and more obese (42.5% vs 24.4%; p=0.003) but had lower AHI (24.0/hr vs 40.9/hr; p<0.001) and less reduction in Slow-Wave Sleep (10.7% vs 6.9%; p=0.046) compared to the patients without REM-predominant OSA. There were no significant differences between the groups with regard to age, excessive daytime sleepiness, mood, comorbidities, cardiac function, inflammatory biomarkers and adherence to continuous positive airway pressure treatment. No between-group differences were observed with regard to cardiovascular outcomes.

Conclusions: REM-predominant OSA is not associated with increased cardiovascular morbidity in patients with an already established CAD.

  • Apnoea / Hypopnea
  • Diagnosis
  • Comorbidities

Footnotes

Cite this article as: European Respiratory Journal 2020; 56: Suppl. 64, 4994.

This abstract was presented at the 2020 ERS International Congress, in session “Respiratory viruses in the "pre COVID-19" era”.

This is an ERS International Congress abstract. No full-text version is available. Further material to accompany this abstract may be available at www.ers-education.org (ERS member access only).

  • Copyright ©the authors 2020
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Clinical and polysomnographic determinants of REM predominant obstructive sleep apnoea and response to treatment in a revascularized coronary artery disease cohort
Baran Balcan, Jennifer Newitt, Seyed M Nouraie, Patrick J Strollo, Erik Thunström, Yuksel Peker
European Respiratory Journal Sep 2020, 56 (suppl 64) 4994; DOI: 10.1183/13993003.congress-2020.4994

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Clinical and polysomnographic determinants of REM predominant obstructive sleep apnoea and response to treatment in a revascularized coronary artery disease cohort
Baran Balcan, Jennifer Newitt, Seyed M Nouraie, Patrick J Strollo, Erik Thunström, Yuksel Peker
European Respiratory Journal Sep 2020, 56 (suppl 64) 4994; DOI: 10.1183/13993003.congress-2020.4994
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