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REM-associated sleep apnoea: prevalence and clinical significance in the HypnoLaus cohort

Patricia Acosta-Castro, Camila Hirotsu, Helena Marti-Soler, Pedro Marques-Vidal, Nadia Tobback, Daniela Andries, Gérard Waeber, Martin Preisig, Peter Vollenweider, José Haba-Rubio, Raphael Heinzer
European Respiratory Journal 2018; DOI: 10.1183/13993003.02484-2017
Patricia Acosta-Castro
Center for Investigation and Research in Sleep (CIRS), University Hospital of Lausanne, Lausanne, SwitzerlandPulmonary Department, University Hospital Ramon y Cajal, Madrid, Spain
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Camila Hirotsu
Center for Investigation and Research in Sleep (CIRS), University Hospital of Lausanne, Lausanne, Switzerland
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Helena Marti-Soler
Institute of Social and Preventive Medicine, University Hospital of Lausanne, Lausanne, Switzerland
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Pedro Marques-Vidal
Department of Internal Medicine, University Hospital of Lausanne, Switzerland
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Nadia Tobback
Center for Investigation and Research in Sleep (CIRS), University Hospital of Lausanne, Lausanne, Switzerland
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Daniela Andries
Center for Investigation and Research in Sleep (CIRS), University Hospital of Lausanne, Lausanne, Switzerland
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Gérard Waeber
Department of Internal Medicine, University Hospital of Lausanne, Switzerland
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Martin Preisig
Psychiatry Department, University Hospital of Lausanne, Switzerland
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Peter Vollenweider
Department of Internal Medicine, University Hospital of Lausanne, Switzerland
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José Haba-Rubio
Center for Investigation and Research in Sleep (CIRS), University Hospital of Lausanne, Lausanne, Switzerland
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  • For correspondence: raphael.heinzer@chuv.ch
Raphael Heinzer
Center for Investigation and Research in Sleep (CIRS), University Hospital of Lausanne, Lausanne, Switzerland
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Abstract

Study Objectives: This study determined the prevalence of rapid eye movement-related sleep-disordered breathing (REM-SDB) in the general population, and investigated the associations of REM-SDB with hypertension, metabolic syndrome, diabetes and depression.

Methods: 2074 home polysomnography (PSG) recordings from the population-based HypnoLaus Sleep Cohort (48.3% men, 57±11 years old) were analysed. The apnoea–hypopnoea index was measured during REM (REM-AHI) and non-REM (NREM-AHI) sleep. Regression models were used to explore the association between REM-SDB and hypertension, diabetes, metabolic syndrome and depression in the entire cohort and in subgroups with NREM-AHI<10/h and total AHI<10/h.

Results: Prevalence of REM-AHI≥20/h was 40.8% in the entire cohort. An association between increasing REM-AHI and metabolic syndrome was found in the entire cohort and in both subgroups (p-trend=0.014, <0.0001 and 0.015, respectively). An association was also found between REM-AHI≥20/h and diabetes in both NREM-AHI<10/h (OR=3.12 [1.35–7.20]) and AHI<10/h (OR=2.92 [1.12–7.63]) subgroups. Systolic and diastolic blood pressure were positively associated with REM-AHI≥20/h.

Conclusions: REM-SDB is highly prevalent in our middle-to-older age sample and is independently associated with metabolic syndrome and diabetes. These findings suggest that an increase in REM-AHI could be clinically relevant.

Footnotes

This manuscript has recently been accepted for publication in the European Respiratory Journal. It is published here in its accepted form prior to copyediting and typesetting by our production team. After these production processes are complete and the authors have approved the resulting proofs, the article will move to the latest issue of the ERJ online. Please open or download the PDF to view this article.

Conflict of interest: Dr. Hirotsu has nothing to disclose.

Conflict of interest: Dr. Marti-Soler has nothing to disclose.

Conflict of interest: Dr. Marques-Vidal has nothing to disclose.

Conflict of interest: Dr. Tobback has nothing to disclose.

Conflict of interest: Dr. Andries has nothing to disclose.

Conflict of interest: Dr. Waeber has nothing to disclose.

Conflict of interest: Dr. Preisig reports grants from Swiss National Science Foundation, grants from GlaxoSmithKline, during the conduct of the study; .

Conflict of interest: Dr. Vollenweider reports grants from GlaxoSmithKline, during the conduct of the study.

Conflict of interest: Dr. HABA-RUBIO has nothing to disclose.

Conflict of interest: Dr. Heinzer reports grants from Swiss National Science Foundation (grants 3200B0–105993, 3200B0-118308, 33CSCO-122661, 33CS30-139468, and 33CS30-148401), grants from Leenaards Foundation, grants from Vaud Pulmonary League , grants from GlaxoSmithKline, grants from Faculty of Biology and Medicine of Lausanne, during the conduct of the study; personal fees from Nightbalance company medical advisory board, outside the submitted work; .

Conflict of interest: Dr. Castro Acosta has nothing to disclose.

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REM-associated sleep apnoea: prevalence and clinical significance in the HypnoLaus cohort
Patricia Acosta-Castro, Camila Hirotsu, Helena Marti-Soler, Pedro Marques-Vidal, Nadia Tobback, Daniela Andries, Gérard Waeber, Martin Preisig, Peter Vollenweider, José Haba-Rubio, Raphael Heinzer
European Respiratory Journal Jan 2018, 1702484; DOI: 10.1183/13993003.02484-2017

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REM-associated sleep apnoea: prevalence and clinical significance in the HypnoLaus cohort
Patricia Acosta-Castro, Camila Hirotsu, Helena Marti-Soler, Pedro Marques-Vidal, Nadia Tobback, Daniela Andries, Gérard Waeber, Martin Preisig, Peter Vollenweider, José Haba-Rubio, Raphael Heinzer
European Respiratory Journal Jan 2018, 1702484; DOI: 10.1183/13993003.02484-2017
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