REM相关阻塞性睡眠呼吸暂停的临床研究进展

Progress in clinical research of REM-related obstructive sleep apnea

阻塞性睡眠呼吸暂停(OSA)是一种以睡眠时上气道反复塌陷引起口鼻气流量降低甚至暂停,造成夜间血氧饱和度降低的综合征;。当前OSA的诊断标准和严重程度分级;是基于多导睡眠监测(PSG)中整夜的总呼吸暂停低通气指数(apnea-hypopnea index,AHI)大小而定(即轻度:5<AHI≤15;中度:15<AHI≤30;重度:AHI>30)。然而临床上有部分患者总AHI值可能很低,甚至总AHI<5,但其在快速眼球运动(rapid eye movement,REM)睡眠期的AHI值却很高。

REM-related obstructive sleep apnea(REM-OSA) refers to apneas and hypopneas in which most respiratory events occur during REM. The total AHI of REM-OSA is low compared to NREM-OSA, but the duration of apnea hypopnea events is longer and the oxygen saturation is lower. Only focusing on the total AHI value will miss the diagnosis of REM-OSA, and even some patients with severe hypoxemia cannot be effectively treated.REM-OSA may be an early manifestation of OSA, and active early recognition and intervention may benefit patients.The pathophysiology and mechanism of REM-OSA are still unclear. In this article, we reviewed the existing REM-OSA related research.