0555 Sex and Age Differences in Rapid Eye Movement Related Obstructive Sleep Apnea

<jats:title>Abstract</jats:title> <jats:sec> <jats:title>Introduction</jats:title> <jats:p>Rapid Eye Movement (REM) related Obstructive Sleep Apnea (OSA) is a subcategory of OSA in which apneas or hypopneas occur predominantly or exclusively during REM and may be more prevalent in women and children. There is no consensus on the definition. Here, we examine interactions of age and sex on diagnosis per definition.</jats:p> </jats:sec> <jats:sec> <jats:title>Methods</jats:title> <jats:p>Patients who underwent a PSG at the Sleep Service at NIH in a 24- month period were included. Four REM-OSA definitions used most in the literature represented the diagnostic criteria.</jats:p> </jats:sec> <jats:sec> <jats:title>Results</jats:title> <jats:p>139 total participants (ages 1.5-76 y, 58 female) were evaluated. Twenty-eight men (20%) and eighteen women (13%) met criteria for at least 1 definition. Twenty participants (1.5-76 years) met definition one (9 female), 19 met definition two (9 female), 19 met definition three (9 female), and 36 met definition four (15 female). Fifteen of fifty-six (27%) pediatric patients (8 female) met criteria by at least one definition. Two female pediatric participants met definitions one, two and three, and all 15 pediatric participants met definition four. The average total AHI was 5.93 for women and 7.78 for men, while the average REM AHI was 17.96 (5.6-47.1) for women and 17.14 (5.3-51.7) for men. Twenty-six (18 female) REM-OSA patients had a total AHI of less than 5. For pediatric patients the average total AHI was 3.56 for girls and 2.73 for boys, and the average REM AHI was 9.41 for girls and 8.29 for boys.</jats:p> </jats:sec> <jats:sec> <jats:title>Conclusion</jats:title> <jats:p>The prevalence of REM-predominant OSA is difficult to determine as there are multiple definitions in use. REM-predominant OSA has been associated with hypertension, poor glycemic control, and mood disturbance and may be underdiagnosed due to current guidelines. Current definitions of mild, moderate and severe apnea are based on total AHI over the course of the sleep period. In our study, more than half of participants with REM-OSA by any definition had a total AHI of less than 5, despite the high average REM AHI for both sexes. These patients would not have met criteria for a diagnosis of OSA which has clear treatment implications.</jats:p> </jats:sec> <jats:sec> <jats:title>Support (if any)</jats:title> <jats:p>National Institutes of Health Intramural Research Program</jats:p> </jats:sec>