Skip to main content
Top
Published in: Sleep and Breathing 3/2016

01-09-2016 | Sleep Breathing Physiology and Disorders • Original Article

REM-related sleep-disordered breathing is associated with depressive symptoms in men but not in women

Authors: Sang-Ahm Lee, Joon-Hyun Paek, Su-Hyun Han

Published in: Sleep and Breathing | Issue 3/2016

Login to get access

Abstract

Purpose

The purposes of the present study are to determine the prevalence and demographic features of rapid eye movement (REM)-related sleep-disordered breathing (SDB) in Korean adults with newly diagnosed obstructive sleep apnea (OSA) and determine if REM-related SDB is associated with depressive symptoms and health-related quality of life (HRQoL) in OSA patients.

Methods

In this cross-sectional study, we evaluated 1281 OSA adults who were consecutively recruited. REM-related SDB was defined as an overall apnea-hypopnea index (AHI) ≥5, an AHINREM <15, and AHIREM to AHINREM ratio of >2. The Epworth Sleepiness Scale (ESS), Beck Depression Inventory (BDI), and Medical Outcomes Study Short-Form Health survey (SF-36) were used to evaluate all patients. Multiple regression analyses were performed to determine the associations between REM-related SDB and clinical outcomes.

Results

The prevalence of REM-related SDB was 18 % in this study. REM-related SDB was more commonly observed in patients with mild or moderate OSA (p < 0.001) and women (p < 0.001). The linear regression analysis showed that the presence of REM-related SDB was significantly associated with higher BDI scores, but only in men. AHIREM was positively associated with the BDI scores, but only in men with REM-related SDB. There were no differences in ESS and SF-36 scores between patients with and without REM-related SDB.

Conclusions

Patients with REM-related SDB account for 18 % of Korean OSA adults. REM-related SDB was associated with depressive symptoms, but only in men. AHIREM is positively related to the degree of depressive symptoms in men with REM-related SDB.
Literature
1.
go back to reference Kass JE, Akers SM, Bartter TC, Pratter MR (1996) Rapid-eye movement-specific sleep-disordered breathing: a possible cause of excessive daytime sleepiness. Am J Respir Crit Care Med 154:167–169CrossRefPubMed Kass JE, Akers SM, Bartter TC, Pratter MR (1996) Rapid-eye movement-specific sleep-disordered breathing: a possible cause of excessive daytime sleepiness. Am J Respir Crit Care Med 154:167–169CrossRefPubMed
2.
go back to reference Koo B, Dostal J, Ioachimescu O, Budur K (2008) The effects of gender and age on REM-related sleep-disordered breathing. Sleep Breath 12:257–264CrossRef Koo B, Dostal J, Ioachimescu O, Budur K (2008) The effects of gender and age on REM-related sleep-disordered breathing. Sleep Breath 12:257–264CrossRef
3.
go back to reference Katz E, White D (2004) Genioglossus activity during sleep in normal control subjects and children with obstructive sleep apnea. Am J Respir Crit Care Med 170:553–560CrossRefPubMed Katz E, White D (2004) Genioglossus activity during sleep in normal control subjects and children with obstructive sleep apnea. Am J Respir Crit Care Med 170:553–560CrossRefPubMed
4.
go back to reference Smith CA, Henderson KS, Xi L, Chow CM, Eastwood PR, Dempsey JA (1997) Neural-mechanical coupling of breathing in REM sleep. J Appl Phys 83:1923–1932 Smith CA, Henderson KS, Xi L, Chow CM, Eastwood PR, Dempsey JA (1997) Neural-mechanical coupling of breathing in REM sleep. J Appl Phys 83:1923–1932
5.
go back to reference Series F, Cormier Y, La Forge J (1990) Influence of apnea type and sleep stage on nocturnal postapneic desaturation. Am Rev Respir Dis 141:1522–1526CrossRefPubMed Series F, Cormier Y, La Forge J (1990) Influence of apnea type and sleep stage on nocturnal postapneic desaturation. Am Rev Respir Dis 141:1522–1526CrossRefPubMed
6.
go back to reference Conwell W, Patel B, Doeing D, Pamidi S, Knutson KL, Ghods F, Mokhlesi B (2012) Prevalence, clinical features, and CPAP adherence in REM-related sleep-disordered breathing: a cross-sectional analysis of a large clinical population. Sleep Breath 16:519–526CrossRefPubMed Conwell W, Patel B, Doeing D, Pamidi S, Knutson KL, Ghods F, Mokhlesi B (2012) Prevalence, clinical features, and CPAP adherence in REM-related sleep-disordered breathing: a cross-sectional analysis of a large clinical population. Sleep Breath 16:519–526CrossRefPubMed
7.
go back to reference Haba-Rubio J, Janssens JP, Rochat T, Sforza E (2005) Rapid eye movement-related disordered breathing: clinical and polysomnographic features. Chest 128:3350–3357CrossRefPubMed Haba-Rubio J, Janssens JP, Rochat T, Sforza E (2005) Rapid eye movement-related disordered breathing: clinical and polysomnographic features. Chest 128:3350–3357CrossRefPubMed
8.
go back to reference O’Connor C, Thornley KS, Hanly PJ (2000) Gender differences in the polysomnographic features of obstructive sleep apnea. Am J Respir Crit Care Med 161:1465–1472CrossRefPubMed O’Connor C, Thornley KS, Hanly PJ (2000) Gender differences in the polysomnographic features of obstructive sleep apnea. Am J Respir Crit Care Med 161:1465–1472CrossRefPubMed
9.
go back to reference Koo BB, Patel SR, Strohl K, Hoffstein V (2008) Rapid eye movement related sleep-disordered breathing: influence of age and gender. Chest 134:1156–1161CrossRefPubMed Koo BB, Patel SR, Strohl K, Hoffstein V (2008) Rapid eye movement related sleep-disordered breathing: influence of age and gender. Chest 134:1156–1161CrossRefPubMed
10.
go back to reference Chervin RD, Aldrich MS (1998) The relation between multiple sleep latency test findings and the frequency of apneic events in REM and non-REM sleep. Chest 113:980–984CrossRefPubMed Chervin RD, Aldrich MS (1998) The relation between multiple sleep latency test findings and the frequency of apneic events in REM and non-REM sleep. Chest 113:980–984CrossRefPubMed
11.
go back to reference Punjabi NM, Bandeen-Roche K, Marx JJ, Neubauer DN, Smith PL, Schwartz AR (2002) The association between daytime sleepiness and sleep-disordered breathing in NREM and REM sleep. Sleep 25:307–314PubMed Punjabi NM, Bandeen-Roche K, Marx JJ, Neubauer DN, Smith PL, Schwartz AR (2002) The association between daytime sleepiness and sleep-disordered breathing in NREM and REM sleep. Sleep 25:307–314PubMed
12.
go back to reference Chami HA, Baldwin CM, Silverman A, Zhang Y, Rapoport D, Punjabi N, Gottlieb DJ (2010) Sleepiness, quality of life, and sleep maintenance in REM versus non-REM sleep-disordered breathing. Am J Respir Crit Care Med 181:997–1002CrossRefPubMedPubMedCentral Chami HA, Baldwin CM, Silverman A, Zhang Y, Rapoport D, Punjabi N, Gottlieb DJ (2010) Sleepiness, quality of life, and sleep maintenance in REM versus non-REM sleep-disordered breathing. Am J Respir Crit Care Med 181:997–1002CrossRefPubMedPubMedCentral
13.
go back to reference Ohayon MM (2003) The effects of breathing-related sleep disorders on mood disturbances in the general population. J Clin Psychiatry 64:1195–1200CrossRefPubMed Ohayon MM (2003) The effects of breathing-related sleep disorders on mood disturbances in the general population. J Clin Psychiatry 64:1195–1200CrossRefPubMed
14.
go back to reference Sharafkhaneh A, Giray N, Richardson P, Young T, Hirshkowitz M (2005) Association of psychiatric disorders and sleep apnea in a large cohort. Sleep 28:1405–1411PubMed Sharafkhaneh A, Giray N, Richardson P, Young T, Hirshkowitz M (2005) Association of psychiatric disorders and sleep apnea in a large cohort. Sleep 28:1405–1411PubMed
15.
go back to reference Lee YH, Song JY (1991) A study of the reliability and the validity of the BDI, SDS, and MMPI-D scales. J Korean Neuropsychiatr Assoc 10:93–113 Lee YH, Song JY (1991) A study of the reliability and the validity of the BDI, SDS, and MMPI-D scales. J Korean Neuropsychiatr Assoc 10:93–113
16.
go back to reference American Academy of Sleep Medicine (2007) The AASM manual for the scoring of sleep and associated events: rules, terminology and technical specifications. Westchester, IL American Academy of Sleep Medicine (2007) The AASM manual for the scoring of sleep and associated events: rules, terminology and technical specifications. Westchester, IL
17.
go back to reference Cho YW, Lee JH, Son HK, Lee SH, Shin C, Johns MW (2011) The reliability and validity of the Korean version of the Epworth Sleepiness Scale. Sleep Breath 15:377–384CrossRefPubMed Cho YW, Lee JH, Son HK, Lee SH, Shin C, Johns MW (2011) The reliability and validity of the Korean version of the Epworth Sleepiness Scale. Sleep Breath 15:377–384CrossRefPubMed
18.
go back to reference Han CW, Lee EJ, Iwaya T, Kataoka H, Kohzuki M (2004) Development of the Korean version of Short-Form 36-Item Health Survey: health related QOL of healthy elderly people and elderly patients in Korea. Tohoku J Exp Med 203:189–194CrossRefPubMed Han CW, Lee EJ, Iwaya T, Kataoka H, Kohzuki M (2004) Development of the Korean version of Short-Form 36-Item Health Survey: health related QOL of healthy elderly people and elderly patients in Korea. Tohoku J Exp Med 203:189–194CrossRefPubMed
19.
go back to reference Sakao S, Sakurai T, Yahaba M, Sakurai Y, Terada J, Tanabe N, Tatsumi K (2015) Features of REM-related sleep disordered breathing in the Japanese population. Intern Med 54:1481–1487CrossRefPubMed Sakao S, Sakurai T, Yahaba M, Sakurai Y, Terada J, Tanabe N, Tatsumi K (2015) Features of REM-related sleep disordered breathing in the Japanese population. Intern Med 54:1481–1487CrossRefPubMed
20.
go back to reference Li KK, Kushida C, Powell NB, Riley RW, Guilleminault C (2000) Obstructive sleep apnea syndrome: a comparison between Far-East Asian and white men. Laryngoscope 110:1689–1693CrossRefPubMed Li KK, Kushida C, Powell NB, Riley RW, Guilleminault C (2000) Obstructive sleep apnea syndrome: a comparison between Far-East Asian and white men. Laryngoscope 110:1689–1693CrossRefPubMed
21.
go back to reference Glovinsky P, Glovinsky PB, Spielman AJ, Carroll P, Weinstein L, Ellman SJ (1990) Sleepiness and REM sleep recurrence: the effects of stage 2 and REM sleep awakenings. Psychophysiology 27:552–559CrossRefPubMed Glovinsky P, Glovinsky PB, Spielman AJ, Carroll P, Weinstein L, Ellman SJ (1990) Sleepiness and REM sleep recurrence: the effects of stage 2 and REM sleep awakenings. Psychophysiology 27:552–559CrossRefPubMed
22.
go back to reference Nykamp K, Rosenthal L, Folkerts M, Roehrs T, Guido P, Roth T (1998) The effect of REM sleep deprivation on the level of sleepiness/alertness. Sleep 21:609–614PubMed Nykamp K, Rosenthal L, Folkerts M, Roehrs T, Guido P, Roth T (1998) The effect of REM sleep deprivation on the level of sleepiness/alertness. Sleep 21:609–614PubMed
23.
go back to reference Armitage R (2007) Sleep and circadian rhythms in mood disorders. Acta Psychiatr Scand 115(Suppl 433):S104–S115 Armitage R (2007) Sleep and circadian rhythms in mood disorders. Acta Psychiatr Scand 115(Suppl 433):S104–S115
24.
go back to reference Gottesmann C, Gottesman I (2007) The neurobiological characteristics of rapid eye movement (REM) sleep are candidate endophenotypes of depression, schizophrenia, mental retardation and dementia. Prog Neurobiol 81:237–250CrossRefPubMed Gottesmann C, Gottesman I (2007) The neurobiological characteristics of rapid eye movement (REM) sleep are candidate endophenotypes of depression, schizophrenia, mental retardation and dementia. Prog Neurobiol 81:237–250CrossRefPubMed
25.
go back to reference Palagini L, Baglioni C, Ciapparelli A, Gemignani A, Riemann D (2013) REM sleep dysregulation in depression: state of the art. Sleep Med Rev 17:377–390CrossRefPubMed Palagini L, Baglioni C, Ciapparelli A, Gemignani A, Riemann D (2013) REM sleep dysregulation in depression: state of the art. Sleep Med Rev 17:377–390CrossRefPubMed
26.
go back to reference Kessler RC, McGonagle KA, Swartz M, Blazer DG, Nelson CB (1993) Sex and depression in the National Comorbidity Survey. I: lifetime prevalence, chronicity and recurrence. J Affect Disord 29:85–96CrossRefPubMed Kessler RC, McGonagle KA, Swartz M, Blazer DG, Nelson CB (1993) Sex and depression in the National Comorbidity Survey. I: lifetime prevalence, chronicity and recurrence. J Affect Disord 29:85–96CrossRefPubMed
27.
go back to reference Shochat T, Umphress J, Israel AG, Ancoli-Israel S (1999) Insomnia in primary care patients. Sleep 22(Suppl 2):S359–S365PubMed Shochat T, Umphress J, Israel AG, Ancoli-Israel S (1999) Insomnia in primary care patients. Sleep 22(Suppl 2):S359–S365PubMed
Metadata
Title
REM-related sleep-disordered breathing is associated with depressive symptoms in men but not in women
Authors
Sang-Ahm Lee
Joon-Hyun Paek
Su-Hyun Han
Publication date
01-09-2016
Publisher
Springer Berlin Heidelberg
Published in
Sleep and Breathing / Issue 3/2016
Print ISSN: 1520-9512
Electronic ISSN: 1522-1709
DOI
https://doi.org/10.1007/s11325-016-1323-2

Other articles of this Issue 3/2016

Sleep and Breathing 3/2016 Go to the issue

Basic Science • Letter to the Editors

Acute mountain sickness and oxygen saturation

Sleep Breathing Physiology and Disorders • Original Article

Prevalence of potential nonallergic rhinitis at a community-based sleep medical center

Sleep Breathing Physiology and Disorders • Original Article

Racial disparity in adherence to positive airway pressure among US veterans

Live Webinar | 27-06-2024 | 18:00 (CEST)

Keynote webinar | Spotlight on medication adherence

Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

WHO estimates that half of all patients worldwide are non-adherent to their prescribed medication. The consequences of poor adherence can be catastrophic, on both the individual and population level.

Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.

Prof. Kevin Dolgin
Prof. Florian Limbourg
Prof. Anoop Chauhan
Developed by: Springer Medicine
Obesity Clinical Trial Summary

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine

Highlights from the ACC 2024 Congress

Year in Review: Pediatric cardiology

Watch Dr. Anne Marie Valente present the last year's highlights in pediatric and congenital heart disease in the official ACC.24 Year in Review session.

Year in Review: Pulmonary vascular disease

The last year's highlights in pulmonary vascular disease are presented by Dr. Jane Leopold in this official video from ACC.24.

Year in Review: Valvular heart disease

Watch Prof. William Zoghbi present the last year's highlights in valvular heart disease from the official ACC.24 Year in Review session.

Year in Review: Heart failure and cardiomyopathies

Watch this official video from ACC.24. Dr. Biykem Bozkurt discusses last year's major advances in heart failure and cardiomyopathies.