Sleepiness, Quality of Life, and Sleep Maintenance in REM versus non-REM Sleep-disordered Breathing

Rationale:TheimpactofREM-predominantsleep-disorderedbreathing(SDB)onsleepiness,qualityoflife(QOL),andsleepmaintenance is uncertain. Objective: To evaluate the association of SDB during REM sleep with daytime sleepiness, health-related QOL, and difficulty maintaining sleep, in comparison to their association with SDB during non-REM sleep in a community-based cohort. Methods: Cross-sectional analysis of 5,649 Sleep Heart Health Study participants (mean age 62.5 [SD 5 10.9], 52.6% women, 22.6% ethnic minorities). SDB during REM and non-REM sleep was quantifiedusingpolysomnographicallyderivedapnea-hypopneaindexin REM (AHIREM) and non-REM (AHINREM) sleep. Sleepiness, sleep maintenance, and QOL were respectively quantified using the Epworth Sleepiness Scale (ESS), the Sleep Heart Health Study Sleep Habit Questionnaire, and the physical and mental compositesscales of the Medical Outcomes Study Short Form (SF)-36. Measurements and Main Results: AHIREM was not associated with the ESS scores or the physical and mental components scales scores of the SF-36 after adjusting for demographics, body mass index, and AHINREM. AHIREM was not associated with frequent difficulty maintainingsleeporearlyawakeningfromsleep.AHINREMwasassociated with the ESS score (b 5 0.25; 95% confidence interval [CI], 0.16 to 0.34) and the physical (b 52 0.12; 95% CI, 20.42 to 20.01) and