{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,28]],"date-time":"2026-01-28T21:10:44Z","timestamp":1769634644210,"version":"3.49.0"},"reference-count":17,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2025,11,23]],"date-time":"2025-11-23T00:00:00Z","timestamp":1763856000000},"content-version":"vor","delay-in-days":22,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,11,1]],"date-time":"2025-11-01T00:00:00Z","timestamp":1761955200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Pulmonology"],"published-print":{"date-parts":[[2025,11]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Obstructive sleep apnea (OSA) occurs predominantly during REM sleep (REM\u2010OSA) compared to NREM sleep (NREM\u2010OSA) in both children and adults. However, it is not clear whether REM\u2010OSA and NREM\u2010OSA are separate clinical phenotypes of OSA or represent 2 ends of OSA severity spectrum.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>We aimed to compare clinical and polysomnography (PSG) characteristics of REM\u2010OSA versus NREM\u2010OSA in children, and to evaluate the effect of these characteristics on REM\u2010related over NREM\u2010related obstructive AHI ratio (REM\u2010OAHI\/NREM\u2010OAHI).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Clinical and PSG data of all children diagnosed with moderate to severe OSA by PSG between 2019 and 2024 were collected and analyzed. REM\u2010OSA was defined as REM\u2010OAHI\/NREM\u2010OAHI ratio of \u22652. NREM\u2010OSA was defined as REM\u2010OAHI\/NREM\u2010OAHI of &lt;\u20092.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 253 patients (169 male and 84 female) met the inclusion criteria. REM\u2010OSA was identified in 174 (68.7%) patients, and NREM\u2010OSA in 79 (31.2%) patients. There was no significant difference between REM\u2010OSA and NREM OSA groups in gender, BMI, clinical diagnosis, symptoms or oxygenation indices. However, REM\u2010OSA group had lower OAHI and less severe OSA than NREM\u2010OSA group (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.004,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.003, respectively). Regression analysis showed that low OAHI was the only significant predictor of REM\u2010OSA and the only predictor of high REM\u2010AHI\/NREM\u2010AHI ratio, respectively (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.001,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>REM\u2010OSA and NREM\u2010OSA are not likely to be separate clinical phenotypes of OSA but only markers of the disease severity, with NREM\u2010OSA indicating more severe disease.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ppul.71399","type":"journal-article","created":{"date-parts":[[2025,11,24]],"date-time":"2025-11-24T07:39:50Z","timestamp":1763969990000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["REM\u2010OSA vs NREM\u2010OSA in Children: Separate Clinical Phenotypes or Markers of OSA Severity"],"prefix":"10.1002","volume":"60","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-9632-1180","authenticated-orcid":false,"given":"Haneen","family":"Toma","sequence":"first","affiliation":[{"name":"Department of Pediatric Medicine Division of Pulmonary Doha Qatar"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amal","family":"Alnaimi","sequence":"additional","affiliation":[{"name":"Department of Pediatric Medicine Division of Pulmonary Doha Qatar"},{"name":"Weill Cornel Medicine\u2010Qatar (WCM\u2010Q), Qatar Foundation Doha Qatar"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mutasim","family":"Abu\u2010Hasan","sequence":"additional","affiliation":[{"name":"Department of Pediatric Medicine Division of Pulmonary Doha Qatar"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Antonisamy","family":"Belavendra","sequence":"additional","affiliation":[{"name":"Department of Pediatric Medicine Division of Pulmonary Doha Qatar"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ibrahim","family":"Janahi","sequence":"additional","affiliation":[{"name":"Department of Pediatric Medicine Division of Pulmonary Doha Qatar"},{"name":"Weill Cornel Medicine\u2010Qatar (WCM\u2010Q), Qatar Foundation Doha Qatar"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,11,23]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.5664\/jcsm.10124"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1378\/chest.87.4.432"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.chest.2020.10.080"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.5664\/jcsm.5678"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1053\/smrv.2001.0164"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1113\/jphysiol.2012.229633"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.2147\/NSS.S331389"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1155\/2018\/9270329"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1183\/16000617.0166-2023"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.3389\/fped.2022.869986"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2869.2009.00760.x"},{"key":"e_1_2_11_13_1","volume-title":"The AASM Manual for the Scoring of Sleep and Associated Events: Rules, Terminology and Technical Specifications Version 2.6","author":"Berry R. B.","year":"2020"},{"key":"e_1_2_11_14_1","volume-title":"The AASM Manual for the Scoring of Sleep and Associated Events: Rules, Terminology and Technical Specifications Version 3","author":"Troester M. M.","year":"2023"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11325-019-01857-9"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1378\/chest.08-1311"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.4103\/atm.ATM_215_19"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11325-018-1727-2"}],"container-title":["Pediatric Pulmonology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ppul.71399","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/ppul.71399","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ppul.71399","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,28]],"date-time":"2026-01-28T08:59:18Z","timestamp":1769590758000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/ppul.71399"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,11]]},"references-count":17,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2025,11]]}},"alternative-id":["10.1002\/ppul.71399"],"URL":"https:\/\/doi.org\/10.1002\/ppul.71399","archive":["Portico"],"relation":{},"ISSN":["8755-6863","1099-0496"],"issn-type":[{"value":"8755-6863","type":"print"},{"value":"1099-0496","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,11]]},"assertion":[{"value":"2025-08-03","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-11-11","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-11-23","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e71399"}}