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In particular, REM sleep can highly increase the occurrence of events in a subset of OSA patients, a condition dubbed REM-OSA (often defined as an AHI 2 times higher in REM than NREM sleep). However, a proper characterization of REM-OSA and its pathological sequelae is still inadequate, partly because of limitations in the current definitions.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods<\/jats:title>\n            <jats:p>We propose a new interpretation of the REM-OSA definition, extending it from a AHI-ratio to a two-dimensional space, considering both time and events ratios in REM over NREM separately. Within this space, we analyzed current definitions of REM-OSA in three large clinical dataset and identified the underlying sources of heterogeneity.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>We observed that REM-OSA and REM-independent-OSA subgroups exist. Some subgroups exhibited abnormal REM characteristics (e.g., REM-OSA with reduced time in REM). Others had OSA features that are intermediate between REM-independent-OSA participants and those with a clear disproportion of REM events.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusion<\/jats:title>\n            <jats:p>We found that a time and events\u2019 ratio of REM and NREM allow a more precise characterization of REM-OSA subgroups. Our new interpretation can be used to bolster new research into REM-OSA pathophysiological mechanisms.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1007\/s11325-024-03236-5","type":"journal-article","created":{"date-parts":[[2025,1,22]],"date-time":"2025-01-22T21:29:09Z","timestamp":1737581349000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Breathtaking dreams: reduced REM phenotype in REM-related sleep apnea"],"prefix":"10.1007","volume":"29","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8571-3971","authenticated-orcid":false,"given":"Luca","family":"Cerina","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pedro","family":"Fonseca","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabriele B.","family":"Papini","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rik","family":"Vullings","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sebastiaan","family":"Overeem","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,1,22]]},"reference":[{"key":"3236_CR1","doi-asserted-by":"publisher","unstructured":"Chokroverty S (2017) Physiological changes of sleep. 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Informed consent was obtained from all individual participants included in the study.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}},{"value":"Informed consent was obtained from all individual participants included in the study. For this particular retrospective study, formal consent was not required.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Informed consent"}},{"value":"All authors certify that they have no affiliations with or involvement in any organization or entity with any financial interest (such as honoraria; educational grants; participation in speakers' bureaus; membership, employment, consultancies, stock ownership, or other equity interest; and expert testimony or patent-licensing arrangements), or non-financial interest (such as personal or professional relationships, affiliations, knowledge or beliefs) in the subject matter or materials discussed in this manuscript.\u00a0L.C., G.P., and P.F. were employed and\/or affiliated with Royal Philips. R.V. is co-founder and shareholder of Nemo Healthcare BV. S.O. received an unrestricted research grant from UCB Pharma and participated in advisory boards for Jazz Pharmaceuticals, Bioprojet, and Abbvie. None of these companies had a role in the study design, decision to publish, or preparation of the manuscript.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflicts of interest"}}],"article-number":"87"}}