{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T16:49:08Z","timestamp":1791391748887,"version":"4.3.3"},"reference-count":25,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,2,20]],"date-time":"2026-02-20T00:00:00Z","timestamp":1771545600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,2,20]],"date-time":"2026-02-20T00:00:00Z","timestamp":1771545600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100005760","name":"University of Gothenburg","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100005760","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Sleep Breath"],"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>Reduced rapid-eye movement (REM) sleep has been linked to increased mortality in the general population. We investigated whether diminished REM sleep is associated with higher mortality in adults with coronary artery disease (CAD) and obstructive sleep apnea (OSA).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This secondary analysis of the RICCADSA trial included 356 revascularized CAD patients with OSA (apnea\u2013hypopnea index [AHI]\u2009\u2265\u200915 events\/h) and total sleep time (TST)\u2009\u2265\u2009240\u00a0min on baseline polysomnography. Reduced REM sleep was defined as the lowest quartile of REM percentage. Cox proportional hazards models assessed the association between reduced REM sleep and mortality over a median 4.7-year follow-up.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The lowest REM quartile corresponded to 8.7% of TST. Participants with reduced REM sleep (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200986) were older (66.0\u2009\u00b1\u20098.1 vs. 63.0\u2009\u00b1\u20098.0 years;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.035), had higher BMI (29.8\u2009\u00b1\u20094.6 vs. 28.7\u2009\u00b1\u20093.8\u00a0kg\/m\u00b2;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.010), shorter TST (369\u2009\u00b1\u200977 vs. 497\u2009\u00b1\u200969\u00a0min;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001), less slow-wave sleep (5.2\u2009\u00b1\u20097.0% vs. 8.1\u2009\u00b1\u200910.0%;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.007), and higher AHI (54.4\u2009\u00b1\u200926.3 vs. 35.6\u2009\u00b1\u200920.1 events\/h;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) than those with REM\u2009\u2265\u20098.7% (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009270). Mortality was 12.8% in the reduced REM group versus 4.4% in the higher REM group (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.006). Reduced REM sleep independently predicted mortality (hazard ratio 2.39; 95% CI 1.03\u20135.56;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.043) after adjustment for age, sex, BMI, and CPAP allocation. Further adjustment for TST, slow-wave sleep, baseline AHI, coronary bypass surgery, atrial fibrillation, and REM\u2013AHI interaction did not alter the association.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Reduced REM sleep independently predicted higher all-cause mortality in revascularized CAD patients with OSA. Identifying diminished REM sleep may help identify particularly vulnerable patients.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s11325-026-03614-1","type":"journal-article","created":{"date-parts":[[2026,2,20]],"date-time":"2026-02-20T20:53:20Z","timestamp":1771620800000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Association of reduced REM sleep with mortality in adults with coronary artery disease and obstructive sleep apnea in the RICCADSA cohort"],"prefix":"10.1007","volume":"30","author":[{"given":"Baran","family":"Balcan","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yeliz","family":"Celik","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erik","family":"Thunstr\u00f6m","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Helena","family":"Glantz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patrick J.","family":"Strollo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susan","family":"Redline","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9067-6538","authenticated-orcid":false,"given":"Y\u00fcksel","family":"Peker","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,2,20]]},"reference":[{"key":"3614_CR1","doi-asserted-by":"crossref","unstructured":"Redline S, Azarbarzin A, Peker Y (2023) Obstructive sleep Apnoea heterogeneity and cardiovascular disease. 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The RICCADSA trial was registered with ClinicalTrials.gov (NCT00519597) and FoU i Sverige (VGSKAS-4731).","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical standards"}},{"value":"PS reports personel fees from Emmi Solutions, Jazz Pharmaceuticals, Itamar Medical, Seperation Design Group, Belluscura, grants and personal fees from ResMed, Inspire Medical Systems, grants from Philips-Respironics, National Football League and PinMed, other from Biologix, outside the submitted work; SR has received consulting fees from E Lilly Inc and Amgen Inc; she receives a stipend for her role as editor for the journal Sleep Health; she is an unpaid Board member for Alliance of Sleep Apnea Partners; she is an unpaid scientific advisor for Apnimed Inc. Her institution received a research grant from Google Inc. YP reports institutional grants from ResMed Foundation. BB, YC, ET and HG have nothing to declare.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}}],"article-number":"60"}}