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Respiratory events are usually longer and more desaturating in REM than in NREM sleep. The prevalence of REM OSA is higher in women than in men and REM OSA usually occurs in the context of mild\u2013moderate OSA based on the apnoea\u2013hypopnoea index calculated for the entire sleep study. Studies have highlighted some detrimental consequences of REM OSA; for example, its frequent association with systemic hypertension and a degree of excessive daytime sleepiness similar to that found in nonsleep-stage-dependent OSA. Moreover, REM OSA could increase cardiometabolic risk. Continuous positive airway pressure (CPAP) treatment aimed at preventing REM OSA should be longer than the 4\u2005h usually considered as good compliance, since REM sleep occurs mostly during the second half of the night. Unfortunately, patients with REM OSA show poor adherence to CPAP. Alternative non-CPAP treatments might be a good choice for REM OSA, but data are lacking. This review summarises the available data on REM OSA and critically examines the weaknesses and strengths of existing literature.<\/jats:p>","DOI":"10.1183\/16000617.0166-2023","type":"journal-article","created":{"date-parts":[[2024,2,14]],"date-time":"2024-02-14T04:35:12Z","timestamp":1707885312000},"page":"230166","update-policy":"https:\/\/doi.org\/10.1183\/ers-crossmark-policy","source":"Crossref","is-referenced-by-count":90,"title":["REM sleep obstructive sleep apnoea"],"prefix":"10.1183","volume":"33","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4875-7796","authenticated-orcid":false,"given":"Maria R.","family":"Bonsignore","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emilia","family":"Mazzuca","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pierpaolo","family":"Baiamonte","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4363-1024","authenticated-orcid":false,"given":"Bernard","family":"Bouckaert","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wim","family":"Verbeke","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7372-8583","authenticated-orcid":false,"given":"Dirk A.","family":"Pevernagie","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"81","published-online":{"date-parts":[[2024,2,14]]},"reference":[{"key":"2024102404182940000_33.171.230166.1","doi-asserted-by":"crossref","first-page":"687","DOI":"10.1016\/S2213-2600(19)30198-5","article-title":"Estimation of the global prevalence and burden of obstructive sleep apnoea: a literature-based analysis","volume":"7","author":"Benjafield","year":"2019","journal-title":"Lancet Respir Med"},{"key":"2024102404182940000_33.171.230166.2","doi-asserted-by":"publisher","DOI":"10.1378\/chest.87.4.432"},{"key":"2024102404182940000_33.171.230166.3","doi-asserted-by":"crossref","first-page":"1522","DOI":"10.1164\/ajrccm\/141.6.1522","article-title":"Influence of apnea type and sleep stage on nocturnal postapneic desaturation","volume":"141","author":"Series","year":"1990","journal-title":"Am Rev Respir Dis"},{"key":"2024102404182940000_33.171.230166.4","doi-asserted-by":"publisher","DOI":"10.1164\/ajrccm.154.1.8680674"},{"key":"2024102404182940000_33.171.230166.5","doi-asserted-by":"crossref","first-page":"514","DOI":"10.1097\/MCP.0000000000000817","article-title":"Rapid eye movement predominant obstructive sleep apnoea: prognostic relevance and clinical approach","volume":"27","author":"Pirzada","year":"2021","journal-title":"Curr Opin Pulm Med"},{"key":"2024102404182940000_33.171.230166.6","doi-asserted-by":"publisher","DOI":"10.5665\/sleep.1570"},{"key":"2024102404182940000_33.171.230166.7","doi-asserted-by":"crossref","first-page":"1088","DOI":"10.1164\/rccm.201410-1897ED","article-title":"REM sleep: a nightmare for patients with obstructive sleep apnea?","volume":"190","author":"Peker","year":"2014","journal-title":"Am J Respir Crit Care Med"},{"key":"2024102404182940000_33.171.230166.8","doi-asserted-by":"crossref","first-page":"2075","DOI":"10.1210\/jc.2018-00946","article-title":"Apnea hypopnea index during rapid eye movement sleep with diabetic retinopathy in patients with type 2 diabetes","volume":"104","author":"Nishimura","year":"2019","journal-title":"J Clin Endocrinol Metab"},{"key":"2024102404182940000_33.171.230166.9","doi-asserted-by":"crossref","first-page":"309","DOI":"10.1007\/s11325-020-02129-7","article-title":"Relationship between obstructive sleep apnoea during rapid eye movement sleep and metabolic syndrome parameters in patients with type 2 diabetes mellitus","volume":"25","author":"Uchida","year":"2021","journal-title":"Sleep Breath"},{"key":"2024102404182940000_33.171.230166.10","doi-asserted-by":"crossref","first-page":"5907","DOI":"10.3390\/jcm12185907","article-title":"REM-OSA as a tool to understand both the architecture of sleep and pathogenesis of sleep apnea\u2013literature review","volume":"12","author":"Karuga","year":"2023","journal-title":"J Clin Med"},{"key":"2024102404182940000_33.171.230166.11","doi-asserted-by":"crossref","first-page":"121","DOI":"10.5664\/jcsm.26814","article-title":"The visual scoring of sleep in adults","volume":"3","author":"Silber","year":"2007","journal-title":"J Clin Sleep Med"},{"key":"2024102404182940000_33.171.230166.12","unstructured":"Javaheri S , Drager LF , Pevernagie DA , et al. 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