Long-term outcomes regarding arterial stiffness and carotid artery atherosclerosis in female patients with rapid eye movement obstructive sleep apnea

J Int Med Res. 2022 Sep;50(9):3000605221121941. doi: 10.1177/03000605221121941.


Objective: Rapid eye movement (REM) obstructive sleep apnea (OSA) is associated with the risk of cardiovascular events. Arterial stiffness and carotid artery intima-media thickness (IMT) predict these events, but few relevant studies have been conducted. We compared long-term changes in arterial stiffness and IMT between patients with REM OSA and non-REM (NREM) OSA receiving continuous positive airway pressure (CPAP) or oral appliance (OA) therapy.

Methods: Newly diagnosed female patients with OSA received CPAP (n = 6) or OA (n = 7). Pulse wave velocity (PWV) and carotid artery ultrasound were performed before and 60 months after treatment.

Results: There were no differences in baseline characteristics (mean age: 56.0 vs. 61.3 years; mean body mass index: 22.6 vs. 21.7 kg/m2) between the REM OSA and non-REM OSA groups. The median apnea-hypopnea index was lower in the REM OSA group than in the non-REM OSA group. Increased PWV (12.92 ± 1.64 to 14.56 ± 2.73 m/s) and deteriorated glucose metabolism were observed in the REM OSA group after treatment. PWV, IMT, and cardiovascular risk factors were unaffected in the non-REM OSA group.

Conclusion: Arterial stiffness and glucose metabolism are deteriorated in patients with REM OSA compared with these parameters in patients with non-REM OSA after CPAP or OA treatment.

Keywords: Rapid eye movement; arterial stiffness; cardiovascular event; glucose metabolism; intima-media thickness; obstructive sleep apnea.

MeSH terms

  • Atherosclerosis*
  • Carotid Artery Diseases* / complications
  • Carotid Artery Diseases* / diagnostic imaging
  • Carotid Artery, Common
  • Carotid Intima-Media Thickness
  • Female
  • Glucose
  • Humans
  • Middle Aged
  • Polysomnography
  • Pulse Wave Analysis
  • Sleep Apnea, Obstructive* / complications
  • Sleep Apnea, Obstructive* / diagnosis
  • Sleep Apnea, Obstructive* / therapy
  • Sleep, REM
  • Vascular Stiffness*


  • Glucose