Do you start PAP in patients who have an overall AHI of less than 5 but demonstrate significant apneas/hypopneas in REM sleep?  

In general, there is a very poor relationship between AHI and symptoms, particularly sleepiness. Some patients with a low AHI are quite sleepy and others with a high AHI have no symptoms. Thus, in general, if a patient has an elevated AHI, even if minimally elevated, and I have no other explanation ...

The issue of REM AHI is fascinating. While we often find increased "scorable" events during REM, this often reflects a more pronounced desaturation for a given decrease in alveolar ventilation. There is no conclusive evidence that the upper airway is more compliant during REM sleep. The compliance o...

Dr. @Badr explained with great evidence below. So many times, I want to treat but insurance coverage is difficult. So unless the patient is ready for self-payment, I am not able to treat.