In patients with severe sleep-disordered breathing, the most common response after successful PAP titration is which?

In patients with severe sleep-disordered breathing, the most common response after successful PAP titration is which?

• A. Increased hypoxemia
• B. Attenuation of alpha activity
• C. Increase in PLMs
• D. REM and slow wave rebound

Answer: (D)

REM and slow-wave rebound is the most common response after successful PAP titration because treating severe sleep-disordered breathing reduces the fragmented, arousal-filled sleep that previously suppressed REM and deep (N3) sleep. With effective PAP, arousals and breathing disturbances decrease and oxygenation improves, allowing the brain to compensate for prior sleep debt by increasing REM sleep and slow-wave sleep. This rebound in restorative sleep is a normal, expected outcome after proper PAP titration. Increased hypoxemia would not occur once therapy is effective, and attenuation of alpha activity or a rise in PLMs are not the characteristic, consistent responses seen with successful PAP titration.

REM and slow-wave rebound is the most common response after successful PAP titration because treating severe sleep-disordered breathing reduces the fragmented, arousal-filled sleep that previously suppressed REM and deep (N3) sleep. With effective PAP, arousals and breathing disturbances decrease and oxygenation improves, allowing the brain to compensate for prior sleep debt by increasing REM sleep and slow-wave sleep. This rebound in restorative sleep is a normal, expected outcome after proper PAP titration. Increased hypoxemia would not occur once therapy is effective, and attenuation of alpha activity or a rise in PLMs are not the characteristic, consistent responses seen with successful PAP titration.