In patients with OSA, apneas and hypopneas tend to be most frequent during REM sleep and the least frequent during slow wave sleep. The protective effect of slow wave sleep is something that I have observed when reading sleep studies, and I have heard several other doctors mention this. Apparently this is an area that has not been previously well researched, as there has been a recent study looking at this:
Slow-wave sleep (SWS) may have a protective effect for events related to sleep apnea, according to research presented at CHEST 2008, the annual meeting of the American College of Chest Physicians.
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This may explain why certain antidepressants (or other medications) that suppress REM sleep may help with obstructive sleep apnea. By shifting REM to SWS, you're less likely to obstruct. One study in particular showed that mirtazapine lowered the AHI by 50%.
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