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Impact of different hypopnea definitions on obstructive sleep apnea severity and cardiovascular mortality risk in women and elderly individuals.

Abstract：

OBJECTIVE:To assess the impact of three hypopnea definitions on the severity classification of obstructive sleep apnea (OSA) and its association with cardiovascular mortality risk in women and elderly individuals. METHODS:We analyzed two Spanish clinical cohorts (1116 women and 939 elderly individuals) who were studied for suspicion of OSA between 1998 and 2007. A calibration model was used to apply different definitions of hypopnea to our two cohorts. Hypopnea was defined as a 30-90% reduction in oronasal flow for ≥10 s followed by (1) ≥4% fall in oxyhemoglobin saturation-AHI4%; (2) ≥3% fall in oxyhemoglobin saturation-AHI3%; or (3) ≥3% fall in oxyhemoglobin saturation or an event-related arousal-AHI3%a. RESULTS:In both cohorts, the prevalence of an AHI ≥30 events/h increased by 14% with AHI3%a, compared to AHI4% criteria. The percentage of women with an AHI <5 events/h decreased from 13.9% with AHI4% to 1.1% with the AHI3%a definition. In fully adjusted multivariable analyses, AHI ≥30 events/h was associated with increased cardiovascular mortality risk in women, regardless of the hypopnea definition, and in elderly individuals diagnosed using the AHI4% and AHI3% but not the AHI3%a definition. CONCLUSIONS:Our findings suggest that hypopnea definitions substantially influence OSA prevalence and severity classification, and also affect the association with cardiovascular outcomes. With the currently recommended criterion (AHI3%a), a threshold of 30 events/h is appropriate to identify women, but not elderly individuals with increased risk of cardiovascular death.

journal_name

Sleep Med

journal_title

Sleep medicine

authors

Campos-Rodriguez F,Martínez-García MA,Reyes-Nuñez N,Selma-Ferrer MJ,Punjabi NM,Farre R

doi

10.1016/j.sleep.2016.05.020

subject

Has Abstract

pub_date

2016-01-01 00:00:00

pages

54-58

eissn

1389-9457

issn

1878-5506

pii

S1389-9457(16)30211-8

journal_volume

27-28

pub_type

杂志文章

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