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Novel parameters indicate significant differences in severity of obstructive sleep apnea with patients having similar apnea–hypopnea index

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Abstract

Sleep apnea–hypopnea syndrome (SAHS) causes impairment of daytime functions and increases risk of cardiovascular diseases. Apnea–hypopnea index (AHI), currently used for the estimation of the severity of SAHS, does not contain information on the morphology or duration aspects of the breathing cessations and related oxygen desaturations. Longer breathing cessations and deeper desaturations may have more severe consequences than shorter and shallower ones. To address these issues, novel parameters containing information on the duration and morphology of breathing cessations and oxygen desaturations were calculated and evaluated on 160 male patients (40 patients in normal, mild, moderate and severe AHI severity categories). Obstruction and desaturation duration parameters consist of sum of event durations normalized with the total analysed time. Desaturation severity is a sum of desaturation event areas normalized with total analysed time and obstruction severity parameter is a sum of the products of apnea and hypopnea durations and related desaturation areas normalized with total analysed time. The median follow-up time of the patients was 183 months (range 154–215 months). The 40 patients in each category were further divided into subgroups A and B with lowest and highest novel parameter values, respectively. AHI showed no differences between the subgroups. Mortality was increased in subgroups B compared to subgroups A. The correlation of the novel parameters with AHI was only moderate and the parameter values were partially overlapping between the AHI severity categories. This suggests that patients with similar AHI may in fact suffer from SAHS of very different severity. Thus, the present results suggest that the novel parameters could bring new insight to the individual estimation of the severity of SAHS.

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Acknowledgments

The study was financially supported by the Seinäjoki Central Hospital and by the Tampere Tuberculosis Foundation and Kuopio University Hospital (EVO-funding).

Conflict of interest

We certify here that we do not have any financial or personal relationships with other people or organizations that could inappropriately influence our work presented in this paper.

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Authors and Affiliations

  1. Department of Clinical Neurophysiology, Seinäjoki Central Hospital, Hanneksenrinne 6, 60220, Seinäjoki, Finland

    Antti Kulkas

  2. Department of Clinical Neurophysiology, Kuopio University Hospital, Kuopio, Finland

    Pekka Tiihonen, Petro Julkunen, Esa Mervaala & Juha Töyräs

  3. Department of Applied Physics, University of Eastern Finland, Kuopio, Finland

    Juha Töyräs

  4. Institute of Clinical Medicine, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland

    Esa Mervaala

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  1. Antti Kulkas
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  2. Pekka Tiihonen
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Correspondence to Antti Kulkas.

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Kulkas, A., Tiihonen, P., Julkunen, P. et al. Novel parameters indicate significant differences in severity of obstructive sleep apnea with patients having similar apnea–hypopnea index. Med Biol Eng Comput 51, 697–708 (2013). https://doi.org/10.1007/s11517-013-1039-4

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  • DOI: https://doi.org/10.1007/s11517-013-1039-4

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