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

• Published in: Sleep medicine 2016-11, Vol.27-28, p.54-58
• Main Authors: Campos-Rodriguez, Francisco, Martínez-García, Miguel A, Reyes-Nuñez, Nuria, Selma-Ferrer, Maria J, Punjabi, Naresh M., MD, Farre, Ramon, PhD
• Format: Article
• Language: English
• Subjects: Aged; Apnea–hypopnea index; Biomarkers - metabolism; Cardiovascular Diseases - complications; Cardiovascular Diseases - mortality; Cardiovascular mortality; Cohort Studies; Female; Humans; Hypopnea definition; Male; Middle Aged; Neurology; Oxyhemoglobins - metabolism; Prevalence; Risk; Scoring; Severity of Illness Index; Sleep apnea; Sleep Apnea, Obstructive - classification; Sleep Apnea, Obstructive - complications; Sleep Apnea, Obstructive - diagnosis; Sleep Apnea, Obstructive - mortality; Sleep Medicine; Spain
• ISSN: 1389-9457; 1878-5506
• DOI: 10.1016/j.sleep.2016.05.020

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 seconds 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