The Hourly Apnea-Hypopnea Duration Better Correlates with OSA-Related Nocturnal Hypoxemia and Excessive Daytime Sleepiness Rather Than AHI
Yuhan Wang,* Wuriliga Yue,* Beini Zhou,* Jingyi Zhang, Yang He, Mengcan Wang, Ke Hu Department of Respiratory and Critical Care Medicine, Renmin Hospital of Wuhan University, Wuhan, 430060, People’s Republic of China*These authors contributed equally t...
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Dove Medical Press
2025-05-01
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| author | Wang Y Yue W Zhou B Zhang J He Y Wang M Hu K |
| author_facet | Wang Y Yue W Zhou B Zhang J He Y Wang M Hu K |
| author_sort | Wang Y |
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| description | Yuhan Wang,&ast; Wuriliga Yue,&ast; Beini Zhou,&ast; Jingyi Zhang, Yang He, Mengcan Wang, Ke Hu Department of Respiratory and Critical Care Medicine, Renmin Hospital of Wuhan University, Wuhan, 430060, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Ke Hu, Department of Respiratory and Critical Care Medicine, Renmin Hospital of Wuhan University, Wuhan, 430060, People’s Republic of China, Email huke-rmhospital@163.comBackground: The apnea-hypopnea index (AHI) has limitations in assessing nocturnal hypoxemia and excessive daytime sleepiness (EDS) in obstructive sleep apnea (OSA) patients. This study evaluated whether hourly apnea-hypopnea duration (HAD) and mean apnea-hypopnea duration (MAD) could complement or outperform AHI.Methods: This study included 1069 OSA patients, of whom 754 completed the Epworth Sleepiness Scale (ESS). Multivariable regression models evaluated the associations between AHI, MAD, HAD, and nocturnal hypoxemia, and standardized Z scores were used for comparison. The predictive ability of AHI, MAD, and HAD models for EDS was evaluated using goodness-of-fit indices, and receiver operating characteristic (ROC) curve analysis was performed using bootstrapping techniques.Results: Nocturnal hypoxemia was observed in 317 participants (29.65%). Patients with nocturnal hypoxemia had significantly higher AHI (43.19 ± 18.41 vs 21.78 ± 14.73 events/hour, P < 0.001) and longer HAD (16.71 ± 7.48 vs 8.24 ± 5.40 minutes, P < 0.001). After adjusting for age, sex, and BMI, AHI and HAD were still significantly associated with nocturnal hypoxemia (P < 0.05). Standardized Z scores analysis revealed that HAD had the strongest association with nocturnal hypoxemia (HAD: OR = 3.69, 95% CI: 3.06− 4.46, P < 0.0001; AHI: OR = 3.48, 95% CI: 2.90− 4.18, P < 0.0001; MAD: OR = 1.01, 95% CI: 0.88− 1.15, P = 0.9314) and mean SpO2 (HAD: β = − 0.91, 95% CI: − 1.02−− 0.79, P < 0.0001; AHI: β = − 0.85, 95% CI: − 0.97−− 0.74, P < 0.0001; MAD: β = 0.00, 95% CI: − 0.12− 0.12, P = 0.9595), outperforming AHI and MAD. The HAD model showed the best fit for predicting EDS, with an area under the curve of 0.61 at a threshold of 5.63.Conclusion: The HAD better correlates with OSA-related nocturnal hypoxemia and EDS rather than AHI. The duration of respiratory events warrants more investigation in clinical assessment.Keywords: obstructive sleep apnea, hourly apnea-hypopnea duration, mean apnea-hypopnea duration, apnea-hypopnea index, nocturnal hypoxemia, excessive daytime sleepiness |
| format | Article |
| id | doaj-art-26e2bd69063042008e4122c096a8d4ab |
| institution | DOAJ |
| issn | 1179-1608 |
| language | English |
| publishDate | 2025-05-01 |
| publisher | Dove Medical Press |
| record_format | Article |
| series | Nature and Science of Sleep |
| spelling | doaj-art-26e2bd69063042008e4122c096a8d4ab2025-08-20T03:24:00ZengDove Medical PressNature and Science of Sleep1179-16082025-05-01Volume 17Issue 111011112103393The Hourly Apnea-Hypopnea Duration Better Correlates with OSA-Related Nocturnal Hypoxemia and Excessive Daytime Sleepiness Rather Than AHIWang Y0Yue W1Zhou B2Zhang J3He Y4Wang M5Hu K6Department of Respiratory and Critical Care MedicineDepartment of Respiratory and Critical Care MedicineDepartment of Respiratory and Critical Care MedicineDepartment of Respiratory and Critical Care MedicineDepartment of Respiratory and Critical Care MedicineDepartment of Respiratory and Critical Care MedicineDepartment of Respiratory and Critical Care MedicineYuhan Wang,&ast; Wuriliga Yue,&ast; Beini Zhou,&ast; Jingyi Zhang, Yang He, Mengcan Wang, Ke Hu Department of Respiratory and Critical Care Medicine, Renmin Hospital of Wuhan University, Wuhan, 430060, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Ke Hu, Department of Respiratory and Critical Care Medicine, Renmin Hospital of Wuhan University, Wuhan, 430060, People’s Republic of China, Email huke-rmhospital@163.comBackground: The apnea-hypopnea index (AHI) has limitations in assessing nocturnal hypoxemia and excessive daytime sleepiness (EDS) in obstructive sleep apnea (OSA) patients. This study evaluated whether hourly apnea-hypopnea duration (HAD) and mean apnea-hypopnea duration (MAD) could complement or outperform AHI.Methods: This study included 1069 OSA patients, of whom 754 completed the Epworth Sleepiness Scale (ESS). Multivariable regression models evaluated the associations between AHI, MAD, HAD, and nocturnal hypoxemia, and standardized Z scores were used for comparison. The predictive ability of AHI, MAD, and HAD models for EDS was evaluated using goodness-of-fit indices, and receiver operating characteristic (ROC) curve analysis was performed using bootstrapping techniques.Results: Nocturnal hypoxemia was observed in 317 participants (29.65%). Patients with nocturnal hypoxemia had significantly higher AHI (43.19 ± 18.41 vs 21.78 ± 14.73 events/hour, P < 0.001) and longer HAD (16.71 ± 7.48 vs 8.24 ± 5.40 minutes, P < 0.001). After adjusting for age, sex, and BMI, AHI and HAD were still significantly associated with nocturnal hypoxemia (P < 0.05). Standardized Z scores analysis revealed that HAD had the strongest association with nocturnal hypoxemia (HAD: OR = 3.69, 95% CI: 3.06− 4.46, P < 0.0001; AHI: OR = 3.48, 95% CI: 2.90− 4.18, P < 0.0001; MAD: OR = 1.01, 95% CI: 0.88− 1.15, P = 0.9314) and mean SpO2 (HAD: β = − 0.91, 95% CI: − 1.02−− 0.79, P < 0.0001; AHI: β = − 0.85, 95% CI: − 0.97−− 0.74, P < 0.0001; MAD: β = 0.00, 95% CI: − 0.12− 0.12, P = 0.9595), outperforming AHI and MAD. The HAD model showed the best fit for predicting EDS, with an area under the curve of 0.61 at a threshold of 5.63.Conclusion: The HAD better correlates with OSA-related nocturnal hypoxemia and EDS rather than AHI. The duration of respiratory events warrants more investigation in clinical assessment.Keywords: obstructive sleep apnea, hourly apnea-hypopnea duration, mean apnea-hypopnea duration, apnea-hypopnea index, nocturnal hypoxemia, excessive daytime sleepinesshttps://www.dovepress.com/the-hourly-apnea-hypopnea-duration-better-correlates-with-osa-related--peer-reviewed-fulltext-article-NSSobstructive sleep apneahourly apnea-hypopnea durationmean apnea-hypopnea durationapnea-hypopnea indexnocturnal hypoxemiaexcessive daytime sleepiness |
| spellingShingle | Wang Y Yue W Zhou B Zhang J He Y Wang M Hu K The Hourly Apnea-Hypopnea Duration Better Correlates with OSA-Related Nocturnal Hypoxemia and Excessive Daytime Sleepiness Rather Than AHI Nature and Science of Sleep obstructive sleep apnea hourly apnea-hypopnea duration mean apnea-hypopnea duration apnea-hypopnea index nocturnal hypoxemia excessive daytime sleepiness |
| title | The Hourly Apnea-Hypopnea Duration Better Correlates with OSA-Related Nocturnal Hypoxemia and Excessive Daytime Sleepiness Rather Than AHI |
| title_full | The Hourly Apnea-Hypopnea Duration Better Correlates with OSA-Related Nocturnal Hypoxemia and Excessive Daytime Sleepiness Rather Than AHI |
| title_fullStr | The Hourly Apnea-Hypopnea Duration Better Correlates with OSA-Related Nocturnal Hypoxemia and Excessive Daytime Sleepiness Rather Than AHI |
| title_full_unstemmed | The Hourly Apnea-Hypopnea Duration Better Correlates with OSA-Related Nocturnal Hypoxemia and Excessive Daytime Sleepiness Rather Than AHI |
| title_short | The Hourly Apnea-Hypopnea Duration Better Correlates with OSA-Related Nocturnal Hypoxemia and Excessive Daytime Sleepiness Rather Than AHI |
| title_sort | hourly apnea hypopnea duration better correlates with osa related nocturnal hypoxemia and excessive daytime sleepiness rather than ahi |
| topic | obstructive sleep apnea hourly apnea-hypopnea duration mean apnea-hypopnea duration apnea-hypopnea index nocturnal hypoxemia excessive daytime sleepiness |
| url | https://www.dovepress.com/the-hourly-apnea-hypopnea-duration-better-correlates-with-osa-related--peer-reviewed-fulltext-article-NSS |
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