Elsevier

Sleep Medicine

Volume 7, Issue 1, January 2006, Pages 5-6
Sleep Medicine

Editorial
Obstructive sleep apnea: re-evaluating our index of severity

https://doi.org/10.1016/j.sleep.2005.08.012Get rights and content

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Acknowledgements

This research was supported in part by NIH grants HL65225 and AG17628 to S.C. Veasey.

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    The current severity criteria based on AHI or RDI also correlate only loosely with symptom or clinical severity.4 Furthermore, investigators have questioned whether the AHI alone is the best predictor for outcomes such as survival, cardiovascular events, or incident hypertension and metabolic dysfunction.5,6 Available evidence supports a need to standardize these other dimensions; for example, recurrence of atrial fibrillation among OSAs may not be best predicted by the AHI but rather by the severity of nocturnal hypoxemia.7

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    Mild sleep apnea has been defined as an AHI of 5 to 15 events per hour, moderate sleep apnea as an AHI of more than 15 to 30 events per hour, and severe as an AHI of more than 30 events per hour.2 Notably, however, AHI correlates poorly with symptom severity,3 and whether it is the best predictor for clinically relevant outcomes has been questioned,4,5 with some arguing that other indices (eg, based on degree of hypoxemia) may be more useful. Obstructive sleep apnea is a very common disease, whose population prevalence is comparable to that of other important chronic diseases such as asthma, chronic obstructive pulmonary disease, type 2 diabetes, and coronary artery disease.6

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