Nature and Science of Sleep (Aug 2022)
Impact of Desaturation Patterns versus Apnea–Hypopnea Index in the Development of Cardiovascular Comorbidities in Obstructive Sleep Apnea Patients
Abstract
Nathan Blekic,1 Ionela Bold,1 Thomas Mettay,2 Marie Bruyneel1,2 1Department of Pulmonary Medicine, Saint-Pierre University Hospital, Brussels, Belgium and Université Libre de Bruxelles, Brussels, Belgium; 2Department of Pulmonary Medicine, Brugmann University Hospital, Brussels, Belgium and Université Libre de Bruxelles, Brussels, BelgiumCorrespondence: Marie Bruyneel, Department of Pulmonary Medicine, Saint-Pierre University Hospital, Rue Haute, 322, Brussels, 1000, Belgium, Tel +322 5354219, Fax: +322 5353362, Email [email protected]: Various phenotypes of obstructive sleep apnea (OSA) have been recently described and are poorly assessed by the commonly used polysomnographic indices, such as the apnea–hypopnea index and oxygen desaturation index. Nocturnal hypoxemia is the hallmark of OSA and new quantitative markers, as hypoxic burden or desaturation severity, have been shown to be associated with cardiovascular (CV) mortality. The purpose of this overview is to review the endophenotypical and clinical characteristics of OSA, the current metrics, and to analyze different measurements of hypoxemia in OSA to predict the cardiovascular impact (eg hypoxic burden). Potential interest of multidimensional models to classify OSA, such as BAVENO classification, is also discussed, with the goal of focusing on specific endophenotypes that are likely to develop CV comorbidities, in order to guide clinicians to more aggressive management of OSA in these individuals.Keywords: obstructive sleep apnea, oxygen desaturation index, hypoxic burden, apnea–hypopnea index, polysomnography, home sleep apnea testing
