Conventional Versus Other Methods to Evaluate Patients with Obstructive Sleep Apnea .

Document Type : Original Article

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Chest Diseases Department, Faculty of Medicine, Minia University, Minia Egypt

Abstract

Background: Obstructive Sleep Apnea (OSA) is a common condition associated with significant cardiovascular and metabolic complications. The apnea–hypopnea index (AHI) has long been the gold standard for assessing OSA severity. However, emerging evidence highlights the role of oxygen desaturation index (ODI)and time spent below90%oxygen saturation(T90) as important markers for hypoxia-related outcomes. Aim: This study aimed to evaluate the clinical relevance of the ODI and the percentage of time spent with T90, in comparison to AHI, for assessing OSA severity. Methods: Its retrospective study,100 adult patients diagnosed with OSA at the sleep unit of the Cardiothoracic Hospital, Minia University, Egypt. Data were collected including clinical evaluation, physical examination, arterial blood gases, chest imaging, and echocardiography. Severity grading was based on AHI, ODI. Epworth Sleepiness Scale (ESS)scores used to assess daytime sleepiness. Associations with cardiometabolic comorbidities were analyzed, and the diagnostic performance of ESS and STOP-BANG questionnaires was compared. Results: A significant correlation was found between AHI and ODI, with a kappa agreement of 0.66 (p < 0.001), demonstrating strong consistency between both indices in grading OSA severity. Both ESS and STOP-BANG scores demonstrated significant correlations with AHI and ODI (p < 0.001), with ESS exhibiting stronger associations. The AHI and ODI values were significantly higher in patients with IHD and DM, indicating a correlation between the severity of OSA and these cardiometabolic conditions. The ROC curve analysis for predicting pulmonary hypertension showed that the ODI had a slightly higher area under the curve (AUC = 0.63) than the AHI (AUC = 0.59), with ODI being statistically significant (p = 0.03). Conclusion: AHI and ODI are robust markers of OSA severity. ESS is a more practical screening tool than STOP-BANG, particularly in identifying severe OSA. The strong association between OSA severity and cardiometabolic comorbidities highlights the need for early identification using both objective and symptom-based tools to optimize risk stratification and management.

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