Comparison of apnoea–hypopnoea index and oxygen desaturation index when identifying obstructive sleep apnoea using type-4 sleep studies

Chamara V. Senaratna, Adrian Lowe, Jennifer L. Perret, Caroline Lodge, Gayan Bowatte, Michael J. Abramson, Bruce R. Thompson, Garun Hamilton, Shyamali C. Dharmage

Research output: Contribution to journalArticleResearchpeer-review

1 Citation (Scopus)

Abstract

The concordance of different indices from type-4 sleep studies in diagnosing and categorising the severity of obstructive sleep apnoea is not known. This is a critical gap as type-4 sleep studies are used to diagnose obstructive sleep apnoea in some settings. Therefore, we aimed to determine the concordance between flow-based apnoea–hypopnoea index (AHI flow50% ) and oxygen desaturation index (ODI 3% ) by measuring them concurrently. Using a random sub-sample of 296 from a population-based cohort who underwent two-channel type-4 sleep studies, we assessed the concordance between AHI flow50% and ODI 3% . We compared the prevalence of obstructive sleep apnoea of various severities as identified by the two methods, and determined their concordance using coefficient Kappa(κ). Participants were aged (mean ± SD) 53 ± 0.9 years (48% male). The body mass index was 28.8 ± 5.2 kg m −2 and neck circumference was 37.4 ± 3.9 cm. The median AHI flow50% was 5 (inter-quartile range 2, 10) and median ODI 3% was 9 (inter-quartile range 4, 15). The obstructive sleep apnoea prevalence reported using AHI flow50% was significantly lower than that reported using ODI 3% at all severity thresholds. Although 90% of those with moderate–severe obstructive sleep apnoea classified using AHI flow50% were identified by using ODI 3% , only 46% of those with moderate–severe obstructive sleep apnoea classified using ODI 3% were identified by AHI flow50% . The overall concordance between AHI flow50% and ODI 3% in diagnosing and classifying the severity of obstructive sleep apnoea was only fair (κ = 0.32), better for males (κ = 0.42 [95% confidence interval 0.32–0.57] versus 0.22 [95% confidence interval 0.09–0.31]), and lowest for those with a body mass index ≥ 35 (κ = 0.11). In conclusion, ODI 3% and AHI flow50% from type-4 sleep studies are at least moderately discordant. Until further evidence is available, the use of ODI 3% as the measure of choice for type-4 sleep studies is recommended cautiously.

Original languageEnglish
Article numbere12804
Number of pages8
JournalJournal of Sleep Research, Supplement
Volume28
Issue number5
DOIs
Publication statusPublished - Oct 2019

Keywords

  • agreement
  • home sleep studies
  • home sleep-testing
  • oxygen desaturation index
  • portable

Cite this

@article{6fa0cb10e3ea42d79fe566bc1d7f7e3a,
title = "Comparison of apnoea–hypopnoea index and oxygen desaturation index when identifying obstructive sleep apnoea using type-4 sleep studies",
abstract = "The concordance of different indices from type-4 sleep studies in diagnosing and categorising the severity of obstructive sleep apnoea is not known. This is a critical gap as type-4 sleep studies are used to diagnose obstructive sleep apnoea in some settings. Therefore, we aimed to determine the concordance between flow-based apnoea–hypopnoea index (AHI flow50{\%} ) and oxygen desaturation index (ODI 3{\%} ) by measuring them concurrently. Using a random sub-sample of 296 from a population-based cohort who underwent two-channel type-4 sleep studies, we assessed the concordance between AHI flow50{\%} and ODI 3{\%} . We compared the prevalence of obstructive sleep apnoea of various severities as identified by the two methods, and determined their concordance using coefficient Kappa(κ). Participants were aged (mean ± SD) 53 ± 0.9 years (48{\%} male). The body mass index was 28.8 ± 5.2 kg m −2 and neck circumference was 37.4 ± 3.9 cm. The median AHI flow50{\%} was 5 (inter-quartile range 2, 10) and median ODI 3{\%} was 9 (inter-quartile range 4, 15). The obstructive sleep apnoea prevalence reported using AHI flow50{\%} was significantly lower than that reported using ODI 3{\%} at all severity thresholds. Although 90{\%} of those with moderate–severe obstructive sleep apnoea classified using AHI flow50{\%} were identified by using ODI 3{\%} , only 46{\%} of those with moderate–severe obstructive sleep apnoea classified using ODI 3{\%} were identified by AHI flow50{\%} . The overall concordance between AHI flow50{\%} and ODI 3{\%} in diagnosing and classifying the severity of obstructive sleep apnoea was only fair (κ = 0.32), better for males (κ = 0.42 [95{\%} confidence interval 0.32–0.57] versus 0.22 [95{\%} confidence interval 0.09–0.31]), and lowest for those with a body mass index ≥ 35 (κ = 0.11). In conclusion, ODI 3{\%} and AHI flow50{\%} from type-4 sleep studies are at least moderately discordant. Until further evidence is available, the use of ODI 3{\%} as the measure of choice for type-4 sleep studies is recommended cautiously.",
keywords = "agreement, home sleep studies, home sleep-testing, oxygen desaturation index, portable",
author = "Senaratna, {Chamara V.} and Adrian Lowe and Perret, {Jennifer L.} and Caroline Lodge and Gayan Bowatte and Abramson, {Michael J.} and Thompson, {Bruce R.} and Garun Hamilton and Dharmage, {Shyamali C.}",
year = "2019",
month = "10",
doi = "10.1111/jsr.12804",
language = "English",
volume = "28",
journal = "Journal of Sleep Research, Supplement",
issn = "0962-1105",
publisher = "Wiley-Blackwell",
number = "5",

}

Comparison of apnoea–hypopnoea index and oxygen desaturation index when identifying obstructive sleep apnoea using type-4 sleep studies. / Senaratna, Chamara V.; Lowe, Adrian; Perret, Jennifer L.; Lodge, Caroline; Bowatte, Gayan; Abramson, Michael J.; Thompson, Bruce R.; Hamilton, Garun; Dharmage, Shyamali C.

In: Journal of Sleep Research, Supplement, Vol. 28, No. 5, e12804, 10.2019.

Research output: Contribution to journalArticleResearchpeer-review

TY - JOUR

T1 - Comparison of apnoea–hypopnoea index and oxygen desaturation index when identifying obstructive sleep apnoea using type-4 sleep studies

AU - Senaratna, Chamara V.

AU - Lowe, Adrian

AU - Perret, Jennifer L.

AU - Lodge, Caroline

AU - Bowatte, Gayan

AU - Abramson, Michael J.

AU - Thompson, Bruce R.

AU - Hamilton, Garun

AU - Dharmage, Shyamali C.

PY - 2019/10

Y1 - 2019/10

N2 - The concordance of different indices from type-4 sleep studies in diagnosing and categorising the severity of obstructive sleep apnoea is not known. This is a critical gap as type-4 sleep studies are used to diagnose obstructive sleep apnoea in some settings. Therefore, we aimed to determine the concordance between flow-based apnoea–hypopnoea index (AHI flow50% ) and oxygen desaturation index (ODI 3% ) by measuring them concurrently. Using a random sub-sample of 296 from a population-based cohort who underwent two-channel type-4 sleep studies, we assessed the concordance between AHI flow50% and ODI 3% . We compared the prevalence of obstructive sleep apnoea of various severities as identified by the two methods, and determined their concordance using coefficient Kappa(κ). Participants were aged (mean ± SD) 53 ± 0.9 years (48% male). The body mass index was 28.8 ± 5.2 kg m −2 and neck circumference was 37.4 ± 3.9 cm. The median AHI flow50% was 5 (inter-quartile range 2, 10) and median ODI 3% was 9 (inter-quartile range 4, 15). The obstructive sleep apnoea prevalence reported using AHI flow50% was significantly lower than that reported using ODI 3% at all severity thresholds. Although 90% of those with moderate–severe obstructive sleep apnoea classified using AHI flow50% were identified by using ODI 3% , only 46% of those with moderate–severe obstructive sleep apnoea classified using ODI 3% were identified by AHI flow50% . The overall concordance between AHI flow50% and ODI 3% in diagnosing and classifying the severity of obstructive sleep apnoea was only fair (κ = 0.32), better for males (κ = 0.42 [95% confidence interval 0.32–0.57] versus 0.22 [95% confidence interval 0.09–0.31]), and lowest for those with a body mass index ≥ 35 (κ = 0.11). In conclusion, ODI 3% and AHI flow50% from type-4 sleep studies are at least moderately discordant. Until further evidence is available, the use of ODI 3% as the measure of choice for type-4 sleep studies is recommended cautiously.

AB - The concordance of different indices from type-4 sleep studies in diagnosing and categorising the severity of obstructive sleep apnoea is not known. This is a critical gap as type-4 sleep studies are used to diagnose obstructive sleep apnoea in some settings. Therefore, we aimed to determine the concordance between flow-based apnoea–hypopnoea index (AHI flow50% ) and oxygen desaturation index (ODI 3% ) by measuring them concurrently. Using a random sub-sample of 296 from a population-based cohort who underwent two-channel type-4 sleep studies, we assessed the concordance between AHI flow50% and ODI 3% . We compared the prevalence of obstructive sleep apnoea of various severities as identified by the two methods, and determined their concordance using coefficient Kappa(κ). Participants were aged (mean ± SD) 53 ± 0.9 years (48% male). The body mass index was 28.8 ± 5.2 kg m −2 and neck circumference was 37.4 ± 3.9 cm. The median AHI flow50% was 5 (inter-quartile range 2, 10) and median ODI 3% was 9 (inter-quartile range 4, 15). The obstructive sleep apnoea prevalence reported using AHI flow50% was significantly lower than that reported using ODI 3% at all severity thresholds. Although 90% of those with moderate–severe obstructive sleep apnoea classified using AHI flow50% were identified by using ODI 3% , only 46% of those with moderate–severe obstructive sleep apnoea classified using ODI 3% were identified by AHI flow50% . The overall concordance between AHI flow50% and ODI 3% in diagnosing and classifying the severity of obstructive sleep apnoea was only fair (κ = 0.32), better for males (κ = 0.42 [95% confidence interval 0.32–0.57] versus 0.22 [95% confidence interval 0.09–0.31]), and lowest for those with a body mass index ≥ 35 (κ = 0.11). In conclusion, ODI 3% and AHI flow50% from type-4 sleep studies are at least moderately discordant. Until further evidence is available, the use of ODI 3% as the measure of choice for type-4 sleep studies is recommended cautiously.

KW - agreement

KW - home sleep studies

KW - home sleep-testing

KW - oxygen desaturation index

KW - portable

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U2 - 10.1111/jsr.12804

DO - 10.1111/jsr.12804

M3 - Article

VL - 28

JO - Journal of Sleep Research, Supplement

JF - Journal of Sleep Research, Supplement

SN - 0962-1105

IS - 5

M1 - e12804

ER -