개정된 미국수면의학회 판독 기준이 무호흡 및 저호흡 지수에 미치는 영향
Influences of the Revised American Academy of Sleep Medicine Criteria for Scoring Apnea and Hypopnea on the Apnea-Hypopnea Index
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Objectives: The definition of accurate recording and measuring of sleep related obstructive breathing events are clinically critical as a base for quantifying disease severity in obstructive sleep apnea (OSA) syndrome. The aim of the study was to compare apnea and hypopnea indices using different scoring recommendations. Methods: We retrospectively selected total 60 patients who were diagnosed with OSA syndrome. All sleep-related parameters including apnea index, hypopnea index, and apnea-hypopnea index (AHI) were measured by two different criteria; 1999 Chicago criteria and 2007 American Academy of Sleep Medicine (AASM) criteria for scoring respiratory events. Results: Apnea index and AHI by Chicago criteria were significantly higher than those by AASM criteria (mean 21.0/hr vs. 15.1/hr, p<0.001; mean 36.8/hr vs. 29.4/hr, p<0.001, respectively). But hypopnea index was not different between two criteria. Bland-Altman plots demonstrated a median (5th, 95th percentiles) reduction of 6.1/h (0.16, 20.57) when comparing AHI by AASM criteria to AHI by Chicago criteria. Conclusions: Our results suggested that AASM criteria intended to diagnose more confirmative OSA patients than Chicago criteria. Updated criteria may be stricter but possibly rule out mild OSA patients.
Abstract
Objectives: The definition of accurate recording and measuring of sleep related obstructive breathing events are clinically critical as a base for quantifying disease severity in obstructive sleep apnea (OSA) syndrome. The aim of the study was to compare apnea and hypopnea indices using different scoring recommendations. Methods: We retrospectively selected total 60 patients who were diagnosed with OSA syndrome. All sleep-related parameters including apnea index, hypopnea index, and apnea-hypopnea index (AHI) were measured by two different criteria; 1999 Chicago criteria and 2007 American Academy of Sleep Medicine (AASM) criteria for scoring respiratory events. Results: Apnea index and AHI by Chicago criteria were significantly higher than those by AASM criteria (mean 21.0/hr vs. 15.1/hr, p<0.001; mean 36.8/hr vs. 29.4/hr, p<0.001, respectively). But hypopnea index was not different between two criteria. Bland-Altman plots demonstrated a median (5th, 95th percentiles) reduction of 6.1/h (0.16, 20.57) when comparing AHI by AASM criteria to AHI by Chicago criteria. Conclusions: Our results suggested that AASM criteria intended to diagnose more confirmative OSA patients than Chicago criteria. Updated criteria may be stricter but possibly rule out mild OSA patients.
참고문헌 (10)
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