Composite severity indices reflect sleep apnea disease burden more comprehensively than the apnea-hypopnea index

Otolaryngol Head Neck Surg. 2013 Feb;148(2):324-30. doi: 10.1177/0194599812464468. Epub 2012 Oct 16.

Abstract

Objective: To compare 2 composite indices of sleep apnea disease burden with the commonly used apnea-hypopnea index with regard to baseline measurement of subjective and objective disease burden.

Study design: Cross-sectional study.

Setting: Tertiary academic medical center sleep laboratory.

Subjects and methods: Patients with suspected diagnosis of sleep apnea undergoing first diagnostic polysomnography. Subjective data were collected via validated questionnaires; objective data were obtained by standardized physical examination, chart extraction, and polysomnography. Four subjective (patient-reported) disease burden measures and 3 objective (anatomic and physiologic) disease burden measures were used for validation. Associations between composite indices or apnea-hypopnea index and these 7 construct validation measures were compared using bootstrapped correlation coefficients.

Results: Two hundred sixteen subjects were included in the final analysis. Both composite disease burden indices showed clinically important or nearly important associations with 3 of 4 subjective validation measures and all 3 objective validation measures, whereas the apnea-hypopnea index was associated only with the objective validation measures.

Conclusion: Composite indices of sleep apnea disease burden may capture the breadth of baseline sleep apnea disease burden, particularly subjective disease burden, better than the apnea-hypopnea index.

Publication types

  • Research Support, N.I.H., Extramural
  • Validation Study

MeSH terms

  • Chi-Square Distribution
  • Cross-Sectional Studies
  • Female
  • Humans
  • Male
  • Middle Aged
  • Physical Examination
  • Polysomnography
  • Quality of Life
  • Severity of Illness Index*
  • Sleep Apnea Syndromes / diagnosis
  • Sleep Apnea Syndromes / physiopathology*
  • Statistics, Nonparametric
  • Surveys and Questionnaires