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J Med Eng Technol. 2016;40(3):119-26. doi: 10.3109/03091902.2016.1148791. Epub 2016 Mar 15.

RemLogic plug-in enables clinical application of apnea-hypopnea index adjusted for severity of individual obstruction events.

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a Department of Clinical Neurophysiology , Kuopio University Hospital , Kuopio , Finland ;
b Department of Clinical Neurophysiology , Seinäjoki Central Hospital , Seinäjoki , Finland ;
c Department of Applied Physics , University of Eastern Finland , Kuopio , Finland ;
d School of Computing , University of Eastern Finland , Kuopio , Finland ;
e Institute of Clinical Medicine, Faculty of Health Sciences , University of Eastern Finland , Kuopio , Finland.


Obstructive sleep apnea (OSA) is diagnosed based on obstruction event incidence, albeit individual obstruction event severity is connected to increased mortality rate. Adjusted-AHI parameter, incorporating number and severity of obstruction events, has shown good potential, but is calculated using custom-made MATLAB(®) functions. To allow its clinical use, this study introduces the RemLogic™ plug-in. It is tested comparing adjusted-AHI values calculated with the plug-in and MATLAB(®) with a hundred patients. Furthermore, retrospective follow-up (mean ± SD = 194.1 ± 54.0 months) of 1128 working-age men was conducted to evaluate potential of adjusted-AHI to enhance diagnostic of OSA. Adjusted-AHI values were strongly correlated (r = 1.000, p < 0.001) and their average difference (mean ± SD) was minimal (0.08 ± 0.19%). Using adjusted-AHI to define OSA severity resulted in a higher hazard ratio of mortality in the severe OSA group and, for the first time, adjusted-AHI was found to explain independently the overall mortality and non-fatal cardiovascular events. Importantly, the present plug-in enables clinical use of adjusted-AHI, enhancing assessment of OSA severity.


AHI; Obstructive sleep apnea; adjusted-AHI; morbidity; mortality

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