AHI: a limited view of heterogenous sleep physiology
Notes: (A and B) Hypnograms from different patients. (A) A case of REM-dominant obstruction with prominent hypoventilation pattern, resulting in a normal 4% AHI value (4.7 per hour), but a severe oxygen nadir of 57% (age 66; female; BMI, 35). (B) A case of supine-dominant sleep apnea, with a full night AHI in the moderate range (19.7 per hour), resulting from the weighted average of supine AHI of 62 and non-supine AHI of 0.9 (age 74; female; BMI, 21). (C–G) The distribution of n=100 individuals with similar 4% AHI values (30–35 per hour), but differ widely across other factors that shape the clinical phenotype and potentially therapy choices (age, BMI, supine AHI, PLMI, and CAI).
Abbreviations: R, rapid eye movement sleep; N1–3, non-rapid eye movement stages 1–3; AHI, apnea–hypopnea index; BMI, body mass index; CAI, central apnea index; PLMI, periodic limb movement index; REM, rapid eye movement.