ArticleSleep & breathing = Schlaf & Atmung2014
Adjustment of apnea-hypopnea index with severity of obstruction events enhances detection of sleep apnea patients with the highest risk of severe health consequences.
Article in Sleep & breathing = Schlaf & Atmung, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 33 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
33 citing papers in PubMed, 62 citations in OpenAlex.
- Beyond a Single Hypoxic Burden Value: Hypoxic Burden Ratio Assessed by Peripheral Arterial Tonometry in Obstructive Sleep Apnea.Nature and science of sleep · 2026Article
- Effectiveness of transoral robotic tongue base surgery in patients with obstructive sleep Apnoea.European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery · 2025Observational
- OSA symptom subtypes and hypoxic burden independently predict distinct cardiovascular outcomes.ERJ open research · 2025Article
- Hypoxaemic load in sleep apnoea is associated with acute changes in T-wave amplitude.ERJ open research · 2024Article
- All Obstructive Sleep Apnea Events Are Not Created Equal: The Relationship between Event-related Hypoxemia and Physiologic Response.Annals of the American Thoracic Society · 2024Article
- Beat-to-beat cardiac repolarization lability increases during hypoxemia and arousals in obstructive sleep apnea patients.American journal of physiology. Heart and circulatory physiology · 2024Article
- REM sleep obstructive sleep apnoea.European respiratory review : an official journal of the European Respiratory Society · 2024Review
- Long-term health outcomes for patients with obstructive sleep apnea: placing the Agency for Healthcare Research and Quality report in context-a multisociety commentary.Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine · 2024Article
- Sleep Apnea Indices Associated with Markers of Inflammation and Cardiovascular Disease: A Proteomic Study in the MUSTACHE Cohort.Annals of the American Thoracic Society · 2024Article
- Redefining Comorbid Insomnia and Sleep Apnea: The Association of Sleep Breathing Impairment and Insomnia with Incident Diabetes.Annals of the American Thoracic Society · 2023Article
- A Review of Novel Oximetry Parameters for the Prediction of Cardiovascular Disease in Obstructive Sleep Apnoea.Diagnostics (Basel, Switzerland) · 2023Review
- Summary of drug therapy to treat cognitive impairment-induced obstructive sleep apnea.Frontiers in cellular neuroscience · 2023Review
- Longer and Deeper Desaturations Are Associated With the Worsening of Mild Sleep Apnea: The Sleep Heart Health Study.Frontiers in neuroscience · 2021Article
- New Indices from Polysomnographic Measures for the Severity of Obstructive Sleep Apnea Syndrome -A Different Look at Obstructive Sleep Apnea Syndrome.Noro psikiyatri arsivi · 2020Article
- Reinventing polysomnography in the age of precision medicine.Sleep medicine reviews · 2020Review
- Sex differences in obstructive sleep apnea phenotypes, the multi-ethnic study of atherosclerosis.Sleep · 2020Article
- Severe desaturations increase psychomotor vigilance task-based median reaction time and number of lapses in obstructive sleep apnoea patients.The European respiratory journal · 2020Article
- Intra-night variation in apnea-hypopnea index affects diagnostics and prognostics of obstructive sleep apnea.Sleep & breathing = Schlaf & Atmung · 2020Article
- A Review of Current Tools Used for Evaluating the Severity of Obstructive Sleep Apnea.Nature and science of sleep · 2020Review
- Usefulness of Home Overnight Pulse Oximetry in Patients with Suspected Sleep-Disordered Breathing.Canadian respiratory journal · 2020Article
Corrections and comments
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Authors and funding
8 authors at 4 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionPresently, the severity of obstructive sleep apnea (OSA) is estimated based on the apnea-hypopnea index (AHI). Unfortunately, AHI does not provide information on the severity of individual obstruction events. Previously, the severity of individual obstruction events has been suggested to be related to the outcome of the disease. In this study, we incorporate this information into AHI and test whether this novel approach would aid in discriminating patients with the highest risk. We hypothesize that the introduced adjusted AHI parameter provides a valuable supplement to AHI in the diagnosis of the severity of OSA.
methodsThis hypothesis was tested by means of retrospective follow-up (mean ± sd follow-up time 198.2 ± 24.7 months) of 1,068 men originally referred to night polygraphy due to suspected OSA. After exclusion of the 264 patients using CPAP, the remaining 804 patients were divided into normal (AHI < 5) and OSA (AHI ≥ 5) categories based on conventional AHI and adjusted AHI. For a more detailed analysis, the patients were divided into normal, mild, moderate, and severe OSA categories based on conventional AHI and adjusted AHI. Subsequently, the mortality and cardiovascular morbidity in these groups were determined.
resultsUse of the severity of individual obstruction events for adjustment of AHI led to a significant rearrangement of patients between severity categories. Due to this rearrangement, the number of deceased patients diagnosed to have OSA was increased when adjusted AHI was used as the diagnostic index. Importantly, risk ratios of all-cause mortality and cardiovascular morbidity were higher in moderate and severe OSA groups formed based on the adjusted AHI parameter than in those formed based on conventional AHI.
conclusionsThe adjusted AHI parameter was found to give valuable supplementary information to AHI and to potentially improve the recognition of OSA patients with the highest risk of mortality or cardiovascular morbidity.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.