ReviewSleep2021
Metrics of sleep apnea severity: beyond the apnea-hypopnea index.
Review in Sleep, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT07132307 (Reducing Obstructive Sleep Apnea After Hypoglossal Nerve Stimulation Through), which is not on this map. Cited by 240 papers, 10 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
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.
The trial behind it
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.
Reducing Obstructive Sleep Apnea After Hypoglossal Nerve Stimulation Through
Who cites it
240 citing papers in PubMed, 10 syntheses or guidelines pooled it.
- Oral appliances for obstructive sleep apnoea in adults.The Cochrane database of systematic reviews · 2026Pooled it
- Accuracy of Machine Learning Algorithms Based on Electroencephalogram in Sleep Apnea Detection: Systematic Review and Meta-Analysis.Journal of medical Internet research · 2026Pooled it
- Efficacy of GLP-1 Receptor agonists in treating Obstructive sleep apnea: A systematic review and meta-analysis of cardiometabolic and respiratory outcomes.Sleep & breathing = Schlaf & Atmung · 2026Pooled it
- Reduced cerebral blood flow in obstructive sleep apnea: A meta-analysis of SPECT and MRI studies.Sleep & breathing = Schlaf & Atmung · 2026Pooled it
- Comparative effects of weight-loss diet, exercise training, respiratory muscle training, and oropharyngeal muscle training in obstructive sleep apnea: a systematic review and network meta-analysis.Frontiers in medicine · 2026Pooled it
- Efficacy of SGLT2 inhibitors, GLP-1 receptor agonists, and aerobic exercise for moderate-to-severe obstructive sleep apnea in overweight or obese patients: a network meta-analysis.Frontiers in endocrinology · 2026Pooled it
- Effectiveness of continuous positive airway pressure therapy on romantic relationships and intimacy among individuals with obstructive sleep apnea: A systematic review and a meta-analysis.Journal of sleep research · 2025Pooled it
- Pooled it
- Anatomical determinants of upper airway collapsibility in obstructive sleep apnea: A systematic review and meta-analysis.Sleep medicine reviews · 2023Pooled it
- Association of alternative polysomnographic features with patient outcomes in obstructive sleep apnea: a systematic review.Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine · 2023Pooled it
- Proximal Hypoglossal Nerve Stimulation for Obstructive Sleep Apnea in the OSPREY Study : A Randomized Controlled Trial.Annals of internal medicine · 2026Trial
- Trial
- Combination Drug Therapy with Acetazolamide, Eszopiclone ± Venlafaxine for Obstructive Sleep Apnea (RESCUE-Combo): A Randomized, Double-Blind, Placebo-controlled Clinical Trial.Annals of the American Thoracic Society · 2025Trial
- Association between multiple sleep dimensions in obstructive sleep apnea and an early sign of atherosclerosis.Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine · 2024Trial
- Hypoxic burden to guide CPAP treatment allocation in patients with obstructive sleep apnoea: aThe European respiratory journal · 2023Trial
- Agreement between automated and manual scoring of level 3 home sleep apnea devices: A single-center retrospective study.Sleep medicine: X · 2026Article
- Obesity, sleep apnea and cancer revisited.International journal of obesity (2005) · 2026Review
- Multimodal neuro-ophthalmologic changes and the impact of CPAP therapy in severe obstructive sleep apnea: a prospective OCT, OCTA, and visual field study.Documenta ophthalmologica. Advances in ophthalmology · 2026Article
- Real-world generalizability of sleep apnea-related polysomnographic metrics and their associations with clinical comorbidities.Annals of the American Thoracic Society · 2026Article
- Central hypopnea classification: bridging the gap between event identification and clinical utility.Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine · 2026Article
180 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
11 authors.
Funding
Abstract
Obstructive sleep apnea (OSA) is thought to affect almost 1 billion people worldwide. OSA has well established cardiovascular and neurocognitive sequelae, although the optimal metric to assess its severity and/or potential response to therapy remains unclear. The apnea-hypopnea index (AHI) is well established; thus, we review its history and predictive value in various different clinical contexts. Although the AHI is often criticized for its limitations, it remains the best studied metric of OSA severity, albeit imperfect. We further review the potential value of alternative metrics including hypoxic burden, arousal intensity, odds ratio product, and cardiopulmonary coupling. We conclude with possible future directions to capture clinically meaningful OSA endophenotypes including the use of genetics, blood biomarkers, machine/deep learning and wearable technologies. Further research in OSA should be directed towards providing diagnostic and prognostic information to make the OSA diagnosis more accessible and to improving prognostic information regarding OSA consequences, in order to guide patient care and to help in the design of future clinical trials.
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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.