Improving the cardiovascular outcomes of obstructive sleep apnea: Towards more precise hypoxia-based models of disease severity.

IF 1.5 Q4 CLINICAL NEUROLOGY

Current Sleep Medicine Reports Pub Date : 2025-01-01 Epub Date: 2025-01-03 DOI:10.1007/s40675-024-00315-7

Nida T Qayyum, Andrew T Cole, Rami N Khayat, Anna Grosberg

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引用次数: 0

Abstract

Purpose of review: Obstructive sleep apnea (OSA) affects at least 1 billion people worldwide, and its increasing prevalence is alarming considering an association to comorbidities such as cardiovascular disease (CVD) and to demonstrated health disparities. This raises concerns regarding the current diagnostic standards, which are also impacted by disparities. The current review was aimed at identifying limitations in the apnea-hypopnea index (AHI), the primary clinical indicator of OSA severity, and analyzing recent alternatives. In addition, the association between OSA and CVD was discussed, and, considering the role of intermittent hypoxia, solutions were proposed for improving OSA diagnosis.

Recent findings: Based on a review of current literature, alternative metrics to the AHI such as the hypoxia burden, sleep apnea-specific pulse rate, and oxygen desaturation rate were shown to be correlated with indicators of CVD in OSA patients. A recent mathematical study also presents the possibility of a model-based metric to eliminate existing bias in diagnostics and provide a more accurate quantification of tissue hypoxia.

Summary: The analyzed studies give incentive to look beyond current clinical standards in OSA. Through this review, we motivate the use of mathematical modeling as a future avenue to improve OSA diagnosis with a hypoxia-based approach.

查看原文本刊更多论文

改善阻塞性睡眠呼吸暂停的心血管结果：迈向更精确的基于缺氧的疾病严重程度模型。

综述目的：阻塞性睡眠呼吸暂停（OSA）影响全球至少10亿人，考虑到其与心血管疾病（CVD）等合并症和已证实的健康差距的关联，其患病率的上升令人担忧。这引起了对目前诊断标准的关注，这些标准也受到差异的影响。目前的综述旨在确定呼吸暂停低通气指数（AHI）的局限性，AHI是OSA严重程度的主要临床指标，并分析最近的替代方案。此外，本文还讨论了OSA与CVD之间的关系，并考虑到间歇性缺氧的作用，提出了提高OSA诊断的解决方案。最近发现：基于对现有文献的回顾，AHI的替代指标，如缺氧负担、睡眠呼吸暂停特异性脉搏率和氧去饱和率，被证明与OSA患者的CVD指标相关。最近的一项数学研究也提出了一种基于模型的度量方法的可能性，以消除诊断中存在的偏差，并提供更准确的组织缺氧定量。总结：所分析的研究激励我们超越目前的OSA临床标准。通过这篇综述，我们鼓励使用数学模型作为未来的途径，以缺氧为基础的方法来改善OSA的诊断。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Current Sleep Medicine Reports Medicine-Pulmonary and Respiratory Medicine

CiteScore

2.50

自引率

5.60%

发文量

期刊介绍： Current Sleep Medicine Reports aims to review the most important, recently published articles in the field of sleep medicine. By providing clear, insightful, balanced contributions by international experts, the journal intends to serve all those involved in the care and prevention of sleep conditions. We accomplish this aim by appointing international authorities to serve as Section Editors in key subject areas such as insomnia, narcolepsy, sleep apnea, circadian rhythm disorders, and parasomnias. Section Editors, in turn, select topics for which leading experts contribute comprehensive review articles that emphasize new developments and recently published papers of major importance, highlighted by annotated reference lists. An international Editorial Board reviews the annual table of contents, suggests articles of special interest to their country/region, and ensures that topics are current and include emerging research. Commentaries from well-known figures in the field are also occasionally provided.