Apnea–hypopnea index–oxygen desaturation index (AHI–ODI) discordance in obstructive sleep apnea: association with symptom burden and cardiometabolic comorbidity: A retrospective cross-sectional study

IF 3.3 3区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Respiratory medicine Pub Date : 2026-11-01 Epub Date: 2026-10-20 DOI:10.1016/j.rmed.2026.109237

Ahmed Ehab, Heba Wagih Abdelwahab, Mohamed Hamoda, Mahmoud M. Elhosiny

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引用次数: 0

Abstract

Background

The apnea–hypopnea index (AHI) counts respiratory events but not the depth or duration of accompanying desaturation. We examined AHI–ODI discordance (AHI minus oxygen desaturation index, ODI) and its associations with daytime symptom burden and prevalent cardiometabolic comorbidity.

Methods

Single-center retrospective cross-sectional study of 200 adults with OSA (January 2023–January 2025). Five indices (AHI, ODI, mean SpO₂, T90 and AHI–ODI discordance) were examined; excessive daytime sleepiness (EDS; Epworth Sleepiness Scale ≥ 11) was the primary outcome. Multivariable logistic regression adjusted for age, sex, BMI and an AHI–ODI × sex interaction.

Results

The cohort was 77.5% male, median age 57 years (48.8–64.2). For EDS, AHI–ODI discordance showed the numerically highest AUC (0.639, p < 0.001), followed by T90 (0.627), and mean SpO₂ and ODI (0.609 each); AHI was not significant (0.546, p = 0.264). No pairwise difference was significant. AHI–ODI discordance remained independently associated with EDS after adjustment (OR 1.04 per event/h, 95% CI 1.01–1.07, p = 0.008), with no significant sex interaction. Among secondary outcomes, T90 showed the highest AUCs for diabetes mellitus (0.644) and hypertension (0.615), and mean SpO₂ for heart failure (0.608). No index discriminated against previous stroke or atrial fibrillation.

Conclusions

AHI–ODI discordance was independently, but only modestly, associated with EDS, whereas oxygenation indices were related to prevalent cardiometabolic comorbidity.

The discrimination was insufficient, and all reported cut-offs are exploratory. AHI–ODI discordance is not a measure of sleep apnea-specific hypoxic burden.

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阻塞性睡眠呼吸暂停的呼吸暂停-低通气指数-氧去饱和指数（AHI-ODI）不一致：与症状负担和心脏代谢合并症的关联：一项回顾性横断面研究

背景：呼吸暂停低通气指数（AHI）计算呼吸事件，但不计算伴随的去饱和的深度或持续时间。我们检查了AHI-ODI不一致（AHI减去氧去饱和指数，ODI）及其与日间症状负担和普遍的心脏代谢合并症的关系。方法：对200例成人OSA患者（2023年1月- 2025年1月）进行单中心回顾性横断面研究。检测5项指标（AHI、ODI、平均SpO2、T90和AHI-ODI不一致性）；白天过度嗜睡（EDS； Epworth嗜睡量表≥11）是主要结局。多变量logistic回归校正了年龄、性别、BMI和AHI-ODI ×性别的相互作用。结果：男性占77.5%，中位年龄57岁（48.8-64.2岁）。对于EDS， AHI-ODI不一致性的AUC （0.639, p 2）和ODI（各0.609）在数值上最高；AHI差异无统计学意义（0.546,p = 0.264）。两两比较无显著差异。调整后，AHI-ODI不一致仍与EDS独立相关（OR 1.04 /事件/小时，95% CI 1.01-1.07, p = 0.008），无显著的性别相互作用。在次要结局中，糖尿病（0.644）和高血压（0.615）的T90 auc最高，心力衰竭（0.608）的平均SpO2最高。没有指标区分既往卒中或房颤。结论：AHI-ODI不一致与EDS独立相关，但仅适度相关，而氧合指数与普遍的心脏代谢合并症相关。这种区分是不充分的，所有报道的截止值都是探索性的。AHI-ODI不一致不是衡量睡眠呼吸暂停特异性缺氧负担的指标。

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

Respiratory medicine 医学-呼吸系统

CiteScore

7.50

自引率

0.00%

发文量

199

审稿时长

38 days

期刊介绍： Respiratory Medicine is an internationally-renowned journal devoted to the rapid publication of clinically-relevant respiratory medicine research. It combines cutting-edge original research with state-of-the-art reviews dealing with all aspects of respiratory diseases and therapeutic interventions. Topics include adult and paediatric medicine, epidemiology, immunology and cell biology, physiology, occupational disorders, and the role of allergens and pollutants. Respiratory Medicine is increasingly the journal of choice for publication of phased trial work, commenting on effectiveness, dosage and methods of action.