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. 2018 Mar;56(1):1-6.
doi: 10.5152/tao.2018.3025. Epub 2018 Mar 1.

The Ignored Parameter in the Diagnosis of Obstructive Sleep Apnea Syndrome: The Oxygen Desaturation Index

Dastan Temirbekov  1 , Selçuk Güneş  1 , Zahide Mine Yazıcı  1 , İbrahim Sayın  1
Affiliations

The Ignored Parameter in the Diagnosis of Obstructive Sleep Apnea Syndrome: The Oxygen Desaturation Index

Dastan Temirbekov et al. Turk Arch Otorhinolaryngol. 2018 Mar.

Abstract

Objective: The apnea-hypopnea index (AHI) does not provide information about the apnea depth and length. We aimed to evaluate the correlation of the oxygen desaturation index (ODI) with AHI and the subjective symptoms because it is known that hypoxia plays an important role in morbidity and complications of obstructive sleep apnea syndrome (OSAS).

Methods: We reviewed the data of patients who applied to our clinic between 2010 and 2014 and underwent polysomnography (PSG) with a diagnosis of suspected sleep apnea. The demographic and anthropometric data of the patients were recorded. Epworth sleepiness scale (ESS) and values of AHI and ODI were analyzed in PSG.

Results: A total of 321 patients were divided into four groups, according to AHI as follows: 82 (25.5%) common snoring, 77 (24%) mild obstructive sleep apnea (OSA), 71 (22.1%) moderate OSA, and 91 (28.3%) severe OSA. A strong correlation was detected between AHI and ODI (p<0.005 and r=0.904) in all patient groups. There was a positive correlation between AHI and ESS (p<0.05 and r=0.435), but the correlation of ESS with ODI was stronger than that with AHI (p<0.05 and r=0.504).

Conclusion: The subjective symptoms of sleep apnea syndrome seem to be closely related to oxygen desaturations. Hypoxia during apnea periods of OSA is important; therefore, we suggest that ODI is as valuable as AHI in diagnosing and grading the OSAS.

Keywords: Epworth sleepiness scale; Obstructive sleep apnea; apnea-hypopnea index; oxygen desaturation index; polysomnography.

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Conflict of interest statement

Conflict of Interest: No conflict of interest was declared by the authors.

Figures

Figure 1. a, b
Figure 1. a, b
PSG images of two patients showing the apnea episodes. (a) It is observed that apnea attacks of the patient were longer and oxygen desaturations were deeper, but attacks were not so frequent (AHI 21.0), (b) It is observed that the patient had shorter apneas not with desaturation and apnea attacks, and they repeated more frequently (AHI 48.5).
Figure 2
Figure 2
Respiratory patterns during a 3-minute time period for a patient with OSA syndrome showing obstructive apneas with typical saw-tooth morphology of the pulse oximetry curve Flowna=Nasal and oral airflow, Respth=Thoracic respiratory effort, Respabd=Abdominal respiratory effort, Respsum=Thoracic and abdominal respiratory effort total, O=Obstructive apnea.
See this image and copyright information in PMC

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