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. 2023 Feb 1;19(2):267-274.
doi: 10.5664/jcsm.10302.

The effectiveness of sleep breathing impairment index in assessing obstructive sleep apnea severity

Lu Dai  1 , Wenhao Cao  1 , Jinmei Luo  1 , Rong Huang  1 , Yi Xiao  1
Affiliations

The effectiveness of sleep breathing impairment index in assessing obstructive sleep apnea severity

Lu Dai et al. J Clin Sleep Med. .

Abstract

Study objectives: Using the apnea-hypopnea index (AHI) and the sleep breathing impairment index (SBII) to assess the severity of obstructive sleep apnea (OSA) to study how effective SBII is in assessing the severity and cardiovascular disease (CVD) prognosis.

Methods: This study comprised a total of 147 patients with diagnosed OSA. The AHI and SBII were calculated from the polysomnography. Patients were enrolled in the cluster analysis using 20 symptoms and the SBII. The prognostic indicator was determined as the moderate-to-high Framingham 10-year CVD risk.

Results: Cluster analysis revealed 3 separate groups: cluster 1 (n = 45, 30.61%) had the lowest symptoms complaints yet the highest PSQI score; cluster 2 (n = 70, 47.62%) had considerably increased symptom complaints but the lowest Epworth Sleepiness Scale score, intermediate PSG indices, a higher low arousal threshold possibility, and a lower SBII quantile; cluster 3 (n = 32, 21.77%) had the largest percentage of smokers, a predominant symptom of restless sleep, severe PSG characteristics, a lower low arousal threshold likelihood, a greater SBII quantile and a higher Framingham CVD risk. There were no differences in severity indicated by AHI between groups. Higher SBII rather than AHI is associated with an increased 10-year CVD risk.

Conclusions: SBII provides higher sensitivity when evaluating OSA severity and better predictive capabilities for CVD outcomes. SBII may be a more effective substitute for AHI in the future.

Citation: Dai L, Cao W, Luo J, Huang R, Xiao Y. The effectiveness of sleep breathing impairment index in assessing obstructive sleep apnea severity. J Clin Sleep Med. 2023;19(2):267-274.

Keywords: Framingham cardiovascular risk; apnea-hypopnea index; cluster analysis; obstructive sleep apnea; sleep breathing impairment index.

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Conflict of interest statement

All authors have seen and approved the manuscript. Work for this study was performed at the Sleep Unit, Peking Union Medical College Hospital, Beijing, China. This study was funded by the National Key Research and Development Project of China (no. 2013BAI09B10), National Natural Science Foundation of China (81570085), and CAMS Innovation Fund for Medical Sciences (CIFMS; 2021-I2M-C&T-B-013). The authors report no conflicts of interest.

Figures

Figure 1
Figure 1. Probability of having a symptom within each cluster.
See this image and copyright information in PMC

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