RemLogic plug-in enables clinical application of apnea-hypopnea index adjusted for severity of individual obstruction events

Abstract

Obstructive sleep apnea (OSA) is diagnosed based on obstruction event incidence, albeit individual obstruction event severity is connected to increased mortality rate. Adjusted-AHI parameter, incorporating number and severity of obstruction events, has shown good potential, but is calculated using custom-made MATLAB^® functions. To allow its clinical use, this study introduces the RemLogic™ plug-in. It is tested comparing adjusted-AHI values calculated with the plug-in and MATLAB^® with a hundred patients. Furthermore, retrospective follow-up (mean ± SD = 194.1 ± 54.0 months) of 1128 working-age men was conducted to evaluate potential of adjusted-AHI to enhance diagnostic of OSA. Adjusted-AHI values were strongly correlated (r = 1.000, p < 0.001) and their average difference (mean ± SD) was minimal (0.08 ± 0.19%). Using adjusted-AHI to define OSA severity resulted in a higher hazard ratio of mortality in the severe OSA group and, for the first time, adjusted-AHI was found to explain independently the overall mortality and non-fatal cardiovascular events. Importantly, the present plug-in enables clinical use of adjusted-AHI, enhancing assessment of OSA severity.

Keywords:

• Obstructive sleep apnea
• AHI
• adjusted-AHI
• mortality
• morbidity