Universität zu Köln

Pevernagie, Dirk A., Gnidovec-Strazisar, Barbara, Grote, Ludger, Heinzer, Raphael, McNicholas, Walter T., Penzel, Thomas ORCID: 0000-0002-4304-0112, Randerath, Winfried, Schiza, Sophia, Verbraecken, Johan and Arnardottir, Erna S. (2020). On the rise and fall of the apnea-hypopnea index: A historical review and critical appraisal. J. Sleep Res., 29 (4). HOBOKEN: WILEY. ISSN 1365-2869

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Abstract

The publication of The Sleep Apnea Syndromes by Guilleminault et al. in the 1970s hallmarked the discovery of a new disease entity involving serious health consequences. Obstructive sleep apnea was shown to be the most important disorder among the sleep apnea syndromes (SAS). In the course of time, it was found that the prevalence of obstructive sleep apnea reached the proportions of a global epidemic, with a major impact on public health, safety and the economy. Early on, a metric was introduced to gauge the seriousness of obstructive sleep apnea, based on the objective measurement of respiratory events during nocturnal sleep. The apnea index and later on the apnea-hypopnea index, being the total count of overnight respiratory events divided by the total sleep time in hours, were embraced as principle measures to establish the diagnosis of obstructive sleep apnea and to rate its severity. The current review summarises the historical evolution of the apnea-hypopnea index, which has been subject to many changes, and has been criticised for not capturing relevant clinical features of obstructive sleep apnea. In fact, the application of the apnea-hypopnea index as a continuous exposure variable is based on assumptions that it represents a disease state of obstructive sleep apnea and that evocative clinical manifestations are invariably caused by obstructive sleep apnea if the apnea-hypopnea index is above diagnostic threshold. A critical appraisal of the extensive literature shows that both assumptions are invalid. This conclusion prompts a reconsideration of the role of the apnea-hypopnea index as the prime diagnostic metric of clinically relevant obstructive sleep apnea.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Pevernagie, Dirk A. UNSPECIFIED UNSPECIFIED UNSPECIFIED Gnidovec-Strazisar, Barbara UNSPECIFIED UNSPECIFIED UNSPECIFIED Grote, Ludger UNSPECIFIED UNSPECIFIED UNSPECIFIED Heinzer, Raphael UNSPECIFIED UNSPECIFIED UNSPECIFIED McNicholas, Walter T. UNSPECIFIED UNSPECIFIED UNSPECIFIED Penzel, Thomas UNSPECIFIED orcid.org/0000-0002-4304-0112 UNSPECIFIED Randerath, Winfried UNSPECIFIED UNSPECIFIED UNSPECIFIED Schiza, Sophia UNSPECIFIED UNSPECIFIED UNSPECIFIED Verbraecken, Johan UNSPECIFIED UNSPECIFIED UNSPECIFIED Arnardottir, Erna S. UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-333810
DOI:	10.1111/jsr.13066
Journal or Publication Title:	J. Sleep Res.
Volume:	29
Number:	4
Date:	2020
Publisher:	WILEY
Place of Publication:	HOBOKEN
ISSN:	1365-2869
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language OBSTRUCTIVE SLEEP-APNEA; POSITIVE AIRWAY PRESSURE; RESPIRATORY EVENTS; CARDIOVASCULAR OUTCOMES; SEVERITY CLASSIFICATION; DAYTIME SLEEPINESS; PRECISION MEDICINE; GENERAL-POPULATION; SCORING CRITERIA; DEFINITIONS Multiple languages Clinical Neurology; Neurosciences Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/33381