Concordancia entre el índice de apnea-hipopnea y tiempo acumulado con saturación de oxihemoglobina bajo 90% en la clasificación de gravedad de la apnea obstructiva del sueño

Abstract

Obstructive sleep apnea (OSA) is classified based on the apnea-hypopnea index (AHI). Another proposed variable for determining the severity of OSA is the total time with oxygen saturation below 90% (T90). Objective: To evaluate the concordance of the severity classification of OSA considering AHI versus T90 in Chilean population. Method: Individuals aged 15 years and older with confirmed OSA by home sleep apnea test (AHI > 5 events/hour) were included. The severity of OSA according to AHI or T90 was determined using the criteria proposed by the Spanish Society of Pulmonology and Thoracic Surgery (SEPAR). Concordance was assessed using weighted kappa statistic. Results: Among 535 cases, considering AHI, 21.3% were classified as mild, 27.9% as moderate, 23.2% as severe, and 27.7% as very severe. According to T90, the percentages were 3.9%, 33.5%, 15.1%, and 47.5%, respec­tively. The concordance between AHI and T90 in determining the severity of OSA was between fair and moderate (kappa = 0.41, IC 95%: 0.35 - 0.46). Conclusion: The concordance between IAH and T90 in determining the severity of OSA was between fair and moderate (kappa = 0.41, IC 95%: 0.35 - 0.46). T90 would contribute to the evaluation of the severity ofobstructive sleep apnea.