Feasibility of screening and diagnosing obstructive sleep apnea-hypopnea syndrome by oxygen desaturation index and its association with nighttime blood pressure

doi:10.16150/j.1671-2870.2017.06.005

Abstract

Abstract: Objectives: To investigate the correlation of oxygen desaturation index (ODI) with apnea-hypopnea index (AHI) and nighttime blood pressure, and to calculate the sensitivity and specificity of ODI for diagnosing obstructive sleep apnea-hypopnea syndrome(OSAS). Methods: Standard polysomnography examination was conducted in patients who had 24-h ambulatory blood pressure and nighttime pulse oxygen saturation monitoring performed and having ODI>3 times/h and 24-h ambulatory hypertension (≥130/80 mmHg). The correlations of ODI with AHI and ambulatory blood pressure were analyzed by Spearman correlation analysis and covariance analysis; sensitivity and specificity of ODI for diagnosing OSAS were calculated by receiver operator characteristic(ROC) curve. Results: A total of 184 patients with average age of 51.3 years, 52.7% were male, and 50.5% were on antihypertensive treatment were enrolled. It showed that ODI was positively correlated with AHI (r=0.38, P<0.001). When ODI≥8 times/h was taken as cutoff value, the sensitivity and specificity for diagnosing moderate and severe OSAS (AHI≥5 times/h) were 69.4%, 65.0% respectively, and the area under the ROC curve was 0.69. When ODI≥14 times/h was taken as the cutoff value for diagnosing moderate and severe OSAS (AHI≥15 times/h), the corresponding values were 48.3%, 83.2% and 0.68, respectively. Nighttime systolic and diastolic blood pressures and heart rate increased with the increase of ODI (P for trends<0.05). Compared with those who had an ODI of <8 times/h, patients with ODI≥14 times/h suffered an increased nighttime blood pressure of 6.2/4.7 mmHg and a faster heart rate by 3.3 beats/min. Conclusions: ODI derived from a simple and noninvasive nighttime pulse oxygen saturation monitoring is correlated with the AHI obtained from polysomnography. The sensitivity and specificity of ODI for diagnosing OSAS is moderate and acceptable. ODI is correlated with nighttime blood pressure and should be helpful to the etiological analysis of nighttime hypertension.

Key words: Obstructive sleep apnea-hypopnea syndrome, Oxygen desaturation index, Apnea-hypopnea index, Nighttime blood pressure

CLC Number:

R544.1

CHEN Qi, CHENG Yibang, HUANG Qifang, WANG Jiguang, LI Yan. Feasibility of screening and diagnosing obstructive sleep apnea-hypopnea syndrome by oxygen desaturation index and its association with nighttime blood pressure[J]. Journal of Diagnostics Concepts & Practice, 2017, 16(06): 587-591.

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