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.
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
.
DOI: 10.16150/j.1671-2870.2017.06.005
[1] Torres G, Sánchez-de-la-Torre M, Barbé F. Relationship between OSA and hypertension[J]. Chest,2015,148(3):824-832.
[2] Qaseem A, Dallas P, Owens DK, et al.Best Practice Advice From the Clinical Guidelines Committee of the American College of Physicians[J]. Ann Intern Med,2014,161(3):210-220.
[3] Lin CL, Yeh C, Yen CW, et al.Comparison of the indices of oxyhemoglobin saturation by pulse oximetry in obstructive sleep apnea hypopnea syndrome[J]. Chest,2009,135(1):86-93.
[4] 中国高血压联盟; 中国医师协会高血压专业委员会血压测量与监测工作委员会; 《中华高血压杂志》编委会. 动态血压监测临床应用中国专家共识[J]. 中华高血压杂志,2015,23(8):727-730.
[5] Zhang L, Li Y, Wei FF, et al.Strategies for classifying patients based on office, home, and ambulatory blood pressure measurement[J]. Hypertension,2015,65(6):1258-1265.
[6] 中华医学会呼吸病学分会睡眠呼吸疾病学组. 睡眠呼吸暂停人群高血压患病率的多中心研究[J]. 中华结核和呼吸杂志, 2007,30(12):894-897.
[7] Logan AG, Perlikowski SM, Mente A, et al.High prevalence of unrecognized sleep apnoea in drug-resistant hypertension[J]. J Hypertens,2001,19(12):2271-2277.
[8] Pedrosa RP, Drager LF, Gonzaga CC, et al.Obstructive sleep apnea: the most common secondary cause of hypertension associated with resistant hypertension[J]. Hypertension,2011,58(5):811-817.
[9] Bradley TD, Floras JS.Obstructive sleep apnoea and its cardiovascular consequences[J]. Lancet,2009,373(9657):82-93.
[10] Berry RB, Budhiraja R, Gottlieb DJ, et al.Rules for sco-ring respiratory events in sleep: update of the 2007 AASM Manual for the Scoring of Sleep and Associated Events. Deliberations of the Sleep Apnea Definitions Task Force of the American Academy of Sleep Medicine[J]. J Clin Sleep Med,2012,8(5):597-619.
[11] Netzer N, Eliasson AH, Netzer C, et al.Overnight pulse oximetry for sleep-disordered breathing in adults: a review[J]. Chest,2001,120(2):625-633.
[12] Ling IT, James AL, Hillman DR.Interrelationships between body mass, oxygen desaturation, and apnea-hypopnea indices in a sleep clinic population[J]. Sleep,2012, 35(1):89-96.
[13] Tkacova R, McNicholas WT, Javorsky M, et al. Nocturnal intermittent hypoxia predicts prevalent hypertension in the European Sleep Apnoea Database cohort study[J]. Eur Respir J,2014,44(4):931-941.
[14] Boggia J, Li Y, Thijs L, Hansen TW, et al.Prognostic accuracy of day versus night ambulatory blood pressure: a cohort study[J]. Lancet,2007,370(9594): 1219-1229.
[15] Hansen TW, Li Y, Boggia J, et al.Predictive role of the nighttime blood pressure[J]. Hypertension,2011,57(1):3-10.
