Obstrüktif Uyku Apne Sendromunda Evrelemeye Farklı Bir Bakış Açısı

Abstract

AMAÇ: Amerikan Uyku Tıbbı Akademisi (AASM) kriterleri obstrüktif uyku apne sendromunu (OSAS) hafif, orta ve şiddetli olmak üzere üç gruba ayırmaktadır. Mevcut sınıflandırma sistemi, apne-hipopne indeksi (AHİ) >30 olan tüm hastaları şiddetli OSAS olarak kabul etmektedir. Bu çalışma, AHI, vücut kitle indeksi (VKİ), oksijen desatürasyon indeksi (ODİ) ve eşlik eden hastalıklar arasındaki ilişkiyi inceleyerek OSASevrelemesine farklı bir bakış açısı sunmaktadır. GEREÇ ve YÖNTEMLER: Haziran 2021 ile Haziran 2023 tarihleri arasında uyku laboratuvarımızda polisomnografi uygulanan hastaların verileri retrospektif olarak incelendi. Demografik veriler, antropometrik ölçümler, eşlik eden hastalıklar, Epworth uyku hali ölçeği (ESS) puanları ve polisomnografi kayıtları değerlendirildi. AHI'ye göre sekiz hasta grubu oluşturuldu: Grup 0 (basit horlama), AHI <5; Grup 1 (hafif OSAS), AHI = 5-15; Grup 2 (orta şiddette OSAS), AHI = 16-30; ve Grup 3-7 (şiddetli OSAS), AHI = sırasıyla 31-45, 46-60, 61-75, 76-90 ve >90 idi. AHI, VKİ, ODİ ve eşlik eden hastalıklar arasındaki ilişkiler değerlendirildi. BULGULAR: Grup 0-7’de sırasıyla 30, 91, 121, 80, 57, 40, 43 ve 22 hasta çalışmaya dahil edildi. ESS skorları, ODİ, VKİ ve eşlik eden hastalıklar arttıkça AHI artıyordu. Ayrıca, şiddetli OSAS grupları arasında anlamlı farklılıklar bulduk. SONUÇ: Çalışmanın sonuçları, hastaları AASM kriterlerine göre üç gruba ayırmanın OSAS şiddetini belirlemek için yeterli olmayabileceğini düşündürmektedir. Bu nedenle, evrelemede grup sayısının artırılması düşünülmelidir.

Keywords

• Obstrüktif uyku apne sendromu
• apne-hipopne indeksi
• vücut kitle indeksi
• oksijen desatürasyon indeksi
• eşlik eden hastalıklar

A Different Perspective on Apnea–Hypopnea Index-Based Severity Classification in Obstructive Sleep Apnea Syndrome

Abstract

OBJECTIVE: The American Academy of Sleep Medicine (AASM) criteria classify obstructive sleep apnea syndrome (OSAS) into three groups: mild, moderate, and severe. The current classification system considers all patients with an apnea-hypopnoea index (AHI) of >30 as having severe OSAS. This study offers a different perspective on OSAS staging by examining the relationship among the AHI, body mass index (BMI), oxygen desaturation index (ODI), and comorbidities. MATERIALS and METHODS: The data of patients who underwent polysomnography at our sleep laboratory between June 2021 and June 2023 were retrospectively reviewed. Demographic data, anthropometric measurements, comorbidities, Epworth sleepiness scale (ESS) scores, and polysomnography records were evaluated. Eight patient groups were created based on the AHI: group 0 (simple snoring), AHI <5; group 1 (mild OSAS), AHI = 5-15; group 2 (moderate OSAS), AHI = 16-30; and groups 3-7 (severe OSAS), AHI = 31-45, 46-60, 61-75, 76-90, and >90, respectively. Relationships among the AHI, BMI, ODI, and comorbidities were evaluated. RESULTS: We included 30, 91, 121, 80, 57, 40, 43, 22 patients in groups 0 to 7, respectively. The ESS scores, ODI, BMI, and comorbidities increased as the AHI increased. Furthermore, we found significant differences among the severe OSAS groups. CONCLUSION: These findings suggest that dividing patients into three groups based on the AASM criteria may be insufficient to determine the severity of OSAS. Therefore, increasing the number of groups in staging should be considered.

Keywords

• Obstructive sleep apnea syndrome
• apnea-hypopnea index
• body mass index
• oxygen desaturation index
• comorbidities

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