Age related disparities in sleep apnea diagnosis using a wearable device: Implications of 4% vs. 3% hypopnea scoring criteria

Sleep Med. 2024 Jun:118:88-92. doi: 10.1016/j.sleep.2024.03.046. Epub 2024 Apr 1.

Abstract

Study objectives: Obstructive sleep apnea (OSA) diagnosis relies on the Apnea-Hypopnea Index (AHI), with discrepancies arising from the 3% and 4% desaturation criteria. This study investigates age-related variations in OSA severity classification, utilizing data from 1201 adult patients undergoing Home Sleep Apnea Testing (HSAT) with SleepImage Ring@.

Methods: The study employs Bland-Altman analysis to compare AHI values obtained with the 3% and 4% desaturation criteria. Age-stratified analysis explores discrepancies across different age groups.

Results: The analysis reveals a systematic bias favoring the 3% criterion, impacting the quantification of apnea events. Age-specific patterns demonstrate diminishing agreement between criteria with increasing age.

Conclusion: This comprehensive study underscores the importance of standardized criteria in OSA diagnosis. The findings emphasize age-specific considerations and ethical concerns, providing crucial insights for optimizing patient care and advancing sleep medicine practices.

Keywords: Apnea/hypopnea index; Desaturation; Diagnostic criteria; Hypopnea; Sleep apnea.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Age Factors
  • Aged
  • Female
  • Humans
  • Male
  • Middle Aged
  • Polysomnography* / instrumentation
  • Polysomnography* / methods
  • Severity of Illness Index
  • Sleep Apnea, Obstructive* / diagnosis
  • Wearable Electronic Devices*