Influences of the Revised American Academy of Sleep Medicine Criteria for Scoring Apnea and Hypopnea on the Apnea-Hypopnea Index

Kim, Cheon Sik; Lee, Sang-Ahm; Kim, Min Ju; Lee, Eun Mi; Lee, Yong Seok; Chung, Yoo-Sam; Kim, Woo Sung

doi:2010.7.2.37

J Korean Sleep Res Soc > Volume 7(2); 2010 > Article

ORIGINAL ARTICLE

J Korean Sleep Res Soc. 2010;7(2):37-42. doi: https://doi.org/10.13078/jksrs.10007

개정된 미국수면의학회 판독 기준이 무호흡 및 저호흡 지수에 미치는 영향

김천식, 이상암, 김민주, 이은미, 이용석, 정유삼, 김우성

¹울산대학교 의과대학 서울아산병원 신경과학교실
²울산대학교 의과대학 서울아산병원 이비인후과학교실
³울산대학교 의과대학 서울아산병원 호흡기내과학교실

Influences of the Revised American Academy of Sleep Medicine Criteria for Scoring Apnea and Hypopnea on the Apnea-Hypopnea Index

Cheon Sik Kim, Sang-Ahm Lee, Min Ju Kim, Eun Mi Lee, Yong Seok Lee, Yoo-Sam Chung, Woo Sung Kim

¹1Departments of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
²Otolarygology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
³Pulmonary and Critical Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea

Corresponding Author: Sang-Ahm Lee ,Tel: +82-2-3010-3445, Fax: +82-2-474- 4691, Email: salee@amc.seoul.kr

Received: August 18, 2010 Accepted: September 20, 2010 Published online: December 31, 2010

ABSTRACT

Objectives: The definition of accurate recording and measuring of sleep related obstructive breathing events are clinically critical as a base for quantifying disease severity in obstructive sleep apnea (OSA) syndrome. The aim of the study was to compare apnea and hypopnea indices using different scoring recommendations.
Methods: We retrospectively selected total 60 patients who were diagnosed with OSA syndrome. All sleep-related parameters including apnea index, hypopnea index, and apnea-hypopnea index (AHI) were measured by two different criteria; 1999 Chicago criteria and 2007 American Academy of Sleep Medicine (AASM) criteria for scoring respiratory events.
Results: Apnea index and AHI by Chicago criteria were significantly higher than those by AASM criteria (mean 21.0/hr vs. 15.1/hr, p<0.001; mean 36.8/hr vs. 29.4/hr, p<0.001, respectively). But hypopnea index was not different between two criteria. Bland-Altman plots demonstrated a median (5th, 95th percentiles) reduction of 6.1/h (0.16, 20.57) when comparing AHI by AASM criteria to AHI by Chicago criteria.
Conclusions: Our results suggested that AASM criteria intended to diagnose more confirmative OSA patients than Chicago criteria. Updated criteria may be stricter but possibly rule out mild OSA patients.

Keywords: 1999 Chicago criteria | 2007 AASM criteria | Apnea-hypopnea index | Obstructive sleep apnea.