Table 3.
Studies assessing oximetric metrics.
| Study | Study Size/Type | Type of PSG (Level 1 or 2) | Sex (% male) | Mean BMI (kg/m2) | Mean AHI (/h) | Mean Age (years) | % OSA Participants | Metric | Outcome | Results |
|---|---|---|---|---|---|---|---|---|---|---|
| Azarbarzin (2019)36 USA | 7854/Retro of Pros | MrOS: 2 SHHS: 1 | MrOS: 100 SHHS: 45.3 | MrOS: 27.2 SHHS: 28.3 | MrOS: 15.7 SHHS: 17.1 | MrOS: 74.3 SHHS: 61.0 | MrOS: 39.8 SHHS: 26 | HB | CVD mortality and all-cause mortality | Individuals in the MrOS study with hypoxic burden in the highest 2 quintiles had hazard ratios of 1.81 and 2.73, respectively, compared with the first quintile for CV-related mortality. The group in the SHHS with HB in the highest quintile had a hazard ratio of 1.96 for CV-related mortality. |
| Azarbarzin (2020)37 USA | 7534/Retro of Pros | MrOS: 2 SHHS: 1 | MrOS: 100 SHHS: 45.3 | MrOS: 27.1 SHHS:28.3 | MrOS: 11.4 SHHS: 8.6 | MrOS: 76.2 SHHS: 63.6 | Not referenced | HB | HF | The sleep HB was associated with incident HF in men in 2 independent cohorts. Moreover, HB predicted incident HF in groups with both high and low AHI levels. |
| Azarbarzin (2021)9 USA | 5970/Retro of Pros | 1 | MESA: 47.5 SHHS: 47.7 | MESA: 28.8 SHHS: 28.3 | MESA: 19.3 SHHS: 14.1 | MESA: 68.5 SHHS: 64.2 | MESA: 3.9 SHHS: 28 | HB | CVD and all-cause mortality | Relationship between delta HR and fatal CVD or all-cause mortality was strengthened in patients with a high HB. They also noted no association between a high delta HR and fatal CVD or all-cause mortality in those with a low HB. |
| Jackson (2021)38 USA | 1895/Retro of Pros | 2 | 46.3 | 28.8 | Not referenced | 68.2 | Not referenced | HB | Chronic kidney disease | ASHB was associated with moderate-to-severe CKD. Black women in highest vs lowest quantile of ASHB also had a higher CKD prevalence. |
| Kim (2021)31 USA | 2055/Cross-sectional | 1 | 46/54 | 28.7 | 14.8 | 68.4 | Not referenced | HB | Hypertension | Higher burden was associated with higher BP. |
| Trzepizur (2022)22 France | 5358/Retro of Pros | 2 | 63.66/36.34 | 30 | 27 | 60 | 200 | HB | MACE | HB was an independent predictor of incident CV events and death. |
| Blanchard (2021)21 France | 3597/Retro of Pros | 2 | 63 | 28 | 20 | 58 | 85 | HB | Risk of stroke incidence | HB was associated with stroke risk in OSA patients. |
| de Chazal (2021)39 Australia | 4686/Retro of Pros | 2 | 48/52 | Not referenced | Not referenced | >40 | Not referenced | REDTA | CVD mortality | Hazard ratios in adjusted Cox analysis for predicting cardiovascular death using REDTA are up to 1.90 in the third quantile. |
| Wang (2020)41 China | 102/Cross-sectional | 1 | 67/33 | 29.5 | 63 | 100 | 50.3 | ODR | Hypertension | ODR was more strongly associated with elevation of BP and BPV in patients with severe OSA |
| Kwon (2021)42 USA | 2631/Retro of Pros | 2 | 100/0 | 27.2 | 18 | 76.4 | Not referenced | LFCt | CVD and all-cause mortality | LFCt was independently associated with both CV and all-cause mortality in older men with SDB, independent of both baseline CV burden and conventional SDB metrics. |
| Kainulainen (2020)52 Finland | 743/Retro | 1 | 58.7 | 35.1 | 23.7 | 56.8 | 100 | Desaturation severity, obstruction severity, respiratory event duration | PVT reaction time and the number of lapses | Desaturation severity is significantly associated with increased risk of impaired PVT performance. |
| Muraja-Murro (2013)43 Finland | 226/Retro | 1 | Not referenced | 29.3 | 19.5 | 54.6 | 38.8 | Desaturation severity, obstruction severity, respiratory event duration | Mortality | Obstruction severity was the only parameter which was related statistically significantly to mortality in the severe OSA category |
AHI = apnea-hypopnea index, BMI = body mass index, BP = blood pressure, BPV = blood pressure variability, CKD = chronic kidney disease, CV = cardiovascular, CVD = cardiovascular disease, HB = hypoxic burden, HF = heart failure, HR = heart rate, LFCt = lung to finger circulation time, MACE = major adverse cardiovascular event, MESA = Multi-Ethnic Study of Atherosclerosis, MrOS = Osteoporotic Fractures in Men Study, ODI = oxygen desaturation index, ODR = oxygen desaturation rate, OSA = obstructive sleep apnea, Pros = prospective, PSG = polysomnography, PVT = Psychomotor Vigilance Test, REDTA = Respiratory Event Desaturation Transient Area, Retro = retrospective, Retro of Pros = retrospective analysis of prospective study, SD = standard deviation, SDB = sleep-disordered breathing, SHHS = Sleep Heart Health Study.