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- Atul Malhotra
- Department of Medicine, University of California San Diego , La Jolla, CA
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- Indu Ayappa
- Department of Medicine, Mt. Sinai , New York, NY
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- Najib Ayas
- Department of Medicine, University of British Columbia , Vancouver, BC , Canada
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- Nancy Collop
- Department of Medicine, Emory University , Atlanta, GA
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- Douglas Kirsch
- Department of Medicine, Atrium Health Sleep Medicine, Atrium Health , Charlotte, NC
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- Nigel Mcardle
- Department of Medicine, The University of Western Australia , Perth , Australia
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- Reena Mehra
- Department of Medicine, Cleveland Clinic , Cleveland, OH
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- Allan I Pack
- Department of Medicine, University of Pennsylvania , Philadelphia, PA
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- Naresh Punjabi
- Department of Medicine, University of Miami , Miami, FL
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- David P White
- Alairion Pharmaceuticals Cambridge, MA
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- Daniel J Gottlieb
- Medical service, VA Boston Healthcare System , Boston, MA
抄録
<jats:title>Abstract</jats:title> <jats:p>Obstructive sleep apnea (OSA) is thought to affect almost 1 billion people worldwide. OSA has well established cardiovascular and neurocognitive sequelae, although the optimal metric to assess its severity and/or potential response to therapy remains unclear. The apnea-hypopnea index (AHI) is well established; thus, we review its history and predictive value in various different clinical contexts. Although the AHI is often criticized for its limitations, it remains the best studied metric of OSA severity, albeit imperfect. We further review the potential value of alternative metrics including hypoxic burden, arousal intensity, odds ratio product, and cardiopulmonary coupling. We conclude with possible future directions to capture clinically meaningful OSA endophenotypes including the use of genetics, blood biomarkers, machine/deep learning and wearable technologies. Further research in OSA should be directed towards providing diagnostic and prognostic information to make the OSA diagnosis more accessible and to improving prognostic information regarding OSA consequences, in order to guide patient care and to help in the design of future clinical trials.</jats:p>
収録刊行物
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- Sleep
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Sleep 44 (7), 2021-03-09
Oxford University Press (OUP)