What does this research mean for the field?

In patients evaluated for obstructive sleep apnea, sleep arousal indices correlate significantly with apnea-hypopnea severity, blood pressure, and obesity measures, but not with parameters of daytime sleepiness. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

January 1, 2009Open Access

Relationship between Arousal Indices and Clinical Manifestations in Patients Who Performed Polysomnography

Structured PICO

Do arousal indices correlate with clinical and physiological parameters in patients undergoing polysomnography for suspected obstructive sleep apnea?

Population

41 patients who performed polysomnography for a diagnosis of obstructive sleep apnea syndrome

Intervention

Measurement of arousal indices (total arousal index [TAI] and respiratory arousal index [RAI]) via polysomnography

Outcome

Correlation between arousal indices and clinical parameters (apnea-hypopnea index, oxygen saturation, blood pressure, sleepiness, BMI, neck circumference)surrogate

In patients evaluated for obstructive sleep apnea, arousal indices correlate strongly with apnea severity and moderately with elevated blood pressure, highlighting the cardiovascular impact of sleep fragmentation.

Abstract

Background: Repeated arousals during sleep have been known to be associated with excessive daytime sleepiness and cardiovascular complications. We investigated the relationship between arousal indices and clinical parameters. Methods: We retrospectively reviewed medical records of 41 patients who performed polysomnography for a diagnosis of obstructive sleep apnea syndrome. We defined total arousal index (TAI) as the number of arousals per hour and respiratory arousal index (RAI) as the number of arousals associated with apnea or hypopnea per hour. Results: There were significant positive correlations between arousal indices and apnea-hypopnea index (AHI) (RAI vs. AHI, r=0.958, p0.001; TAI vs. AHI, r=0.840, p0.001). RAI and mean oxygen saturation showed a significant negative correlation with each other (r=-0.460, p=0.002). TAI revealed a significant positive correlation with mean systolic blood pressure (MSBP) and mean diastolic blood pressure (MDBP) (TAI vs. MSBP, r=0.389, p=0.014; TAI vs. MDBP, r=0.373, p=0.019). There was no significant correlation between arousal indices and parameters of sleepiness. RAI had a significant positive correlation with body mass index (BMI) and neck circumference (NC) (RAI vs. BMI, r=0.371, p=0.017; RAI vs. NC, r=0.444, p=0.004). When partial correlation analysis was performed to adjust for other variables, there was significant correlation between RAI and AHI (r=0.935, p0.001).

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