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

Abstract

Address for correspondence Sang-Ahm Lee, MD, PhD Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, 86 Asanbeongwon-gil, Songpa-gu, Seoul 138-736, Korea Tel: +82-2-3010-3445 Fax: +82-2-4744691 E-mail: salee@amc.seoul.kr 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. J Korean Sleep Res Soc 2010;7:37-42