title: Effectiveness of treatment apnea-hypopnea index: a mathematical estimate of the true apnea-hypopnea index in the home setting.
abstract: OBJECTIVE
  To present a new measurement instrument, the Effectiveness of Treatment Apnea-Hypopnea Index (ET-AHI), which the authors developed to determine an estimate of the therapeutic control of obstructive sleep apnea (OSA).
  
  
  METHODS
  The authors retrospectively evaluated a cohort of patients with OSA who initially attempted to use continuous positive airway pressure (CPAP) therapy and subsequently underwent maxillomandibular advancement (MMA) surgery. The ET-AHI calculations were performed to estimate the level of CPAP adherence that would be necessary to achieve equivalence with the MMA surgical result and to reach effective AHIs of 5 and 15.
  
  
  RESULTS
  The sample was composed of 37 adult patients (mean age, 44.2 ± 9.0 yr; 73% men) with moderate to severe OSA (baseline AHI, 56.3 ± 22.6). CPAP therapy was highly efficacious (CPAP titration AHI, 4.3 ± 5.9), but no patient could adequately adhere to treatment. MMA produced a significant decrease in OSA (AHI after MMA, 11.6 ± 7.4). The ET-AHI calculations predicted that an 86% adherence rate with CPAP would be necessary to achieve equivalence with MMA, whereas adherence rates of 99% and 79% may be required to achieve effective AHIs of 5 and 15, respectively.
  
  
  CONCLUSIONS
  The ET-AHI has the potential to significantly affect the care of patients with OSA because it may provide the treating clinician with a valuable tool to estimate the control of OSA for any therapeutic intervention. How closely the ET-AHI predicts the true effective AHI in the home setting requires further validation.
authors: Department of Oral and Maxillofacial Surgery, Vanderbilt University School of Medicine, Nashville, TN 37232-2103, USA. scott.boyd@vanderbilt.edu
authors: Scott B
authors: SB
authors: Boyd
authors: Arthur S
authors: AS
authors: Walters
mesh_terms: D000328:Adult; D015331:Cohort Studies; D045422:Continuous Positive Airway Pressure / Q000706:statistics & numerical data; D005260:Female; D005500:Follow-Up Studies; D005544:Forecasting; D006801:Humans; D008297:Male; D019186:Mandibular Advancement / Q000706:statistics & numerical data; D008433:Mathematics; D008437:Maxilla / Q000601:surgery; D010349:Patient Compliance / Q000706:statistics & numerical data; D017286:Polysomnography; D012189:Retrospective Studies; D012720:Severity of Illness Index; D020181:Sleep Apnea, Obstructive / Q000145:classification* / Q000517:prevention & control / Q000628:therapy; D016896:Treatment Outcome