Composite severity indices reflect sleep apnea disease burden more comprehensively than the apnea-hypopnea index.
OBJECTIVE
To compare 2 composite indices of sleep apnea disease burden with the commonly used apnea-hypopnea index with regard to baseline measurement of subjective and objective disease burden.


METHODS
Cross-sectional study.


METHODS
Tertiary academic medical center sleep laboratory.


METHODS
Patients with suspected diagnosis of sleep apnea undergoing first diagnostic polysomnography. Subjective data were collected via validated questionnaires; objective data were obtained by standardized physical examination, chart extraction, and polysomnography. Four subjective (patient-reported) disease burden measures and 3 objective (anatomic and physiologic) disease burden measures were used for validation. Associations between composite indices or apnea-hypopnea index and these 7 construct validation measures were compared using bootstrapped correlation coefficients.


RESULTS
Two hundred sixteen subjects were included in the final analysis. Both composite disease burden indices showed clinically important or nearly important associations with 3 of 4 subjective validation measures and all 3 objective validation measures, whereas the apnea-hypopnea index was associated only with the objective validation measures.


CONCLUSIONS
Composite indices of sleep apnea disease burden may capture the breadth of baseline sleep apnea disease burden, particularly subjective disease burden, better than the apnea-hypopnea index.
Department of Otolaryngology-Head & Neck Surgery, University of Washington, Seattle, Washington 98108, USA.
Karthik
K
Balakrishnan
Kathryn T
KT
James
Edward M
EM
Weaver
D016009:Chi-Square Distribution; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010808:Physical Examination; D017286:Polysomnography; D011788:Quality of Life; D012720:Severity of Illness Index; D012891:Sleep Apnea Syndromes / Q000175:diagnosis / Q000503:physiopathology*; D018709:Statistics, Nonparametric; D011795:Surveys and Questionnaires