title: Sleep apnea diagnosis varies with the hypopnea criteria applied.
abstract: OBJECTIVE
  We aimed to evaluate the three hypopnea criteria, A and B from 2007 and the revised from 2012, proposed by the American Academy of Sleep Medicine (AASM) for scoring sleep-related breathing disorders (SRBDs) in patients with acute stroke or transient ischemic attack (TIA).
  
  
  METHODS
  Polysomnographies (PSGs) in patients with TIA or stroke were scored according to the A-, B-, and 2012-hypopnea criteria.
  
  
  RESULTS
  Sixty-three PSGs were eligible for hypopnea scoring. There was no difference in the number of patients diagnosed with the B- and 2012-criteria. Therefore, they are mentioned as one. Forty-seven patients (75 %) were diagnosed with SRBD using the A-criteria versus 57 patients (90 %) using the B/2012-criteria (p < 0.0016). In 30 cases, a change from A- to B/2012-criteria resulted in a change in diagnosis. Ten cases of "no SRBD" changed to mild/moderate/severe SRBD. An apnea hypopnea index (AHI) >15 is a typical indication of treatment. With the B/2012-criteria, we found an additional indication of treatment in 18 patients, compared to when the A-criteria were applied (p < 0.0001). Two of these patients were labeled as no SRBD with the A-criteria.
  
  
  CONCLUSIONS
  The difference is significant between the AHIs achieved by the A- and the B-/2012-hypopnea criteria, with much lower AHIs achieved with the A-criteria. As SRBD treatment lessens the risk of complications, correct identification of SRBD patients is of the utmost importance.
authors.affiliation: Danish Center for Sleep Medicine, Department of Clinical Neurophysiology, Rigshospitalet, University of Copenhagen, Nordre Ringvej 57, 2600, Glostrup, Denmark. laura_ponsaing@hotmail.com.|Center for Healthy Aging, Copenhagen University, Copenhagen, Denmark. laura_ponsaing@hotmail.com.
authors.forename: Laura B
authors.initials: LB
authors.lastname: Ponsaing
authors.affiliation: The Stroke Unit, Department of Neurology, Rigshospitalet, University of Copenhagen, Glostrup, Denmark.
authors.forename: Helle K
authors.initials: HK
authors.lastname: Iversen
authors.affiliation: Danish Center for Sleep Medicine, Department of Clinical Neurophysiology, Rigshospitalet, University of Copenhagen, Nordre Ringvej 57, 2600, Glostrup, Denmark.|Center for Healthy Aging, Copenhagen University, Copenhagen, Denmark.
authors.forename: Poul
authors.initials: P
authors.lastname: Jennum
mesh_terms: D000208:Acute Disease; D000368:Aged; D015897:Comorbidity; D005260:Female; D006801:Humans; D002546:Ischemic Attack, Transient / Q000145:classification / Q000175:diagnosis*; D008297:Male; D008875:Middle Aged; D017286:Polysomnography / Q000295:instrumentation; D012815:Signal Processing, Computer-Assisted; D012891:Sleep Apnea Syndromes / Q000145:classification / Q000175:diagnosis*; D012984:Software; D013223:Statistics as Topic; D020521:Stroke / Q000145:classification / Q000175:diagnosis*
keywords: Apnea hypopnea index; Cheyne-Stokes respiration; Hypopnea; Obstructive sleep apnea; Sleep fragmentation; Sleep-related breathing disorders