title: RemLogic plug-in enables clinical application of apnea-hypopnea index adjusted for severity of individual obstruction events.
abstract: Obstructive sleep apnea (OSA) is diagnosed based on obstruction event incidence, albeit individual obstruction event severity is connected to increased mortality rate. Adjusted-AHI parameter, incorporating number and severity of obstruction events, has shown good potential, but is calculated using custom-made MATLAB(®) functions. To allow its clinical use, this study introduces the RemLogic™ plug-in. It is tested comparing adjusted-AHI values calculated with the plug-in and MATLAB(®) with a hundred patients. Furthermore, retrospective follow-up (mean ± SD = 194.1 ± 54.0 months) of 1128 working-age men was conducted to evaluate potential of adjusted-AHI to enhance diagnostic of OSA. Adjusted-AHI values were strongly correlated (r = 1.000, p < 0.001) and their average difference (mean ± SD) was minimal (0.08 ± 0.19%). Using adjusted-AHI to define OSA severity resulted in a higher hazard ratio of mortality in the severe OSA group and, for the first time, adjusted-AHI was found to explain independently the overall mortality and non-fatal cardiovascular events. Importantly, the present plug-in enables clinical use of adjusted-AHI, enhancing assessment of OSA severity.
authors.affiliation: a Department of Clinical Neurophysiology , Kuopio University Hospital , Kuopio , Finland ;|b Department of Clinical Neurophysiology , Seinäjoki Central Hospital , Seinäjoki , Finland ;|c Department of Applied Physics , University of Eastern Finland , Kuopio , Finland ;
authors.forename: Timo
authors.initials: T
authors.lastname: Leppänen
authors.affiliation: a Department of Clinical Neurophysiology , Kuopio University Hospital , Kuopio , Finland ;|d School of Computing , University of Eastern Finland , Kuopio , Finland ;
authors.forename: Mikko
authors.initials: M
authors.lastname: Särkkä
authors.affiliation: b Department of Clinical Neurophysiology , Seinäjoki Central Hospital , Seinäjoki , Finland ;|c Department of Applied Physics , University of Eastern Finland , Kuopio , Finland ;
authors.forename: Antti
authors.initials: A
authors.lastname: Kulkas
authors.affiliation: a Department of Clinical Neurophysiology , Kuopio University Hospital , Kuopio , Finland ;|e Institute of Clinical Medicine, Faculty of Health Sciences , University of Eastern Finland , Kuopio , Finland.
authors.forename: Anu
authors.initials: A
authors.lastname: Muraja-Murro
authors.affiliation: a Department of Clinical Neurophysiology , Kuopio University Hospital , Kuopio , Finland ;|e Institute of Clinical Medicine, Faculty of Health Sciences , University of Eastern Finland , Kuopio , Finland.
authors.forename: Salla
authors.initials: S
authors.lastname: Kupari
authors.affiliation: a Department of Clinical Neurophysiology , Kuopio University Hospital , Kuopio , Finland ;
authors.forename: Meri
authors.initials: M
authors.lastname: Anttonen
authors.affiliation: a Department of Clinical Neurophysiology , Kuopio University Hospital , Kuopio , Finland ;
authors.forename: Pekka
authors.initials: P
authors.lastname: Tiihonen
authors.affiliation: a Department of Clinical Neurophysiology , Kuopio University Hospital , Kuopio , Finland ;|e Institute of Clinical Medicine, Faculty of Health Sciences , University of Eastern Finland , Kuopio , Finland.
authors.forename: Esa
authors.initials: E
authors.lastname: Mervaala
authors.affiliation: a Department of Clinical Neurophysiology , Kuopio University Hospital , Kuopio , Finland ;|c Department of Applied Physics , University of Eastern Finland , Kuopio , Finland ;
authors.forename: Juha
authors.initials: J
authors.lastname: Töyräs
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017286:Polysomnography / Q000379:methods*; D012189:Retrospective Studies; D012720:Severity of Illness Index; D012815:Signal Processing, Computer-Assisted; D020181:Sleep Apnea, Obstructive / Q000145:classification* / Q000175:diagnosis* / Q000503:physiopathology; D055815:Young Adult
keywords: AHI; Obstructive sleep apnea; adjusted-AHI; morbidity; mortality