title: The AASM 2012 recommended hypopnea criteria increase the incidence of obstructive sleep apnea but not the proportion of positional obstructive sleep apnea.
abstract: This study compared the effects of using the 2007 and 2012 American Academy of Sleep Medicine (AASM) recommended hypopnea criteria on the proportion of positional obstructive sleep apnea (pOSA). The effect of modifying the minimum recording time in each sleeping position on the proportion of pOSA was also investigated.
  
  
  
  207 of 303 consecutive patients (91 of 207 were female) participated in polysomnography (PSG) for the suspicion of OSA met the inclusion criteria for this retrospective investigation. PSGs were scored for both the 2007 AASM recommended hypopnea criteria (AASM2007Rec) and the 2012 AASM recommended hypopnea criteria (AASM2012Rec). For each hypopnea criteria OSA patients were grouped as positional [either supine predominant OSA (spOSA) or supine independent OSA (siOSA)] or non-positional. Outcome measures such as SF-36, FOSQ, PVT, and DASS-21 were compared between groups.
  
  
  
  The AASM2012Recincreased the incidence of OSA compared to AASM2007Rec(84% vs 49% respectively). AASM2012Recincreased the number of patients with supine predominant OSA (spOSA) and supine independent OSA (siOSA) but did not change the proportion (spOSA: 61% AASM2012Recvs 61% AASM2007Rec, siOSA: 32% AASM2012Recvs 36% AASM2007Rec). OSA patients diagnosed by AASM2007Rec criteriahad similar outcome measures to those diagnosed by the AASM2012Reccriteria. The AASM2012Recincreased the proportion of female OSA patients with spOSA and siOSA. A minimum recording time of 60 minutes in each position decreased the proportion of spOSA, but not siOSA patients when compared to a minimum time of 15 minutes.
  
  
  
  This study demonstrates that, compared to AASM2007Rec, AASM2012Recalmost doubles the incidence of OSA but does not alter the proportion of OSA patients with pOSA. The proportion of female OSA patients with pOSA however, increases as a result of AASM2012Rec. Furthermore, the use of different minimum recording times in each sleeping position can alter the proportion of spOSA.
authors.affiliation: Sleep Disorders Centre, Department of Respiratory & Sleep Medicine, Princess Alexandra Hospital, Ipswich Rd, Woolloongabba, Queensland, Australia; Faculty of Science and Engineering, Queensland University of Technology, Queensland, Australia. Electronic address: brett.duce@health.qld.gov.au.
authors.forename: Brett
authors.initials: B
authors.lastname: Duce
authors.affiliation: Department of Clinical Neurophysiology, Seinäjoki Central Hospital, Seinäjoki, Finland; Department of Applied Physics, University of Eastern Finland, Kuopio, Finland.
authors.forename: Antti
authors.initials: A
authors.lastname: Kulkas
authors.affiliation: Faculty of Science and Engineering, Queensland University of Technology, Queensland, Australia.
authors.forename: Christian
authors.initials: C
authors.lastname: Langton
authors.affiliation: Faculty of Science and Engineering, Queensland University of Technology, Queensland, Australia; Department of Applied Physics, University of Eastern Finland, Kuopio, Finland; Diagnostic Imaging Center, Kuopio University Hospital, Kuopio, Finland.
authors.forename: Juha
authors.initials: J
authors.lastname: Töyräs
authors.affiliation: Sleep Disorders Centre, Department of Respiratory & Sleep Medicine, Princess Alexandra Hospital, Ipswich Rd, Woolloongabba, Queensland, Australia.
authors.forename: Craig
authors.initials: C
authors.lastname: Hukins
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D017286:Polysomnography / Q000379:methods*; D017410:Practice Guidelines as Topic; D012189:Retrospective Studies; D017678:Sex Distribution; D020181:Sleep Apnea, Obstructive / Q000145:classification / Q000175:diagnosis* / Q000453:epidemiology*; D016683:Supine Position / Q000502:physiology*
keywords: Gender; Hypopnea definition; Methodology; Obstructive sleep apnea; Positional OSA; Proportion