Patrick Daly

DocwireNews

Data have shown that sleep apnea-specific intermittent hypoxemia, defined via hypoxic burden (HB), was able to predict cardiovascular disease (CVD)-related mortality. However, according to researchers led by Neda Esmaeili, HB is calculated based on manual scoring of hypopneas and apneas, an approach that is slow and inconsistent. They developed a novel oximetry-based method to quantify HB using automatically identified blood oxygen desaturation signals.The original calculation for HB was based on an ensemble average of SpO2 signals during patient-specific search windows, which were time-fitted to the end of scored respiratory events.Comparatively, the novel method was based on average SpO2 signals during patient-specific search windows that were time-fitted to an interval surrounding the minimum of all identified desaturations, with a threshold of &ge;2% (3% and 4% in sensitivity analysis). A patients&rsquo; oximetry-derived hypoxic burden (HBOxi) was then characterized as the total area under all desaturation curves within the search window divided by the total sleep time.<h2>Streamlining Qualification of Hypoxic Burden From Hypoxemia</h2>Esmaeili and colleagues applied their novel method to the original HB cohort of 5655 patients (52.8% female; mean age, 63.2 &plusmn; 11.3 years) from the Sleep Heart Health Study. According to their report, the Spearman&rsquo;s rank correlation between the original median HB of 34.4% min/h (interquartile range [IQR], 18.4-59.8) and the median HBOxi of 34.5% min/h (IQR, 21.6-53.8) was 0.81 (P&lt;.001).The authors then used logistic and Cox regression models to estimate risk for <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5234199/" target="_blank" rel="noopener">excessive daytime sleepiness</a> (EDS), hypertension, and CVD-related mortality per each 1 standard deviation increase in HBOxi.Notably, HBOxi demonstrated significant associations similar to HB with EDS (adjusted odds ratio [aOR], 1.17; 95% CI, 1.09-1.26), hypertension (aOR, 1.13; 95% CI, 1.05-1.21), and CVD-related mortality (adjusted hazard ratio, 1.15; 95% CI, 1.01-1.30) after adjusted analysis.Overall, the study authors concluded HBOxi &ldquo;was highly correlated with the hypoxic burden based on manually scored apneas and hypopneas and was associated with EDS, [hypertension], and CVD mortality,&rdquo; and they suggested this methodology could be implemented in wearable technologies that measure oxygen saturation.Related:<a href="https://docwirenews.com/post/defining-the-burden-of-idiopathic-hypersomnia"> Defining the Burden of Idiopathic Hypersomnia</a>

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An Automated Approach to Calculating Hypoxic Burden Based on Oximetry

Sleep Disorders

Researchers presented a novel method for calculating hypoxic burden using automatically identified desaturations that was comparable with manual scoring.

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