Oxygen resaturation rate is significantly associated with objectively assessed excessive daytime sleepiness in suspected obstructive sleep apnoea patients

Timothy P. Howarth, Tuomas Karhu, Samu Kainulainen, Xin Chen, Alaa Mahamid, Juha Töyräs, Timo Leppänen

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Abstract

Introduction: Commonly utilised metrics such as the apnoea-hypopnoea index show limited correlation to excessive daytime sleepiness (EDS). Oxygen desaturation parameters show better predictive power, however oxygen resaturation parameters have not yet been investigated. Oxygen resaturation may represent increased cardiovascular fitness and thus we hypothesized that a higher resaturation rate would be protective against EDS. Methods: Oxygen saturation parameters were computed via ABOSA software for adult patients referred for polysomnography and multiple sleep latency test in Israel Loewenstein hospital 2001–2011. EDS was defined as a mean sleep latency (MSL) below 8 min. Results: 1629 patients (75% male, 53% obese, median age of 54 years) were included for analysis. The average desaturation event nadir was 90.4% and resaturation rate 0.59%/second. Median MSL was 9.6 min, and 606 patients met criteria for EDS. Patients who were younger, female, and with larger desaturations had significantly higher resaturation rates (p < 0.001). In multivariate models, adjusted for age, sex, body mass index, and average desaturation depth, resaturation rate showed a significant negative correlation with MSL (z-score standardised beta, −1 (95%CI -0.49, −1.52)), and significantly increased odds ratio (OR) of EDS (OR, 1.28 (95%CI 1.07, 1.53)). The beta associated with resaturation rate was larger, though non-significantly, than that of desaturation depth (difference 0.36 (95% CI -1.34, 0.62), p = 0.470). Conclusion: Oxygen resaturation parameters show significant associations with objectively assessed EDS independent of desaturation parameters. Thus, resaturation and desaturation parameters may reflect differing underlying mechanistic pathways and both be considered novel and appropriate markers for assessing sleep-disordered breathing and associated outcomes.

Original languageEnglish
Pages (from-to)171-178
Number of pages8
JournalSleep Medicine
Volume107
DOIs
Publication statusPublished - Jul 2023

Bibliographical note

Funding Information:
SK has received research funding from the Research Committee of the Kuopio University Hospital Catchment Area for the State Research Funding (project 5041804 ), Tampere Tuberculosis Foundation , and Finnish Cultural Foundation – Central fund.

Funding Information:
JT has received funding from NordForsk (NordSleep project 90458 ) through the Business Finland ( 5133/31/2018 ), European Union's Horizon 2020 Research and Innovation Programme (grant 965417 ), and the National Health and Medical Research Council (Australia).

Funding Information:
TL has received research funding from the European Union's Horizon 2020 Research and Innovation Programme (grant 965417 ), NordForsk (NordSleep project 90458 ) through the Business Finland ( 5133/31/2018 ), and the Research Committee of the Kuopio University Hospital Catchment Area for the State Research Funding (project 5041794 ).

Funding Information:
TK has received funding from the Instrumentarium Science Foundation .

Publisher Copyright:
© 2023 The Authors

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