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Introduction <p>Excessive Daytime Sleepiness (EDS) is commonly associated with underlying Obstructive Sleep Apnea (OSA). Several studies concluded a high hypoxic burden in OSA patients with EDS. Intermittent hypoxia in OSA patients leads to oxidative stress, systemic, and vascular inflammation with endothelial dysfunction, and sympathetic activation, contributing to multiorgan comorbidities.</p> Materials and methods <p>This prospective observational study was done in a tertiary care hospital with a facility of level 1 polysomnography with CPAP titration. A total of 120 adult patients with typical OSA symptoms were included. Patients were classified into mild (ESS ≤ 8), moderate (9–14), and severe (15–24) groups in terms of severity of sleepiness based on Epworth Sleepiness Scale(ESS) score. Demographic and anthropometric data, vitals, and comorbidities were recorded. Arterial blood gas (ABG) analysis, spirometry, thyroid function test, lipid profile, and HbA<sub>1</sub>C were done in each patient. A 3% Oxygen Desaturation Index (ODI), an indicator of hypoxic burden, was compared with the Apnea Hypopnea Index (AHI) in predicting the severity of sleepiness in OSA patients.</p> Results <p>The current study showed ODI (<i>r</i> 0.340, <i>p</i> 0.0002) has a stronger correlation with ESS score than AHI (<i>r</i> 0.218, <i>p</i> 0.017). The ESS score also showed a positive correlation with desaturation below 90% (r 0.236, <i>p</i> = 0.010) and a weak negative correlation with SpO<sub>2</sub> nadir (<i>r</i> − 0.184, <i>p</i> 0.045). A strong positive correlation between AHI and ODI (<i>r</i> 0.903 <i>p</i> &lt; 0.0001) was found. A significant association of AHI (<i>p</i> 0.033), ODI (<i>p</i> 0.001), and desaturation below 90% (<i>p</i> 0.03) with ESS score was also found. The current study concluded a significant positive correlation of prevalent hypertension with both ODI (<i>r</i> 0.311, <i>p</i> 0.001) and AHI (<i>r</i> 0.330, <i>p</i> 0.0002).</p> Conclusion <p>This study concluded stronger correlation of ODI with ESS score than AHI and significant positive correlation of prevalent hypertension with both ODI and AHI. Good concordance between ODI and AHI suggests a promising role of modern fingertip pulse oximetry in predicting OSA in patients with high pretest probability of severe OSA.</p>

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Oxygen Desaturation Index in Patients of OSA: Correlation with Sleepiness and Hypertension

  • 期刊论文

  • 发表日期：

    2025年3月18日

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  • Sumanta Jha,
  • Shibdas Chakrabarti,
  • Tanmaya Talukdar,
  • Rohit Kumar,
  • Rajnish Kaushik,
  • Nitesh Gupta,
  • Pranav Ish

摘要

Introduction

Excessive Daytime Sleepiness (EDS) is commonly associated with underlying Obstructive Sleep Apnea (OSA). Several studies concluded a high hypoxic burden in OSA patients with EDS. Intermittent hypoxia in OSA patients leads to oxidative stress, systemic, and vascular inflammation with endothelial dysfunction, and sympathetic activation, contributing to multiorgan comorbidities.

Materials and methods

This prospective observational study was done in a tertiary care hospital with a facility of level 1 polysomnography with CPAP titration. A total of 120 adult patients with typical OSA symptoms were included. Patients were classified into mild (ESS ≤ 8), moderate (9–14), and severe (15–24) groups in terms of severity of sleepiness based on Epworth Sleepiness Scale(ESS) score. Demographic and anthropometric data, vitals, and comorbidities were recorded. Arterial blood gas (ABG) analysis, spirometry, thyroid function test, lipid profile, and HbA1C were done in each patient. A 3% Oxygen Desaturation Index (ODI), an indicator of hypoxic burden, was compared with the Apnea Hypopnea Index (AHI) in predicting the severity of sleepiness in OSA patients.

Results

The current study showed ODI (r 0.340, p 0.0002) has a stronger correlation with ESS score than AHI (r 0.218, p 0.017). The ESS score also showed a positive correlation with desaturation below 90% (r 0.236, p = 0.010) and a weak negative correlation with SpO2 nadir (r − 0.184, p 0.045). A strong positive correlation between AHI and ODI (r 0.903 p < 0.0001) was found. A significant association of AHI (p 0.033), ODI (p 0.001), and desaturation below 90% (p 0.03) with ESS score was also found. The current study concluded a significant positive correlation of prevalent hypertension with both ODI (r 0.311, p 0.001) and AHI (r 0.330, p 0.0002).

Conclusion

This study concluded stronger correlation of ODI with ESS score than AHI and significant positive correlation of prevalent hypertension with both ODI and AHI. Good concordance between ODI and AHI suggests a promising role of modern fingertip pulse oximetry in predicting OSA in patients with high pretest probability of severe OSA.