Breathing disturbances without hypoxia are associated with objective sleepiness in sleep apnea

Henriette Koch, Logan Douglas Schneider, Laurel A Finn, Eileen B Leary, Paul E Peppard, Erika Hagen, Helge Bjarup Dissing Sørensen, Poul Jennum, Emmanuel Mignot

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Determine if defining two subtypes of sleep-disordered breathing (SDB) events - with or without hypoxia - results in measures that are more strongly associated with hypertension and sleepiness. A total of 1,022 subjects with 2,112 nocturnal polysomnograms (PSGs) from the Wisconsin Sleep Cohort were analyzed with our automated algorithm, developed to detect breathing disturbances and desaturations. Breathing events were time-locked to desaturations, resulting in 2 indices - desaturating (H-BDI) and non-desaturating (NH-BDI) events - regardless of arousals. Measures of subjective (Epworth Sleepiness Scale) and objective (2,981 multiple sleep latency tests from a subset of 865 subjects) sleepiness were analyzed, in addition to clinically relevant clinicodemographic variables. Hypertension was defined as BP ≥140/90 or antihypertensive use. H-BDI, but not NH-BDI, correlated strongly with SDB severity indices that included hypoxia (r≥0.89, p≤0.001 with 3% ODI and AHI with 4%-desaturations). A doubling of desaturation-associated events was associated with hypertension prevalence, which was significant for ODI but not H-BDI (3% ODI OR=1.06, 95% CI=1.00-1.12, p
Original languageEnglish
Number of pages10
Publication statusPublished - 2017


  • Outcome Assessment (Health Care)
  • Pattern Recognition, Automated
  • Sleep Apnea Syndromes


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