Current diagnostic parameters estimating obstructive sleep apnoea (OSA) severity have a poor connection to the psychomotor vigilance of OSA patients. Thus, we aimed to investigate how the severity of apnoeas, hypopnoeas and intermittent hypoxaemia is associated with impaired vigilance. We retrospectively examined type I polysomnography data and corresponding psychomotor vigilance tasks (PVTs) of 743 consecutive OSA patients (apnoea–hypopnoea index (AHI) ≥5 events·h−1). Conventional diagnostic parameters (e.g. AHI and oxygen desaturation index (ODI)) and novel parameters (e.g. desaturation severity and obstruction severity) incorporating duration of apnoeas and hypopnoeas as well as depth and duration of desaturations were assessed. Patients were grouped into quartiles based on PVT outcome variables. The odds of belonging to the worst-performing quartile were assessed. Analyses were performed for all PVT outcome variables using binomial logistic regression. A relative 10% increase in median depth of desaturations elevated the odds (ORrange 1.20–1.37, p<0.05) of prolonged mean and median reaction times as well as increased lapse count. Similarly, an increase in desaturation severity (ORrange 1.26–1.52, p<0.05) associated with prolonged median reaction time. Female sex (ORrange 2.21–6.02, p<0.01), Epworth Sleepiness Scale score (ORrange 1.05–1.07, p<0.01) and older age (ORrange 1.01–1.05, p<0.05) were significant risk factors in all analyses. In contrast, increases in conventional AHI, ODI and arousal index were not associated with deteriorated PVT performance. These results show that our novel parameters describing the severity of intermittent hypoxaemia are significantly associated with increased risk of impaired PVT performance, whereas conventional OSA severity and sleep fragmentation metrics are not. These results underline the importance of developing the assessment of OSA severity beyond the AHI. Parameters considering characteristic properties of desaturations have a significant association with impaired vigilance, highlighting the importance of developing methods beyond the AHI for a more detailed assessment of OSA severity http://bit.ly/2veqxD9

中文翻译：

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严重的饱和度降低会增加 OSA 患者基于 PVT 的中位反应时间和失效次数

当前估计阻塞性睡眠呼吸暂停 (OSA) 严重程度的诊断参数与 OSA 患者的精神运动警惕性联系很差。因此，我们旨在调查呼吸暂停、呼吸不足和间歇性低氧血症的严重程度如何与警觉性受损有关。我们回顾性检查了 743 名连续 OSA 患者（呼吸暂停-低通气指数（AHI）≥5 个事件·h-1）的 I 型多导睡眠图数据和相应的精神运动警戒任务（PVT）。评估了常规诊断参数（例如 AHI 和氧饱和度指数 (ODI)）和新参数（例如去饱和度和阻塞严重度），包括呼吸暂停和呼吸不足的持续时间以及去饱和度的深度和持续时间。根据 PVT 结果变量将患者分为四分位数。评估了属于表现最差的四分位数的几率。使用二项逻辑回归对所有 PVT 结果变量进行分析。去饱和的中值深度相对增加 10% 提高了平均和中值反应时间延长以及失效计数增加的几率（OR范围 1.20-1.37，p<0.05）。类似地，去饱和严重程度的增加（ORrange 1.26–1.52，p<0.05）与延长的中位反应时间相关。在所有分析中，女性（ORrange 2.21-6.02，p<0.01）、Epworth 嗜睡量表评分（ORrange 1.05-1.07，p<0.01）和年龄较大（ORrange 1.01-1.05，p<0.05）是显着的危险因素。相比之下，传统 AHI、ODI 和唤醒指数的增加与 PVT 性能恶化无关。这些结果表明，我们描述间歇性低氧血症严重程度的新参数与 PVT 性能受损风险的增加显着相关，而传统的 OSA 严重程度和睡眠片段化指标则不然。这些结果强调了在 AHI 之外进行 OSA 严重程度评估的重要性。考虑到去饱和特征的参数与警觉性受损有显着关联，强调了开发超越 AHI 的方法以更详细地评估 OSA 严重程度的重要性 http://bit.ly/2veqxD9 这些结果强调了在 AHI 之外进行 OSA 严重程度评估的重要性。考虑到去饱和特征的参数与警觉性受损有显着关联，强调了开发超越 AHI 的方法以更详细地评估 OSA 严重程度的重要性 http://bit.ly/2veqxD9 这些结果强调了在 AHI 之外进行 OSA 严重程度评估的重要性。考虑到去饱和特征的参数与警觉性受损有显着关联，强调了开发超越 AHI 的方法以更详细地评估 OSA 严重程度的重要性 http://bit.ly/2veqxD9