Presented as a podium presentation at the 116th Triological Society Annual Meeting at COSM, Orlando, Florida, U.S.A., April 13, 2013.This study was funded by a grant from the International Sleep Surgical Society.
Outcome measurements in obstructive sleep apnea: Beyond the apnea-hypopnea index
Article first published online: 9 JUL 2013
© 2013 The American Laryngological, Rhinological and Otological Society, Inc.
Volume 124, Issue 1, pages 337–343, January 2014
How to Cite
Tam, S., Woodson, B. T. and Rotenberg, B. (2014), Outcome measurements in obstructive sleep apnea: Beyond the apnea-hypopnea index. The Laryngoscope, 124: 337–343. doi: 10.1002/lary.24275
The authors have no other funding, financial relationships, or conflicts of interest to disclose.
- Issue published online: 20 DEC 2013
- Article first published online: 9 JUL 2013
- Accepted manuscript online: 22 JUN 2013 02:44AM EST
- Manuscript Accepted: 4 JUN 2013
- Manuscript Revised: 23 MAY 2013
- Manuscript Received: 28 MAR 2013
- Obstructive sleep apnea;
- outcome measures;
- quality of life;
- cognitive outcomes;
- physiological outcomes
The apnea-hypopnea index (AHI) is overwhelmingly used as the main therapeutic metric in the assessment of obstructive sleep apnea (OSA) in surgical studies. However, using AHI as the sole measure is problematic. This study investigates the utility of other outcome measures for patients with OSA undergoing surgery.
Systematic review of cohort and review studies.
A review was performed using the PubMed database. English articles focusing on outcome measures in adults with OSA were included. Studies in pediatric populations, those combining obstructing and central sleep apnea, and those without the use of outcome measures were excluded. Articles were categorized according to level of evidence. The Downs and Black scale and AMSTAR scale were used to assess quality.
Of a total of 10,454 retrieved articles, 21 studies met inclusion and exclusion criteria. Most articles related to continuous positive airway pressure outcomes. Many categories of outcome measures were found: general quality of life, OSA-specific quality of life, measurements of sleepiness, performance, and physiological. Subjects with OSA scored differently in measurement tools in all categories compared to control populations or after treatment, and generally a poor correlation with AHI was seen.
The literature shows a range of tools based on symptoms and physiology of OSA that can assess effects of treatment. Assessment of surgical treatment for OSA should neither be limited to AHI as an outcome, nor should this be the only outcome stressed.
Level of Evidence
NA. Laryngoscope, 124:337–343, 2014