Impact of AASM 2012 Recommended Hypopnea Criteria on Surgical Outcomes for Obstructive Sleep Apnea.

Abstract

OBJECTIVES: To assess the impact of the American Academy of Sleep Medicine (AASM) 2012Rec criteria on the surgical success rate and polysomnography (PSG) parameters of patients with obstructive sleep apnea (OSA).

STUDY DESIGN: A prospective clinical trial.

METHODS: A total of 60 patients who performed surgery for treatment of OSA at the sleep breathing disorder center of a tertiary referral university hospital from October 1, 2015, to September 30, 2016, were enrolled. Preoperative and postoperative PSG were performed and scored using AASM 2007Rec and AASM 2012Rec . Surgical success was determined by criteria 1 (postoperative Apnea-Hypopnea Index [AHI] <20% and 50% reduction) and criteria 2 (postoperative AHI <10), and surgical success rates according to AASM 2007Rec and AASM 2012Rec were compared.

RESULTS: PSG parameters including AHI, hypopnea index, respiratory effort-related arousals, respiratory disturbance index, and supine AHI scored significantly higher with AASM 2012Rec compared to AASM 2007Rec criteria, both preoperatively and postoperatively (all P < 0.05). Furthermore, when compared to the AASM 2007Rec criteria, AASM 2012Rec resulted in increased proportion of patients with severe OSA (70.0% vs. 95.0%; P < 0.001). For the surgical outcomes, AASM 2012Rec showed significantly lower surgical success rate both in criteria 1 (51.7% vs. 38.3%) and criteria 2 (35.0% vs. 18.3%) compared to the AASM 2007Rec , respectively (P < 0 .05).

CONCLUSIONS: This study demonstrated that AASM 2012Rec tends to decrease the success rate of surgical outcome for OSA patients, suggesting that defining success of surgical treatment for OSA could be changed dramatically according to the hypopnea scoring criteria.