Obstructive sleep apnea (OSA) is a prevalent chronic sleep disorder that impacts approximately 30 million people in the United States alone.
Traditional diagnosis methods have long relied on the Apnea-Hypopnea Index (AHI), which, while informative, has limitations in predicting cardiovascular risks and mortality associated with the condition.
Addressing these limitations, researchers at Mount Sinai have developed an innovative, automated metric called the “ventilatory burden,” which aims to offer a more comprehensive understanding of OSA severity and associated risks.
What is Ventilatory Burden?
Developed by the Mount Sinai Sleep and Circadian Analysis (SCAN) Group, the ventilatory burden is an automated breath-by-breath measure that evaluates the proportion of small breaths during a routine sleep study.
Unlike AHI, this novel metric does not depend on the low level of oxygen in the blood (hypoxemia) or the awakenings often seen in OSA patients. It offers a robust insight into upper-airway obstruction and is stable from night to night.
Importance and Advantages
Ankit Parekh, Ph.D., Assistant Professor of Medicine at Mount Sinai, highlighted that the traditional clinical methods are “crude” and do not effectively predict cardiovascular disease risk or mortality.
The ventilatory burden, derived from analyzing more than 34 million breaths from over 5,000 participants, was found to be stable across multiple nights and was effective in predicting mortality related to cardiovascular diseases.
This is considered a significant leap as it transcends the limitations of AHI, such as its variability and subjective baselines.
Implications and Future Research
The Mount Sinai team aims to build on this work by developing an artificial intelligence algorithm based on the ventilatory burden.
The goal is to not only replace AHI but also identify which patients are likely to benefit from continuous positive airway pressure (CPAP), the first-line therapy for sleep apnea.
Moreover, the team plans to diversify their patient dataset to include more racially and ethnically diverse populations.
Conclusion
The introduction of the ventilatory burden as a novel diagnostic metric represents a promising advancement in the field of sleep medicine.
By addressing the limitations of current diagnostic tools, this new approach aims to improve patient outcomes by offering a more accurate measure of OSA severity and associated risks, thus aiding in timely and effective treatment.
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The research findings can be found in the American Journal of Respiratory and Critical Care Medicine.
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