Amsterdam positional OSA classification: the AASM 2012 recommended hypopnoea criteria increases the number of positional therapy candidates

Sleep Breath (2017) 21:411417 DOI 10.1007/s11325-016-1432-y

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Web End = SLEEP BREATHING PHYSIOLOGY AND DISORDERS ORIGINAL ARTICLE

Amsterdam positional OSA classification: the AASM 2012 recommended hypopnoea criteria increases the numberof positional therapy candidates

Brett Duce1,2 & Antti Kulkas3,4 & Christian Langton2 & Juha Tyrs2,4,5 & Craig Hukins1

http://orcid.org/0000-0002-3134-5138

Web End = Received: 12 July 2016 /Revised: 22 September 2016 /Accepted: 2 November 2016 /Published online: 11 November 2016 # Springer-Verlag Berlin Heidelberg 2016

AbstractPurpose This study examined the effect of hypopnoea criteria on the prevalence of positional obstructive sleep apnoea (pOSA) identified under the Amsterdam Positional OSA Classification (APOC) system.

Methods Three hundred three consecutive patients undertaking polysomnography (PSG) for the suspicion of OSA were included in this retrospective investigation. PSGs were scored using both the 2007 American Academy of Sleep Medicine (AASM) recommended hypopnoea criteria (AASM2007Rec)

and the 2012 AASM recommended hypopnoea criteria (AASM2012Rec). For each hypopnoea criteria, OSA patients

were grouped according to the APOC categories (I, II or II) or else deemed non-APOC if they did not meet the APOC criteria. Outcome measures, such as Functional Outcomes of Sleep Questionnaire (FOSQ), MOS 36-item short-form health survey (SF-36) and psychomotor vigilance task (PVT), were also compared between the groups.

Results The AASM2012Rec increased the prevalence of OSA compared to AASM2007Rec. The AASM2012Rec trebled the

number of APOC I patients compared to AASM2007Rec

(297% increase) as well as increased the proportion of females in the APOC I group. AASM2012Rec did not change the num

ber of APOC II and APOC III patients. In fact, the same patients were present in these categories irrespective of hypopnoea criteria. The proportion of non-APOC patients proportionally decreased with the AASM2012Rec criteria.

There were no differences in outcome measures between the AASM2012Rec and AASM2007Rec groups.

Conclusions This study demonstrates that, compared to AASM2007Rec, AASM2012Rec increases the prevalence of

who could be successfully treated with positional therapy. The proportion of females with pOSA also increases as a consequence of AASM2012Rec.

Keywords Obstructivesleepapnoea .Hypopnoeadefinition . Positional OSA . Amsterdam Positional OSA Classification . Prevalence

Introduction

Obstructive sleep apnoea (OSA) is a prevalent disorder characterised by repeated partial or complete closure of the upper airway during sleep. The consequences of this disorder include excessive daytime somnolence [1], reduced...