Distribution patterns of obstructive and central apnea in adults with obstructive sleep apnea-hypopnea syndrome

Objective: This study aimed to investigate the distribution patterns of obstructive and central apnea events in adults with obstructive sleep apnea-hypopnea syndrome (OSAHS). Methods: Utilizing polysomnography (PSG) data, we selected patients with a habitual snoring condition and categorized them into OSAHS and non-OSAHS groups. The OSAHS group was further stratified into mild, moderate, and severe subgroups based on disease severity. We compared the distribution of obstructive sleep apnea (OSA) and central sleep apnea (CSA) events between the groups, analyzing their correlation with the apnea-hypopnea index (AHI), age, gender, and other factors. Results: A total of 460 patients were enrolled for the study, 374 patients were in the OSAHS group and 86 patients in the non-OSAHS group. (1) There were statistical differences in AHI and obstructive apnea index (OAI) in all groups (P < 0.05), with the OSAHS group having a higher AHI and OAI than the non-OSAHS group. (2) In the OSAHS group, OAI and AHI had the highest correlation (r = 0.884, P < 0.01), and central apnea index (CAI) and AHI had the lowest correlation (r = 0.237, P < 0.01); in the non-OSAHS group, OAI and AHI had the highest correlation (r = 0.520, P < 0.01), and CAI and AHI had the lowest correlation (r = 0.312, P < 0.01). (3) In the OSAHS group, OAI was significantly correlated with the severity of patient disease (r = 0.828, P < 0.01), whereas CAI was marginally correlated with the severity of patient disease (r = 0.235, P < 0.01), but it increased as the condition became more severe. Conclusion: Patients with OSAHS exhibited both CSA and OSA, with OAI having a significantly greater impact. OAI can serve as a valuable index for evaluating OSAHS severity, while CSA appears to be primarily influenced by the overall disease severity. Notably, patients with OSAHS had a higher CAI compared to those without OSAHS.