Gender equity: AASM scoring criteria for OSA diagnosis

作者：Kate V. Cole, R.B. Dexter, A Malhotra, Peter A. Cistulli, Alison J. Wimms, W. Mcconnell, Kimberly L. Sterling, Jean‐Louis Pépin · 发表于：04.02 - Clinical and epidemiological respiratory sleep medicine · 年份：2022 · DOI：10.1183/13993003.congress-2022.838 · 研究领域：Obstructive Sleep Apnea Research

Rationale: Due to hypopnea definition differences, the use of different apnea hypopnea index (AHI) scoring criteria may disproportionately impact women with obstructive sleep apnea (OSA) and their treatment indications. We sought to investigate the impact of American Academy of Sleep Medicine (AASM) AHI scoring criteria for the diagnosis of OSA on women using real world data. Methods: Type III home sleep apnea testing (HST) data evaluated using either AASM2007 or AASM2012 scoring criteria were linked to de-identified US claims data. HST data was automatically scored but could have been adjusted manually by a provider. Baseline comorbidities from diagnosis codes in the claims data and HST results were described by gender. Results: 80,307 patients were included, 42.5% female; mean age 50.7y. Women had higher rates of mood disorders, insomnia, GERD, and asthma; men had higher rates of atrial fibrillation. No demographic differences existed between populations scored with AASM2007 vs 2012 criteria. AHI was 2.5 events/hour (e/hr) higher with AASM2012 scoring for both genders. Higher hypopnea/apnea ratios occurred in women vs men; with larger differences using AASM2012 (Table). Conclusion: Women may be disproportionately impacted by the AASM2007 scoring criteria. For countries with treatment reimbursement guidelines specifying an AHI cutoff at 15 e/hr, these criteria may lead to underdiagnosis and undertreatment of women.