Obstructive sleep apnea (OSA) is usually diagnosed from a single night of home sleep apnea testing using the apnea-hypopnea index (AHI). However, the AHI varies substantially from night to night, undermining diagnostic accuracy, and shows only modest correlation with symptoms. This variability further limits its usefulness for predicting cardiovascular and other complications. Besides the traditional AHI, more robust physiological markers are needed. Several emerging physiological metrics - hypoxic burden, ventilatory burden, heart rate variability, autonomic arousals, and the pulse wave amplitude drop index - capture the physiological impact of OSA more comprehensively and demonstrate stronger associations with cardiovascular risk. Despite this promise, their night-to-night variability has not been studied. A systematic evaluation of both established and novel OSA metrics across nights is essential to identify reliable, stable parameters suitable for clinical routine. This improves diagnostic precision beyond what traditional metrics can provide, enhances patient selection, reduces costs and patient harm, and may improve treatment outcomes.
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Night-to-night variability of apnea-hypopnea index (events per hour of sleep) over 4 nights
Timeframe: 4 nights of respiratory polygraphy
Night-to-night variability of oxygen desaturation index (events per hour of sleep) over 10 nights
Timeframe: 4 nights of respiratory polygraphy and 10 nights of oxymetry
Night-to-night variability of hypoxic burden (minute x percent per hour of sleep) over 10 nights
Timeframe: 4 nights of respiratory polygraphy and 10 nights of oxymetry
Night-to-night variability of ventilatory burden over 4 nights
Timeframe: 4 nights of respiratory polygraphy
Night-to-night variability of heart rate variability over 10 nights
Timeframe: 4 nights of respiratory polygraphy and 10 nights of oxymetry
Night-to-night variability of pulse wave amplitude drops (events per hour) over 10 nights
Timeframe: 4 nights of respiratory polygraphy and 10 nights of oxymetry