The modified Baveno classification for obstructive sleep apnoea: development and evaluation based on the ESADA...

Area of Science:

• Cardiology
• Pulmonology
• Sleep Medicine

Background:

• Obstructive sleep apnoea (OSA) treatment indications are shifting from the apnoea-hypopnoea index (AHI) to symptoms and comorbidities.
• The Baveno classification is an evolving standard for OSA treatment indication.

Purpose of the Study:

• To evaluate a modified Baveno classification for OSA treatment indication.
• To integrate cardiovascular disease (CVD) risk scores and severe breathing disturbances into OSA management.
• To assess the effectiveness of positive airway pressure (PAP) therapy based on the modified classification.

Main Methods:

• Retrospective analysis of 8625 OSA patients from the European Sleep Apnoea Database (ESADA).
• Patients were stratified into CVD risk groups (1-3) using the SCORE2 model.
• Treatment indication (weak, intermediate, strong) was determined by AHI, symptoms, and CVD risk.
• Changes in Epworth Sleepiness Scale (ESS) and systolic blood pressure (SBP) were assessed after 12-24 months of PAP therapy.

Main Results:

• Treatment indication was strong in 70% of patients.
• PAP prescription rates increased significantly with stronger treatment indications (52% to 93%).
• Significant improvements in ESS scores (-2 to -5) and SBP reductions were observed, particularly in patients with high CVD risk and severe AHI.

Conclusions:

• CVD risk assessment and evaluation of severe breathing disturbances are crucial for identifying OSA patients who benefit from treatment.
• The modified Baveno classification effectively guides OSA treatment decisions.
• PAP therapy demonstrates significant benefits in improving patient outcomes.