Impact of mean apnea-hypopnea duration on disease severity in obstructive sleep apnea: A retrospective study

The mean of apnea hypopnea duration (MAD) may reflect obstructive sleep apnea (OSA) severity, but its clinical relevance remains unclear. Our aim was to assess the impact of MAD on OSA severity.

A retrospective study (2015-2022) was conducted in a pneumology department, including 521 patients diagnosed with OSA by ventilatory polygraphy. Patients were divided by the median MAD into group 1 (≥median, n = 264), and group 2 (

The frequency of severe OSA was comparable between the two groups (p = 0.1). Patients in G1 had a lower minimum oxygen saturation during sleep (p = 0.004) and a higher total recording time with a saturation below 88 % (p = 0.03). There was a positive correlation between MAD and age (r = 0.1; p = 0.001) and a negative correlation between MAD and minimum oxygen saturation during sleep (r = -0.14; p = 0.001). The apnea-hypopnea index, desaturation index and mean oxygen saturation during sleep were not correlated with MAD. Older age (p = 0.01), male sex (p = 0.001), coffee consumption (p = 0.002), and restless sleep (p = 0.001) were independently associated with greater-than-median MAD in multivariate analysis.

MAD provides complementary information to traditional indices such as AHI and oxygen desaturation, which could help refine OSA phenotyping, improve risk stratification, and support more personalized management strategies.