The modified Baveno classification for obstructive sleep apnoea: design of a pan-European prospective study

Area of Science:

• Sleep Medicine
• Cardiology
• Internal Medicine

Background:

• The apnoea-hypopnoea index (AHI) alone is insufficient for guiding obstructive sleep apnoea (OSA) treatment.
• The modified Baveno classification integrates respiratory disturbances, symptoms, and cardiovascular disease (CVD) risk for comprehensive OSA management.
• Previous retrospective analyses suggest this classification improves symptoms and cardiovascular parameters.

Purpose of the Study:

• To prospectively evaluate the clinical utility of the modified Baveno classification in guiding OSA treatment.
• To assess the impact of this classification on patient symptoms and cardiovascular health.
• To establish a robust evidence base for a multicomponent approach to OSA management.

Main Methods:

• A multicentre, prospective, observational, long-term follow-up study enrolling patients aged 40+ with OSA.
• Treatment decisions guided by the modified Baveno classification, incorporating AHI, CVD status, and CVD risk scores (SCORE2/SCORE2-OP/SCORE2-diabetes) with symptom assessment.
• Primary outcome: change in office systolic blood pressure (SBP); secondary outcome: Epworth Sleepiness Scale. Follow-up at 6, 12, 24, and 36 months.

Main Results:

• Retrospective data from 1081 patients showed a mean SBP reduction of -5±14 mmHg in 393 treated individuals.
• Study powered for 894 patients, targeting 1800 to account for a 50% 3-year dropout rate.
• This prospective study aims to confirm and expand upon these preliminary findings.

Conclusions:

• This study will determine the clinical relevance of the modified Baveno classification for OSA assessment.
• It will provide evidence for improved treatment decision-making in routine clinical practice.
• The findings are expected to refine OSA management strategies by incorporating a broader patient profile.