Beyond the Apnea-Hypopnea Index: Circulating Biomarkers and Device-Based Metrics for Cardiometabolic Risk...

Area of Science:

• Sleep Medicine
• Cardiovascular Medicine
• Metabolic Medicine

Background:

• Obstructive sleep apnea (OSA) is increasingly understood as a systemic condition, not just an airway issue.
• The traditional apnea-hypopnea index (AHI) has limitations in predicting adverse health outcomes.
• Novel markers are needed for improved risk stratification in OSA.

Purpose of the Study:

• To review emerging circulating biomarkers and device-based metrics for OSA risk stratification.
• To explore how these novel markers complement the AHI in assessing patient risk.
• To highlight the multifaceted nature of OSA beyond traditional diagnostic measures.

Main Methods:

• Narrative review of recent scientific evidence.
• Focus on circulating biomarkers (inflammatory, vascular, metabolic, molecular) and device-based metrics.
• Analysis of studies linking these markers to OSA severity and outcomes.

Main Results:

• Emerging biomarkers offer a comprehensive view of OSA pathophysiology, including inflammation, endothelial dysfunction, and metabolic imbalance.
• Commonly studied markers correlate with OSA severity and adverse health outcomes.
• Novel molecular markers like microRNAs and advanced sleep metrics provide deeper prognostic insights.

Conclusions:

• A multidimensional approach integrating laboratory markers and device metrics can enhance risk identification in OSA.
• This framework may improve the prediction of cardiovascular and metabolic complications in OSA patients.
• Refined risk stratification is crucial for managing the systemic impact of OSA.