Abstract
OBJECTIVE: To compare 2 composite indices of sleep apnea disease burden with the commonly used apnea-hypopnea index with regard to baseline measurement of subjective and objective disease burden. STUDY DESIGN: Cross-sectional study. SETTING: Tertiary academic medical center sleep laboratory. SUBJECTS AND METHODS: Patients with suspected diagnosis of sleep apnea undergoing first diagnostic polysomnography. Subjective data were collected via validated questionnaires; objective data were obtained by standardized physical examination, chart extraction, and polysomnography. Four subjective (patient-reported) disease burden measures and 3 objective (anatomic and physiologic) disease burden measures were used for validation. Associations between composite indices or apnea-hypopnea index and these 7 construct validation measures were compared using bootstrapped correlation coefficients. RESULTS: Two hundred sixteen subjects were included in the final analysis. Both composite disease burden indices showed clinically important or nearly important associations with 3 of 4 subjective validation measures and all 3 objective validation measures, whereas the apnea-hypopnea index was associated only with the objective validation measures. CONCLUSION: Composite indices of sleep apnea disease burden may capture the breadth of baseline sleep apnea disease burden, particularly subjective disease burden, better than the apnea-hypopnea index.