The differential impact of respiratory event scoring criteria on CPAP eligibility in women and men
- S-Med
- Apr 2
- 1 min read
Utilizing different hypopnea scoring criteria to define OSA has been shown to significantly impact the prevalence and severity classification of OSA and even eligibility for CPAP therapy. The use of the more strict CMS criteria to score hypopneas, compared to AASM criteria, results in fewer patients being eligible for treatment of OSA in both women and men. However, the differential impact of varying hypopnea scoring criteria on the clinical care of women vs men has not been fully explored. This study not only examined the role that different hypopnea definitions have on CPAP eligibility for women vs men, but uniquely investigated how weight and age may influence this relationship.
Not unexpected, using CMS scoring criteria (vs AASM criteria) doubled the odds of a missed diagnosis of OSA in women compared to men with a similar symptom burden as measured by daytime sleepiness. This finding did not significantly change even after accounting for age, BMI, and polysomnographic variables (percent REM sleep time and mean oxygen saturation). Subgroup analysis after stratification based on age and BMI
showed that the odds of a missed diagnosis was 6-fold higher in middle age (40-60) women with obesity (BMI >40 kg/m2 ) than in comparable men. It is interesting to note that while weight gain appeared to lessen the discrepancy between AHIs determined by CMS and AASM scoring criteria, sex was a considerably more robust determining factor and superseded the relationship between BMI and differences in AHI by scoring criteria.
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