超越呼吸暂停低通气指数：对阻塞性睡眠呼吸暂停多维评估的行动呼吁

文献信息

中文摘要

阻塞性睡眠呼吸暂停（OSA）是一种高度异质性的慢性疾病，其中传统的疾病严重程度指标——呼吸暂停低通气指数（AHI）与患者报告的症状相关性差，与心血管结局的相关性也不一致。本观点文章提出对OSA患者多维评估新概念的初步讨论，该概念整合了上气道阻塞的客观指标（AHI）和慢性间歇性缺氧（缺氧负荷），以及夜间和日间症状负担的主观评估，包括打鼾、主观睡眠质量、日间嗜睡、疲劳和生活质量。这种整合方法旨在改善患者特征描述，并指导更个体化的治疗目标，包括改善生活质量和减少心血管及代谢后果。它还支持在OSA领域的行动呼吁，鼓励对OSA治疗反应和临床意义进行更全面的评估。

英文摘要

Obstructive sleep apnea (OSA) is a highly heterogeneous chronic disease, in which the conventional measure of disease severity, the apnea-hypopnea index (AHI), correlates poorly with patient-reported symptoms and inconsistently with cardiovascular outcomes. The present perspective proposes an initial discussion of a new concept for multidimensional evaluation of patients with OSA that integrates both objective measures of upper airway obstruction (AHI) and chronic intermittent hypoxia (hypoxic burden), along with subjective assessments of nighttime and daytime symptoms burden including snoring, subjective sleep quality, daytime sleepiness, fatigue, and quality of life. This integrated approach aims to improve characterization of patients and guide more individualized therapeutic goals, including improvements in quality of life and reduction in cardiovascular and metabolic consequences. It also supports a call to action in the OSA field, encouraging the development of a more comprehensive assessment of treatment response and clinical meaningfulness in OSA.