MAD vs. AHI: Sleep patterns, oxygenation among polysomnography diagnosed by OSA patients

ABSTRACT Background and Objective: Obstructive sleep apnea is a common sleep disorder characterized by repeated airway obstructive during sleep, leading to breating pauses, reduced sleep quality and decreased blood oxygen levels. Materials and Methods: Polysomnographic data in Obstructive Sleep Apnea patients were analysed to explore correlations between Apnea Hypopnea Index, Mean Apnea hypopnea Duration, oxygen desaturation and sleep stages. Results: Among 136 Obstructive Sleep Apnea patients, Mean Apnea hypopnea duration showed a mild correlation with Apnea Hypopnea Index but no association with age, weight and height. Patients with longer Mean Apnea hypopnea duration had association ( P < 0.05) with poorer oxygenation, lower average saturation, loss of sleep, Mean oxygen desaturation, shorter sleep latency, less Non Rapid Eye Movement 3, more Non Rapid Eye Movement 1 and higher arousal/desaturation. After adjusting Apnea Hypopnea Index, Mean Apnea hypopnea duration remained significantly associated with Epworth Sleep Scale, sleep latency, Non Rapid Eye Movement 1/3, arousal index and all oxygen metrics. These associations were stronger in severe Obstructive Sleep Apnea ( n = 90), while in mild-moderate cases ( n = 46), only Non Rapid Eye Movement 3 duration correlated negatively with Mean Apnea hypopnea duration ( r = –0.14, P = 0.02). Conclusion: Mean apnea hypopnea duration emerged as an independent marker of oxygen desaturation and sleep disruption in OSA, beyond the Apnea Hypopnea Index. Its critical relevance was more pronounced in severe cases suggesting added value in assessing disease burden. Incorporating event duration into routine evaluation may refine patient stratification and guide targeted management strategies.