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Edward M. Weaver, MD, MPH; Vishesh Kapur, MD, MPH; Bevan Yueh, MD, MPH

Arch Otolaryngol Head Neck Surg. 2004;130:453-458.

Background  While obstructive sleep apnea syndrome is defined by both polysomnographic (PSG) abnormalities and symptoms, severity is quantified primarily by the apnea-hypopnea index (AHI) alone.

Objective  To determine the correlation between standard PSG indices (AHI and others) and self-reported sleepiness, mental health status, and general health in patients with sleep apnea.

Design  Cross-sectional study.

Setting  University-affiliated outpatient sleep laboratory.

Patients  Ninety-six consecutive patients with PSG-confirmed sleep apnea (AHI 5).

Measurements  Patients completed a questionnaire that included the Epworth Sleepiness Scale, Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36) mental health domain, and self-rated health on the evening of diagnostic PSG. Spearman correlation coefficients were computed. This sample had 85% power to detect a correlation of 0.3 or greater. The associations between PSG indices and self-reported measures were further assessed with multivariable regression techniques, adjusting for age, sex, body mass index, comorbidity, and PSG type.

Results  The PSG parameters correlated poorly with self-reported measures (15 correlations; range of magnitude, 0.004-0.24; mean, 0.09). AHI was not associated with self-reported sleepiness or general health, and it was associated with the SF-36 Health Status mental health domain only on multiple linear regression (P = .04) but not on multiple logistic regression (adjusted odds ratio, 1.02; 95% confidence interval, 1.00-1.04; P = .09).

Conclusions  In general, PSG measures, and AHI in particular, correlated poorly with self-reported measures in a clinical sleep laboratory sample. After adjustment for potentially confounding variables, weak associations were found between some PSG indices and selected self-reported measures. These findings suggest that sleep apnea disease burden should be quantified with both physiologic and subjective measures.

From the Department of Otolaryngology–Head and Neck Surgery (Drs Weaver and Yueh), Sleep Disorders Center (Drs Weaver and Kapur), Center for Cost and Outcomes Research (Drs Weaver and Yueh); Pulmonary and Critical Care Medicine Division, Department of Medicine (Dr Kapur), and Department of Health Services (Dr Yueh), University of Washington, Seattle; and Surgery and Perioperative Care Service and Health Services Research and Development Service (Drs Weaver and Yueh), Veterans Affairs Puget Sound Health Care System, Seattle, Wash. The authors have no relevant financial interest in this article.

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