Российская академия наук

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Deyneka E.A.

Federal Scientific Clinical Center for Specialized Types of Medical Care and Medical Technologies for the Federal Medical-Biological Agency, Moscow, Russia, edeyneka@mail.ru

In our paper for the Congress in 2012, about physiological meaning of apnea-hypopnea index (AHI), we pointed out that this integrative clinical indicator does not fully reflect the specific pathogenic mechanisms quantitatively described by it. Expressing the frequency of apnea-hypopnea episodes during sleep, the AHI considers only conditionally accepted level of blood deoxygenation (usually >3-4%) at some conventional level of reduced oronasal airway flow (usually >90% for sleep apnea and >50-70% & <90% for sleep hypopnea) but says nothing about the duration of these respiratory-saturation phenomena (except it’s limitation within a conventional range of 10-120 s). However, a number of our studies have shown that the dependence of the duration of respiratory disturbances episodes during sleep on the frequency of occurrence of such episodes and the degree of blood deoxygenation is not completely clear and depends on many factors, namely, on respiratory, circulatory and metabolic rates, acid-base balance, sensitivity of respiratory chemoreceptors, neurogenic regulation etc. Thus, an important indicator about the state of these physiological systems, in our opinion, is the partial pressure of CO2 in blood. Due to the fact that AHI is used to assess the severity of respiratory disorders in sleep, it is an important problem of establishing the appropriate range of AHI values. In our study involving 126 subjects all of them were divided into 4 groups: 1. AHI<5 (normal), 1,82±1,59 episodes per hour with an average night desaturation 4,33±0,81%; 2. 5
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