Apnea-hypopnea index prediction through an assessment of autonomic influence on heart rate in wakefulness

Abstract With the high prevalence of obstructive sleep apnea, the issue of developing a practical tool for obstructive sleep apnea screening has been raised. Conventional obstructive sleep apnea screening tools are limited in their ability to help clinicians make rational decisions due to their inability to predict the apnea-hypopnea index. Our study aimed to develop a new prediction model that can provide a reliable apnea-hypopnea index value during wakefulness. We hypothesized that patients with more severe obstructive sleep apnea would exhibit more attenuated waking vagal tone, which may result in lower effectiveness in decreasing heart rate as a response to deep inspiration breath-holding. Prior to conducting nocturnal in-laboratory polysomnography, 30 non-obstructive sleep apnea (apnea-hypopnea index  k -fold cross-validation tests were performed to develop an apnea-hypopnea index prediction model. For the remaining 92 individuals, the developed model provided an absolute error (mean ± SD) of 3.53 ± 2.67 events/h and a Pearson's correlation coefficient of 0.99 ( P