{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T22:03:04Z","timestamp":1789596184387,"version":"build-2803163510"},"reference-count":40,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2015,8,18]],"date-time":"2015-08-18T00:00:00Z","timestamp":1439856000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2016,4,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>BACKGROUND<\/jats:title>\n                  <jats:p>Sleep-disordered breathing (SDB) is associated with repeated intermittent hypoxemia, and it is known as one of the risk factors for cardiovascular diseases. Previous studies assessing the effects of frequency and depth of hypoxemia on cardiovascular diseases have shown conflicting results. The aim of the current study was to clarify what SDB-related parameters most predict endothelial dysfunction to better understand the pathogenesis of endothelial dysfunction in patients with SDB.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>METHODS<\/jats:title>\n                  <jats:p>We conducted polysomnography (PSG) and measured flow-mediated vasodilation response (%FMD) in 50 outpatients suspected of SDB. Evaluated indices included: apnea-hypopnea index (AHI), 3% oxygen desaturation index (3%ODI), averaged arterial oxygen saturation (averaged SpO 2 ), lowest arterial oxygen saturation (lowest SpO 2 ), ratio of arterial oxygen saturation &amp;lt;90% (&amp;lt;SpO 2 90%), and averaged time desaturation summation index (TDS: [100%-averaged SpO 2 ] \u00d7 total sleep time).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESULTS<\/jats:title>\n                  <jats:p>Significant differences were observed only in the TDS between the first and third ( P = 0.03) and between the first and forth ( P = 0.04) quartile groups, stratified by %FMD. The %FMD showed a significant relationship with TDS ( \u03b2 = \u22120.47, P = 0.001), even after adjusting for confounding factors ( \u03b2 = \u22120.33, P = 0.02). In contrast, AHI, 3%ODI, averaged SpO 2 , lowest SpO 2 , and &amp;lt;SpO 2 90% showed no significant relationships.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>CONCLUSIONS<\/jats:title>\n                  <jats:p>This study shows the validity of TDS in predicting endothelial damage in patients with SDB. Cumulative hypoxemia, rather than the frequency of hypoxemic events presented as AHI, may be a greater contributing factor in causing endothelial dysfunction. A simple index like TDS may be a useful and novel indicator of the influence of SDB on the vasculature.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ajh\/hpv135","type":"journal-article","created":{"date-parts":[[2016,3,10]],"date-time":"2016-03-10T05:24:18Z","timestamp":1457587458000},"page":"458-463","source":"Crossref","is-referenced-by-count":20,"title":["Cumulative Hypoxemia During Sleep Predicts Vascular Endothelial Dysfunction in Patients With Sleep-Disordered Breathing"],"prefix":"10.1093","volume":"29","author":[{"given":"Hiroyuki","family":"Sawatari","sequence":"first","affiliation":[{"name":"Department of Health Sciences, Kyushu University Graduate School of Medical Sciences 1 , Fukuoka , Japan ;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akiko","family":"Chishaki","sequence":"additional","affiliation":[{"name":"Department of Health Sciences, Kyushu University Graduate School of Medical Sciences 1 , Fukuoka , Japan 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