{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T17:54:25Z","timestamp":1789062865246,"version":"build-2803163510"},"reference-count":107,"publisher":"MDPI AG","issue":"21","license":[{"start":{"date-parts":[[2023,10,26]],"date-time":"2023-10-26T00:00:00Z","timestamp":1698278400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>Obstructive sleep apnoea (OSA) is a sleep disorder with repetitive collapse of the upper airway during sleep, which leads to intermittent hypoxic events overnight, adverse neurocognitive, metabolic complications, and ultimately an increased risk of cardiovascular disease (CVD). The standard diagnostic parameter for OSA, apnoea\u2013hypopnoea index (AHI), is inadequate to predict CVD morbidity and mortality, because it focuses only on the frequency of apnoea and hypopnoea events, and fails to reveal other physiological information for the prediction of CVD events. Novel parameters have been introduced to compensate for the deficiencies of AHI. However, the calculation methods and criteria for these parameters are unclear, hindering their use in cross-study analysis and studies. This review aims to discuss novel parameters for predicting CVD events from oximetry signals and to summarise the corresponding computational methods.<\/jats:p>","DOI":"10.3390\/diagnostics13213323","type":"journal-article","created":{"date-parts":[[2023,10,27]],"date-time":"2023-10-27T09:56:36Z","timestamp":1698400596000},"page":"3323","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":18,"title":["A Review of Novel Oximetry Parameters for the Prediction of Cardiovascular Disease in Obstructive Sleep Apnoea"],"prefix":"10.3390","volume":"13","author":[{"given":"Siying","family":"He","sequence":"first","affiliation":[{"name":"Charles Perkins Centre, Faculty of Engineering, Sydney University, Camperdown, NSW 2050, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7920-4924","authenticated-orcid":false,"given":"Peter A.","family":"Cistulli","sequence":"additional","affiliation":[{"name":"Charles Perkins Centre, Faculty of Medicine and Health, Sydney University, Camperdown, NSW 2050, Australia"},{"name":"Department of Respiratory and Sleep Medicine, Royal North Shore Hospital, St Leonards, NSW 2065, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2091-207X","authenticated-orcid":false,"given":"Philip","family":"de Chazal","sequence":"additional","affiliation":[{"name":"Charles Perkins Centre, Faculty of Engineering, Sydney University, Camperdown, NSW 2050, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,10,26]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"60","DOI":"10.1590\/2177-6709.20.6.060-067.oar","article-title":"Facial morphology and obstructive sleep apnea","volume":"20","author":"Capistrano","year":"2015","journal-title":"Dent. Press J. Orthod."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"e15","DOI":"10.4081\/ni.2011.e15","article-title":"Obstructive sleep apnea","volume":"3","author":"Ho","year":"2011","journal-title":"Neurol. Int."},{"key":"ref_3","first-page":"277","article-title":"Obstructive sleep apnea and cardiovascular disease: Evidence and underlying mechanisms","volume":"48","author":"Zizi","year":"2009","journal-title":"Minerva Pneumol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"533","DOI":"10.1093\/eurheartj\/ehy838","article-title":"Composition of nocturnal hypoxaemic burden and its prognostic value for cardiovascular mortality in older community-dwelling men","volume":"41","author":"Baumert","year":"2020","journal-title":"Eur. Heart J."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"705","DOI":"10.1007\/s00392-015-0859-7","article-title":"The importance of sleep-disordered breathing in cardiovascular disease","volume":"104","author":"Linz","year":"2015","journal-title":"Clin. Res. Cardiol."},{"key":"ref_6","first-page":"1079","article-title":"Sleep apnea as an independent risk factor for all-cause mortality: The Busselton Health Study","volume":"31","author":"Marshall","year":"2008","journal-title":"Sleep"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"256","DOI":"10.1016\/j.ijcard.2010.09.034","article-title":"Clinical impact of screening for sleep related breathing disorders in atrial fibrillation","volume":"154","author":"Altmann","year":"2012","journal-title":"Int. J. Cardiol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"1101","DOI":"10.1164\/ajrccm.160.4.9903020","article-title":"Risk factors for central and obstructive sleep apnea in 450 men and women with congestive heart failure","volume":"160","author":"Sin","year":"1999","journal-title":"Am. J. Respir. Crit. Care Med."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"101","DOI":"10.1111\/j.1365-2869.2011.00935.x","article-title":"Classification algorithms for predicting sleepiness and sleep apnea severity","volume":"21","author":"Eiseman","year":"2012","journal-title":"J. Sleep Res."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"970","DOI":"10.1513\/AnnalsATS.201802-121OC","article-title":"Association between Obstructive Sleep Apnea and Cardiovascular Risk Factors: Variation by Age, Sex, and Race. The Multi-Ethnic Study of Atherosclerosis","volume":"15","author":"Geovanini","year":"2018","journal-title":"Ann. Am. Thorac Soc."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"zsab030","DOI":"10.1093\/sleep\/zsab030","article-title":"Metrics of sleep apnea severity: Beyond the apnea-hypopnea index","volume":"44","author":"Malhotra","year":"2021","journal-title":"Sleep"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"151","DOI":"10.4103\/lungindia.lungindia_302_19","article-title":"The uses of overnight pulse oximetry","volume":"37","author":"Singh","year":"2020","journal-title":"Lung India"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"1267","DOI":"10.1164\/rccm.201808-1493OC","article-title":"The Combination of Atomoxetine and Oxybutynin Greatly Reduces Obstructive Sleep Apnea Severity. A Randomized, Placebo-controlled, Double-Blind Crossover Trial","volume":"199","author":"Messineo","year":"2019","journal-title":"Am. J. Respir. Crit. Care Med."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1149","DOI":"10.1093\/eurheartj\/ehy624","article-title":"The hypoxic burden of sleep apnoea predicts cardiovascular disease-related mortality: The Osteoporotic Fractures in Men Study and the Sleep Heart Health Study","volume":"40","author":"Azarbarzin","year":"2019","journal-title":"Eur. Heart J."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"903","DOI":"10.1164\/rccm.201804-0758OC","article-title":"Apnea-Hypopnea Event Duration Predicts Mortality in Men and Women in the Sleep Heart Health Study","volume":"199","author":"Butler","year":"2019","journal-title":"Am. J. Respir. Crit. Care Med."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"16","DOI":"10.1378\/chest.14-2261","article-title":"COUNTERPOINT: Is the Apnea-Hypopnea Index the Best Way to Quantify the Severity of Sleep-Disordered Breathing? No","volume":"149","author":"Punjabi","year":"2016","journal-title":"Chest"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"1195","DOI":"10.1183\/09031936.00111208","article-title":"Cardiovascular disease in obstructive sleep apnoea syndrome: The role of intermittent hypoxia and inflammation","volume":"33","author":"Garvey","year":"2009","journal-title":"Eur. Respir. J."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1397","DOI":"10.2147\/NSS.S370471","article-title":"Independent Association Between Oxygen Desaturation Index and Cardiovascular Disease in Non-Sleepy Sleep-Disordered Breathing Subtype: A Chinese Community-Based Study","volume":"14","author":"Wang","year":"2022","journal-title":"Nat. Sci. Sleep"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"1013","DOI":"10.1088\/0967-3334\/34\/9\/1013","article-title":"Novel parameters reflect changes in morphology of respiratory events during weight loss","volume":"34","author":"Kulkas","year":"2013","journal-title":"Physiol. Meas."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"135","DOI":"10.3109\/03091902.2012.754509","article-title":"Novel parameters for evaluating severity of sleep disordered breathing and for supporting diagnosis of sleep apnea-hypopnea syndrome","volume":"37","author":"Kulkas","year":"2013","journal-title":"J. Med. Eng. Technol."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"665","DOI":"10.5664\/jcsm.6576","article-title":"AASM Scoring Manual Updates for 2017 (Version 2.4)","volume":"13","author":"Berry","year":"2017","journal-title":"J. Clin. Sleep Med."},{"key":"ref_22","doi-asserted-by":"crossref","unstructured":"Damiani, M.F., Zito, A., Carrat\u00f9, P., Falcone, V.A., Bega, E., Scicchitano, P., Ciccone, M.M., and Resta, O. (2015). Obstructive Sleep Apnea, Hypertension, and Their Additive Effects on Atherosclerosis. Biochem. Res. Int., 2015.","DOI":"10.1155\/2015\/984193"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"71","DOI":"10.1016\/j.sleep.2019.08.021","article-title":"Cardiovascular consequences of obstructive sleep apnea in women: A historical cohort study","volume":"68","author":"Kendzerska","year":"2020","journal-title":"Sleep Med."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"1695","DOI":"10.1093\/eurheartj\/ehv624","article-title":"Nocturnal hypoxaemia is associated with increased mortality in stable heart failure patients","volume":"37","author":"Oldenburg","year":"2016","journal-title":"Eur. Heart J."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"531","DOI":"10.5665\/sleep.5520","article-title":"Sleep Disordered Breathing and Risk of Stroke in Older Community-Dwelling Men","volume":"39","author":"Stone","year":"2016","journal-title":"Sleep"},{"key":"ref_26","doi-asserted-by":"crossref","unstructured":"Kendzerska, T., Gershon, A.S., Hawker, G., Leung, R.S., and Tomlinson, G. (2014). Obstructive sleep apnea and risk of cardiovascular events and all-cause mortality: A decade-long historical cohort study. PLoS Med., 11.","DOI":"10.1371\/journal.pmed.1001599"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"76","DOI":"10.1136\/thoraxjnl-2021-217714","article-title":"Cardiovascular outcomes in obstructive sleep apnoea and implications of clinical phenotyping on effect of CPAP treatment","volume":"78","author":"Xu","year":"2023","journal-title":"Thorax"},{"key":"ref_28","doi-asserted-by":"crossref","unstructured":"Frangopoulos, F., Nicolaou, I., Zannetos, S., Economou, N.T., Adamide, T., and Trakada, G. (2020). Association between Respiratory Sleep Indices and Cardiovascular Disease in Sleep Apnea-A Community-Based Study in Cyprus. J. Clin. Med., 9.","DOI":"10.3390\/jcm9082475"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"zsac179","DOI":"10.1093\/sleep\/zsac179","article-title":"Comparative associations of oximetry patterns in Obstructive Sleep Apnea with incident cardiovascular disease","volume":"45","author":"Sutherland","year":"2022","journal-title":"Sleep"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"1023","DOI":"10.2147\/NSS.S275252","article-title":"A Review of Current Tools Used for Evaluating the Severity of Obstructive Sleep Apnea","volume":"12","author":"Cao","year":"2020","journal-title":"Nat. Sci. Sleep"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"e13638","DOI":"10.1111\/jsr.13638","article-title":"Nocturnal oximetry parameters as predictors of sleep apnea severity in resource-limited settings","volume":"32","author":"Polytarchou","year":"2023","journal-title":"J. Sleep Res."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"1677","DOI":"10.1007\/s11325-022-02757-1","article-title":"Proposal of a diagnostic algorithm based on the use of pulse oximetry in obstructive sleep apnea","volume":"27","author":"Borsini","year":"2022","journal-title":"Sleep Breath."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"657126","DOI":"10.3389\/fnins.2021.657126","article-title":"Longer and Deeper Desaturations Are Associated With the Worsening of Mild Sleep Apnea: The Sleep Heart Health Study","volume":"15","author":"Karhu","year":"2021","journal-title":"Front. Neurosci."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"599","DOI":"10.5664\/jcsm.6552","article-title":"Oxygen Desaturation Index Differs Significantly Between Types of Sleep Software","volume":"13","author":"Ng","year":"2017","journal-title":"J. Clin. Sleep Med."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"1","DOI":"10.5152\/tao.2018.3025","article-title":"The Ignored Parameter in the Diagnosis of Obstructive Sleep Apnea Syndrome: The Oxygen Desaturation Index","volume":"56","author":"Temirbekov","year":"2018","journal-title":"Turk. Arch. Otorhinolaryngol."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"993","DOI":"10.1213\/ANE.0b013e318248f4f5","article-title":"Oxygen desaturation index from nocturnal oximetry: A sensitive and specific tool to detect sleep-disordered breathing in surgical patients","volume":"114","author":"Chung","year":"2012","journal-title":"Anesth. Analg."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"805","DOI":"10.2147\/NSS.S351840","article-title":"Nocturnal Oxygen Desaturation Index Correlates with Respiratory Depression in Post-Surgical Patients Receiving Opioids\u2014A Post-Hoc Analysis from the Prediction of Opioid-Induced Respiratory Depression in Patients Monitored by Capnography (PRODIGY) Study","volume":"14","author":"Liew","year":"2022","journal-title":"Nat. Sci. Sleep"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"13","DOI":"10.1016\/j.artmed.2007.06.002","article-title":"Improving diagnostic ability of blood oxygen saturation from overnight pulse oximetry in obstructive sleep apnea detection by means of central tendency measure","volume":"41","author":"Alvarez","year":"2007","journal-title":"Artif. Intell. Med."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"50","DOI":"10.1164\/ajrccm\/147.1.50","article-title":"A comparison of clinical assessment and home oximetry in the diagnosis of obstructive sleep apnea","volume":"147","author":"Gyulay","year":"1993","journal-title":"Am. Rev. Respir. Dis."},{"key":"ref_40","doi-asserted-by":"crossref","unstructured":"Hang, L.W., Wang, H.L., Chen, J.H., Hsu, J.C., Lin, H.H., Chung, W.S., and Chen, Y.F. (2015). Validation of overnight oximetry to diagnose patients with moderate to severe obstructive sleep apnea. BMC Pulm. Med., 15.","DOI":"10.1186\/s12890-015-0017-z"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"440","DOI":"10.1002\/lary.28663","article-title":"The Value of Oxygen Desaturation Index for Diagnosing Obstructive Sleep Apnea: A Systematic Review","volume":"131","author":"Rashid","year":"2021","journal-title":"Laryngoscope"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"1929","DOI":"10.5665\/sleep.3232","article-title":"Predictors of long-term adherence to continuous positive airway pressure therapy in patients with obstructive sleep apnea and cardiovascular disease in the SAVE study","volume":"36","author":"Luo","year":"2013","journal-title":"Sleep"},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"224","DOI":"10.5935\/1984-0063.20200119","article-title":"Oxygen desaturation index as alternative parameter in screening patients with severe obstructive sleep apnea","volume":"15","author":"Varghese","year":"2022","journal-title":"Sleep Sci."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"1150","DOI":"10.1164\/rccm.200712-1884OC","article-title":"Sleep-disordered breathing and cardiovascular disease: An outcome-based definition of hypopneas","volume":"177","author":"Punjabi","year":"2008","journal-title":"Am. J. Respir. Crit. Care Med."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"89","DOI":"10.5665\/sleep.1592","article-title":"Interrelationships between body mass, oxygen desaturation, and apnea-hypopnea indices in a sleep clinic population","volume":"35","author":"Ling","year":"2012","journal-title":"Sleep"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"347","DOI":"10.1007\/s10554-019-01710-w","article-title":"Severe obstructive sleep apnea is associated with significant coronary artery plaque burden independent of traditional cardiovascular risk factors","volume":"36","author":"Mo","year":"2020","journal-title":"Int. J. Cardiovasc. Imaging"},{"key":"ref_47","first-page":"5496","article-title":"Predicting Cardiovascular Outcomes Using the Respiratory Event Desaturation Transient Area Derived from Overnight Sleep Studies","volume":"2021","author":"Sadr","year":"2021","journal-title":"Annu. Int. Conf. IEEE Eng. Med. Biol. Soc."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"697","DOI":"10.1007\/s11517-013-1039-4","article-title":"Novel parameters indicate significant differences in severity of obstructive sleep apnea with patients having similar apnea-hypopnea index","volume":"51","author":"Kulkas","year":"2013","journal-title":"Med. Biol. Eng. Comput."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"703","DOI":"10.1007\/s11325-017-1616-0","article-title":"Nocturnal hypoxemic burden is associated with epicardial fat volume in patients with acute myocardial infarction","volume":"22","author":"Linz","year":"2018","journal-title":"Sleep Breath."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"108","DOI":"10.1164\/rccm.202105-1274OC","article-title":"Sleep Apnea-Specific Hypoxic Burden, Symptom Subtypes, and Risk of Cardiovascular Events and All-Cause Mortality","volume":"205","author":"Trzepizur","year":"2022","journal-title":"Am. J. Respir. Crit. Care Med."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"12","DOI":"10.1164\/rccm.202110-2371ED","article-title":"Sleep Apnea\u2013Specific Hypoxic Burden and Not the Sleepy Phenotype as a Novel Measure of Cardiovascular and Mortality Risk in a Clinical Cohort","volume":"205","author":"Mehra","year":"2021","journal-title":"Am. J. Respir. Crit. Care Med."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"36","DOI":"10.1016\/j.arbres.2022.08.005","article-title":"Hypoxic Burden in Obstructive Sleep Apnea: Present and Future","volume":"59","author":"White","year":"2023","journal-title":"Arch. Bronconeumol."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"2004022","DOI":"10.1183\/13993003.04022-2020","article-title":"Hypoxic burden and heart rate variability predict stroke incidence in sleep apnoea","volume":"57","author":"Blanchard","year":"2021","journal-title":"Eur. Respir. J."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"739","DOI":"10.1016\/j.chest.2020.03.053","article-title":"The Sleep Apnea-Specific Hypoxic Burden Predicts Incident Heart Failure","volume":"158","author":"Azarbarzin","year":"2020","journal-title":"Chest"},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"57","DOI":"10.1136\/thoraxjnl-2019-213533","article-title":"Association of novel measures of sleep disturbances with blood pressure: The Multi-Ethnic Study of Atherosclerosis","volume":"75","author":"John","year":"2020","journal-title":"Thorax"},{"key":"ref_56","doi-asserted-by":"crossref","unstructured":"Karhu, T., Lepp\u00e4nen, T., T\u00f6yr\u00e4s, J., Oksenberg, A., Myllymaa, S., and Nikkonen, S. (2022). ABOSA\u2014Freely available automatic blood oxygen saturation signal analysis software: Structure and validation. Comput. Methods Programs Biomed., 226.","DOI":"10.1016\/j.cmpb.2022.107120"},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"1563","DOI":"10.1164\/rccm.202206-1052LE","article-title":"Dying with OSA, or from It: A Cautionary Note about Novel Hypoxia Metrics","volume":"206","author":"Jun","year":"2022","journal-title":"Am. J. Respir. Crit. Care Med."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"2122","DOI":"10.1109\/TBME.2023.3236680","article-title":"Obstructive Sleep Apnea Patients with Atrial Arrhythmias Suffer from Prolonged Recovery from Desaturations","volume":"70","author":"Rissanen","year":"2023","journal-title":"IEEE Trans. Biomed. Eng."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"e000218","DOI":"10.1136\/bmjmed-2022-000218","article-title":"Role of precision medicine in obstructive sleep apnoea","volume":"2","author":"Liu","year":"2023","journal-title":"BMJ Med."},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"e13803","DOI":"10.1111\/jsr.13803","article-title":"Obstructive sleep apnea-related intermittent hypoxaemia is associated with impaired vigilance","volume":"32","author":"Pahari","year":"2023","journal-title":"J. Sleep Res."},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"e13441","DOI":"10.1111\/jsr.13441","article-title":"Diabetes and cardiovascular diseases are associated with the worsening of intermittent hypoxaemia","volume":"31","author":"Karhu","year":"2022","journal-title":"J. Sleep Res."},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"e13581","DOI":"10.1111\/jsr.13581","article-title":"Novel oxygen desaturation parameters are associated with cardiac troponin I: Data from the Akershus Sleep Apnea Project","volume":"31","author":"Sigurdardottir","year":"2022","journal-title":"J. Sleep Res."},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"00121-2022","DOI":"10.1183\/23120541.00121-2022","article-title":"Obstructive sleep apnoea-related respiratory events and desaturation severity are associated with the cardiac response","volume":"8","author":"Hietakoste","year":"2022","journal-title":"ERJ Open Res."},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"1901849","DOI":"10.1183\/13993003.01849-2019","article-title":"Severe desaturations increase psychomotor vigilance task-based median reaction time and number of lapses in obstructive sleep apnoea patients","volume":"55","author":"Kainulainen","year":"2020","journal-title":"Eur. Respir. J."},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"231","DOI":"10.1016\/j.sleep.2020.07.015","article-title":"Power spectral densities of nocturnal pulse oximetry signals differ in OSA patients with and without daytime sleepiness","volume":"73","author":"Kainulainen","year":"2020","journal-title":"Sleep Med."},{"key":"ref_66","unstructured":"Kainulainen, S. (2020). Pulse Oximetry-Derived Biomarkers for Severity Assessment of Obstructive Sleep Apnea: Associating Parametric and Frequency-Domain Features of SPO2 and PPG Signals with Daytime Sleepiness and Impaired Vigilance. [Ph.D. Thesis, University of Eastern Finlan]. Volume 387."},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"1135","DOI":"10.5664\/jcsm.7806","article-title":"Severity of Desaturations Reflects OSA-Related Daytime Sleepiness Better Than AHI","volume":"15","author":"Kainulainen","year":"2019","journal-title":"J. Clin. Sleep Med."},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"204","DOI":"10.1016\/j.sleep.2023.02.001","article-title":"Implication of a novel measure of obstructive sleep apnea severity for cardiovascular morbidity","volume":"103","author":"Cao","year":"2023","journal-title":"Sleep Med."},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"32","DOI":"10.1016\/j.sleep.2017.06.004","article-title":"Severity of individual obstruction events increases with age in patients with obstructive sleep apnea","volume":"37","author":"Mervaala","year":"2017","journal-title":"Sleep Med."},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"1465","DOI":"10.1007\/s11325-021-02464-3","article-title":"Association between nocturnal hypoxemic burden and glucose metabolism","volume":"26","author":"Thanaviratananich","year":"2022","journal-title":"Sleep Breath."},{"key":"ref_71","doi-asserted-by":"crossref","first-page":"575","DOI":"10.1111\/jch.13202","article-title":"The association between different features of sleep-disordered breathing and blood pressure: A cross-sectional study","volume":"20","author":"Khoshkish","year":"2018","journal-title":"J. Clin. Hypertens."},{"key":"ref_72","doi-asserted-by":"crossref","first-page":"219","DOI":"10.1007\/978-3-031-06413-5_13","article-title":"Oximetry Indices in the Management of Sleep Apnea: From Overnight Minimum Saturation to the Novel Hypoxemia Measures","volume":"1384","author":"Moreno","year":"2022","journal-title":"Adv. Exp. Med. Biol."},{"key":"ref_73","doi-asserted-by":"crossref","first-page":"1070","DOI":"10.1016\/j.chest.2017.05.009","article-title":"Obstructive Sleep Apnea and Diabetes: A State of the Art Review","volume":"152","author":"Reutrakul","year":"2017","journal-title":"Chest"},{"key":"ref_74","first-page":"1127","article-title":"Sleep disordered breathing and hypertension: Does self-reported sleepiness modify the association?","volume":"31","author":"Kapur","year":"2008","journal-title":"Sleep"},{"key":"ref_75","doi-asserted-by":"crossref","first-page":"391","DOI":"10.1038\/hr.2016.11","article-title":"Hypertension and obstructive sleep apnea","volume":"39","author":"Cai","year":"2016","journal-title":"Hypertens. Res."},{"key":"ref_76","doi-asserted-by":"crossref","first-page":"14","DOI":"10.2337\/diaspect.29.1.14","article-title":"Sleep Apnea in Type 2 Diabetes","volume":"29","author":"Doumit","year":"2016","journal-title":"Diabetes Spectr."},{"key":"ref_77","doi-asserted-by":"crossref","first-page":"1654","DOI":"10.1016\/j.eswa.2013.08.062","article-title":"Novel multiclass classification for home-based diagnosis of sleep apnea hypopnea syndrome","volume":"41","year":"2014","journal-title":"Expert Syst. Appl."},{"key":"ref_78","doi-asserted-by":"crossref","first-page":"1049","DOI":"10.1016\/j.medengphy.2011.11.009","article-title":"Feature selection from nocturnal oximetry using genetic algorithms to assist in obstructive sleep apnoea diagnosis","volume":"34","author":"Hornero","year":"2012","journal-title":"Med. Eng. Phys."},{"key":"ref_79","doi-asserted-by":"crossref","first-page":"86","DOI":"10.1378\/chest.08-0057","article-title":"Comparison of the Indices of Oxyhemoglobin Saturation by Pulse Oximetry in Obstructive Sleep Apnea Hypopnea Syndrome","volume":"135","author":"Lin","year":"2009","journal-title":"Chest"},{"key":"ref_80","doi-asserted-by":"crossref","first-page":"375","DOI":"10.1088\/0967-3334\/31\/3\/007","article-title":"The classification of oximetry signals using Bayesian neural networks to assist in the detection of obstructive sleep apnoea syndrome","volume":"31","author":"Marcos","year":"2010","journal-title":"Physiol. Meas."},{"key":"ref_81","doi-asserted-by":"crossref","first-page":"882","DOI":"10.1109\/JBHI.2018.2823384","article-title":"Evaluation of Machine-Learning Approaches to Estimate Sleep Apnea Severity From At-Home Oximetry Recordings","volume":"23","author":"Alvarez","year":"2019","journal-title":"IEEE J. Biomed. Health Inform."},{"key":"ref_82","doi-asserted-by":"crossref","first-page":"693","DOI":"10.5664\/jcsm.6586","article-title":"Automated Screening of Children With Obstructive Sleep Apnea Using Nocturnal Oximetry: An Alternative to Respiratory Polygraphy in Unattended Settings","volume":"13","author":"Crespo","year":"2017","journal-title":"J. Clin. Sleep Med."},{"key":"ref_83","doi-asserted-by":"crossref","first-page":"971","DOI":"10.1016\/j.medengphy.2009.05.010","article-title":"Assessment of four statistical pattern recognition techniques to assist in obstructive sleep apnoea diagnosis from nocturnal oximetry","volume":"31","author":"Marcos","year":"2009","journal-title":"Med. Eng. Phys."},{"key":"ref_84","doi-asserted-by":"crossref","first-page":"895","DOI":"10.1007\/s11517-010-0646-6","article-title":"Automated detection of obstructive sleep apnoea syndrome from oxygen saturation recordings using linear discriminant analysis","volume":"48","author":"Marcos","year":"2010","journal-title":"Med. Biol. Eng. Comput."},{"key":"ref_85","doi-asserted-by":"crossref","first-page":"1350020","DOI":"10.1142\/S0129065713500202","article-title":"Assessment of feature selection and classification approaches to enhance information from overnight oximetry in the context of apnea diagnosis","volume":"23","author":"Alvarez","year":"2013","journal-title":"Int. J. Neural Syst."},{"key":"ref_86","doi-asserted-by":"crossref","first-page":"1591","DOI":"10.1164\/rccm.201705-0930OC","article-title":"Nocturnal Oximetry-based Evaluation of Habitually Snoring Children","volume":"196","author":"Hornero","year":"2017","journal-title":"Am. J. Respir. Crit. Care Med."},{"key":"ref_87","first-page":"1071","article-title":"Sleep disordered breathing and mortality: Eighteen-year follow-up of the Wisconsin sleep cohort","volume":"31","author":"Young","year":"2008","journal-title":"Sleep"},{"key":"ref_88","doi-asserted-by":"crossref","first-page":"1829","DOI":"10.1001\/jama.283.14.1829","article-title":"Association of Sleep-Disordered Breathing, Sleep Apnea, and Hypertension in a Large Community-Based Study","volume":"283","author":"Nieto","year":"2000","journal-title":"JAMA"},{"key":"ref_89","doi-asserted-by":"crossref","first-page":"1007","DOI":"10.1007\/s11325-019-01860-0","article-title":"Do T90 and SaO2 nadir identify a different phenotype in obstructive sleep apnea?","volume":"23","author":"Labarca","year":"2019","journal-title":"Sleep Breath."},{"key":"ref_90","doi-asserted-by":"crossref","first-page":"101309","DOI":"10.1016\/j.smrv.2020.101309","article-title":"Sleep apnoea and endothelial dysfunction: An individual patient data meta-analysis","volume":"52","author":"Bironneau","year":"2020","journal-title":"Sleep Med. Rev."},{"key":"ref_91","doi-asserted-by":"crossref","first-page":"2621","DOI":"10.1016\/j.chest.2020.06.072","article-title":"Low Prognostic Value of Novel Nocturnal Metrics in Patients With OSA and High Cardiovascular Event Risk: Post Hoc Analyses of the SAVE Study","volume":"158","author":"Linz","year":"2020","journal-title":"Chest"},{"key":"ref_92","doi-asserted-by":"crossref","first-page":"213","DOI":"10.5664\/jcsm.10286","article-title":"Implication of prolonged nocturnal hypoxemia and obstructive sleep apnea for pulmonary hemodynamics in patients being evaluated for pulmonary hypertension: A retrospective study","volume":"19","author":"Huang","year":"2023","journal-title":"J. Clin. Sleep Med."},{"key":"ref_93","doi-asserted-by":"crossref","first-page":"329","DOI":"10.1016\/j.sleep.2010.06.014","article-title":"The role of obstructive sleep apnea in metabolic syndrome: A population-based study in women","volume":"12","author":"Berne","year":"2011","journal-title":"Sleep Med."},{"key":"ref_94","doi-asserted-by":"crossref","unstructured":"Hassan, S.M., Ganglberger, W., Azarbarzin, A., Antkowiak, M.C., Badlam, J., Ahmad, I., Rahaghi, F.N., Washko, G.R., Westover, M.B., and Redline, S. (2023). Polysomnography-Derived Hypoxemic Markers Associated with Pulmonary Hypertension in Obstructive Sleep Apnea, American Thoracic Society.","DOI":"10.1164\/ajrccm-conference.2023.207.1_MeetingAbstracts.A5971"},{"key":"ref_95","doi-asserted-by":"crossref","first-page":"206","DOI":"10.1016\/j.ijcard.2016.09.110","article-title":"Utility of overnight pulse oximeter as a screening tool for sleep apnea to assess the 8-year risk of cardiovascular disease: Data from a large-scale bus driver cohort study","volume":"225","author":"Wu","year":"2016","journal-title":"Int. J. Cardiol."},{"key":"ref_96","doi-asserted-by":"crossref","first-page":"1495","DOI":"10.1007\/s11325-019-02010-2","article-title":"Acute stroke and TIA patients have specific polygraphic features of obstructive sleep apnea","volume":"24","author":"Leino","year":"2020","journal-title":"Sleep Breath."},{"key":"ref_97","doi-asserted-by":"crossref","unstructured":"Punjabi, N.M., Caffo, B.S., Goodwin, J.L., Gottlieb, D.J., Newman, A.B., O\u2019Connor, G.T., Rapoport, D.M., Redline, S., Resnick, H.E., and Robbins, J.A. (2009). Sleep-disordered breathing and mortality: A prospective cohort study. PLoS Med., 6.","DOI":"10.1371\/journal.pmed.1000132"},{"key":"ref_98","doi-asserted-by":"crossref","first-page":"114004","DOI":"10.1088\/1361-6579\/aae42c","article-title":"Differences in arousal probability and duration after apnea and hypopnea events in adult obstructive sleep apnea patients","volume":"39","author":"Kulkas","year":"2018","journal-title":"Physiol. Meas."},{"key":"ref_99","doi-asserted-by":"crossref","first-page":"641","DOI":"10.1007\/s11325-013-0927-z","article-title":"Adjustment of apnea-hypopnea index with severity of obstruction events enhances detection of sleep apnea patients with the highest risk of severe health consequences","volume":"18","author":"Kulkas","year":"2014","journal-title":"Sleep Breath."},{"key":"ref_100","doi-asserted-by":"crossref","first-page":"475","DOI":"10.1111\/resp.13635","article-title":"A review of approaches for analysing obstructive sleep apnoea-related patterns in pulse oximetry data","volume":"25","author":"Terrill","year":"2020","journal-title":"Respirology"},{"key":"ref_101","unstructured":"Iber, C., Ancoli-Israel, S., Chesson, A.L., and Quan, S. (2007). The AASM Manual for the Scoring of Sleep and Associated Events: Rules, Terminology and Technical Specifications, American Academy of Sleep Medicine."},{"key":"ref_102","doi-asserted-by":"crossref","first-page":"597","DOI":"10.5664\/jcsm.2172","article-title":"Rules for scoring respiratory events in sleep: Update of the 2007 AASM Manual for the Scoring of Sleep and Associated Events. Deliberations of the Sleep Apnea Definitions Task Force of the American Academy of Sleep Medicine","volume":"8","author":"Berry","year":"2012","journal-title":"J. Clin. Sleep Med."},{"key":"ref_103","doi-asserted-by":"crossref","first-page":"2008","DOI":"10.1001\/jama.283.15.2008","article-title":"Meta-analysis of observational studies in epidemiology: A proposal for reporting. Meta-analysis Of Observational Studies in Epidemiology (MOOSE) group","volume":"283","author":"Stroup","year":"2000","journal-title":"JAMA"},{"key":"ref_104","doi-asserted-by":"crossref","first-page":"207","DOI":"10.1016\/j.ijcard.2013.08.088","article-title":"Obstructive sleep apnea and risk of cardiovascular disease and all-cause mortality: A meta-analysis of prospective cohort studies","volume":"169","author":"Wang","year":"2013","journal-title":"Int. J. Cardiol."},{"key":"ref_105","doi-asserted-by":"crossref","first-page":"352","DOI":"10.1161\/CIRCULATIONAHA.109.901801","article-title":"Prospective study of obstructive sleep apnea and incident coronary heart disease and heart failure: The sleep heart health study","volume":"122","author":"Gottlieb","year":"2010","journal-title":"Circulation"},{"key":"ref_106","doi-asserted-by":"crossref","first-page":"541","DOI":"10.1097\/HCO.0b013e32834b806a","article-title":"Role of obstructive sleep apnea in cardiovascular disease","volume":"26","author":"Monahan","year":"2011","journal-title":"Curr. Opin. Cardiol."},{"key":"ref_107","doi-asserted-by":"crossref","first-page":"2088","DOI":"10.1093\/eurheartj\/ehab151","article-title":"Sleep arousal burden is associated with long-term all-cause and cardiovascular mortality in 8001 community-dwelling older men and women","volume":"42","author":"Shahrbabaki","year":"2021","journal-title":"Eur. Heart J."}],"container-title":["Diagnostics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2075-4418\/13\/21\/3323\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T21:12:22Z","timestamp":1760130742000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2075-4418\/13\/21\/3323"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,10,26]]},"references-count":107,"journal-issue":{"issue":"21","published-online":{"date-parts":[[2023,11]]}},"alternative-id":["diagnostics13213323"],"URL":"https:\/\/doi.org\/10.3390\/diagnostics13213323","relation":{},"ISSN":["2075-4418"],"issn-type":[{"value":"2075-4418","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,10,26]]}}}