(Obstructive sleep apnoea) Definition of OSA by Dr Older

Mouraux S; Department of Medicine, University of Lausanne
Lechartier B; Imler T; von Garnier C; Heinzer R; Vollenweider
P; Preisig M; Solelhac G; Touilloux B

Chest. 169(4):1091-1100, 2026 Apr.

BACKGROUND: Dyspnea increases mortality and remains unexplained in 15% of
patients. Although OSA is linked to reduced exercise capacity during
cardiopulmonary exercise testing, the association between dyspnea and OSA
remains uncertain.

RESEARCH QUESTION: Is there an association between exertional dyspnea and
OSA in the general population? What are the polysomnographic OSA-related
measures associated with exertional dyspnea?

STUDY DESIGN AND METHODS: We used data from a prospective cohort study of
the general population conducted in an urban area. Participants underwent
polysomnography and completed a respiratory questionnaire. Logistic
regression models were used to determine the association between
self-reported dyspnea (modified Medical Research Council Dyspnea scale >=
1) and OSA categories or apnea-hypopnea index (AHI) cutoffs. We performed
an adjusted model for sex, BMI, age, FEV1, psychiatric disorders, cardiac
and respiratory disorders, and smoking history.

RESULTS: We included 1,200 participants (mean age, 62.1 years; 54%
female), of whom 515 (42.9%) reported exertional dyspnea. The adjusted
model revealed a positive association between exertional dyspnea and AHI
>= 15 events/h (OR, 1.57; 95% CI, 1.13-2.19), AHI >= 30 events/h (OR,
1.72; 95% CI, 1.06-2.78), moderate OSA (OR, 1.60; 95% CI, 1.04-2.46), and
severe OSA (OR, 2.25; 95% CI, 1.28-3.96). Moreover, in the adjusted model,
dyspnea was associated with AHI, respiratory disturbance index,
respiratory pulse wave amplitude drop index, sleep apnea-specific
pulse-rate response, respiratory arousal index, and oxygen desaturation
index 3%.

INTERPRETATION: Our results suggest that exertional dyspnea is associated
with moderate and severe OSA, potentially due to heightened autonomic and
cortical responses to increased respiratory efforts. Further research is
needed to assess the effectiveness of OSA treatment on dyspnea in patients
with OSA.