Aim: Nocturnal hypoxaemia measured by the percentage of total sleep time spent with saturation below 90% (TST90%) may better predict cardiovascular consequences of obstructive sleep apnoea (OSA) than the number of obstructive respiratory events measured with the apnoea-hypopnea index (AHI). Deeper hypoxaemia may potentially induce more severe pathophysiological consequences. However, the additional value of the percentage of total sleep time spent with saturation below 80% (TST80%) to TST90% is not fully explored.

Methods: Comprehensive medical history was taken, fasting lipid and C-reactive protein levels were measured in 797 volunteers participating in two cohort studies in Hungary and Romania. Sleep parameters, including AHI, TST90% and TST80% were recorded following a polysomnography (n=598) or inpatient cardiorespiratory polygraphy (n=199). The performance of TST80% to predict cardiovascular risk was compared with TST90% using linear and logistic regression analyses as well receiver operating characteristics curves.

Results: Both parameters significantly related to cardiovascular risk factors; however, TST80% did not show better predictive value for cardiovascular risk than TST90%. On the other hand, patients with more severe hypoxaemia reported worsening excessive daytime sleepiness.

Conclusions: TST80% has limited additional clinical value compared to TST90% when evaluating cardiovascular risk in patients with OSA.