Beyond AHI: Limitations of a Single Metric in Capturing Sleep Apnea's True Disease Burden

Monday, October 13, 2025

4:00 PM - 5:00 PM EDT

Location: 103

CME/MOC Credit: 1

Disclosure(s):

Rahul Ramesh Modi, MBBS, MS(ENT), DNB, MNAMS:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

srinivas kishore k. sistla, Consultant:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Anupam Kanodia, MBBS, MS, MRCS:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Sandeep Bansal, MS:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

PROGRAM DESCRIPTION: The Apnea-Hypopnea Index (AHI) has been the cornerstone of sleep apnea diagnosis and management for decades. However, a growing body of evidence suggests that AHI has significant limitations in not only capturing the true disease burden of sleep apnea, but also in predicting treatment outcomes.

This talk will delve into the shortcomings of AHI, including:

- Inability to predict neuro-cognitive morbidity: AHI only measures the frequency of respiratory events, neglecting the impact of sleep fragmentation on daytime functioning.
- Failure to capture hypoxic burden: AHI does not account for the severity of oxygen desaturation, which can have significant implications for cardiovascular morbidity.
- Limited ability to predict treatment outcomes and quality of life: AHI has been shown to have a limited correlation with various treatment outcomes and quality of life measures, suggesting that it may not be an adequate surrogate marker for disease severity.

We will explore alternative metrics and approaches to better assess sleep apnea severity and impact on quality of life including a more comprehensive approach to judge treament outcomes. By moving beyond AHI, we can gain a more comprehensive understanding of sleep apnea's true disease burden and develop more effective treatment strategies to improve patient outcomes.

Learning Objectives:

Examine the origins and development of AHI as a diagnostic metric for OSA, and its role in advancing the field of sleep medicine.
Acknowledge AHI's limitations in capturing OSA's complete disease burden, particularly neuro-cognitive and cardiovascular risks
Recognize the limits of the Sher Criteria and why evaluation of surgical treatment outcomes requires an alternative and more nuanced approach

Moderator(s)

Rahul Ramesh Modi, MBBS, MS(ENT), DNB, MNAMS

Director, ENT &Head Neck Surgery; Sleep Apnea Services
Dr L. H. Hiranandani Hospital, Mumbai
Mumbai, Maharashtra, India

Disclosure(s):
faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Panelist(s)

Vikas Agrawal, MD

Consultant, ENT Surgeon
speciality ent hospital
mumbai, India

Disclosure information not submitted.
srinivas kishore k. sistla, Consultant

director ent
AIG HOSPITALS
HYDERABAD, Telangana, India

Disclosure(s):
faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.
Anupam Kanodia, MBBS, MS, MRCS

Consultant and Director
Dr Kanodia's Clinic, Jaipur
Jaipur, Rajasthan, India

Disclosure(s):
faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.
Sandeep Bansal, MS

Professor
PGIMER, Chandigarh
Chandigarh, Chandigarh, India

Disclosure(s):
faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.