TY - JOUR T1 - Evaluation of a multicomponent grading system (Baveno classification) for obstructive sleep apnoea JF - ERJ Open Research JO - erjor DO - 10.1183/23120541.00928-2020 SP - 00928-2020 AU - Winfried J. Randerath AU - Simon Herkenrath AU - Marcel Treml AU - Ludger Grote AU - Jan Hedner AU - Maria Rosaria Bonsignore AU - Jean Louis Pépin AU - Silke Ryan AU - Sophia Schiza AU - Johan Verbraecken AU - Walter T. McNicholas AU - Athanasia Pataka AU - Pawel Sliwinski AU - Özen K. Basoglu Y1 - 2021/01/01 UR - http://openres.ersjournals.com/content/early/2021/01/21/23120541.00928-2020.abstract N2 - New findings on pathophysiology, epidemiology, and outcome have raised concerns on the relevance of the apnoea-hypopnoea index (AHI) in the classification of obstructive sleep apnoea (OSA) severity. Recently, a multicomponent grading system, decision integrating symptomatology and comorbidities (Baveno classification), was proposed to characterise OSA and to guide therapeutic decisions. We evaluated if this system reflects the OSA population, if it translates into differences in outcomes, and if the addition of AHI improves the scheme. 14 499 OSA patients from the European Sleep Apnoea Database (ESADA) cohort were analysed. The groups were homogeneously distributed and were found to clearly stratify the population with respect to baseline parameters. Differences in sleepiness and blood pressure between the groups were analysed in a subgroup of patients after 24–36 months of treatment. Group A (minor symptoms and comorbidities) did not demonstrate any effect of treatment on outcome. However, groups B (severe symptoms, minor comorbidities), C (minor symptoms, severe comorbidities) and D (severe symptoms and comorbidities) were associated with improvement in either or both parameters with treatment. The AHI is an essential prerequisite of the diagnosis. However, adding the AHI did not improve the classification. Rather, it was inferior with respect to guiding the treatment decision. Thus, the Baveno classification allows a better stratification of the OSA population and may provide a better guidance for therapeutic decisions in OSA.FootnotesThis manuscript has recently been accepted for publication in the ERJ Open Research. It is published here in its accepted form prior to copyediting and typesetting by our production team. After these production processes are complete and the authors have approved the resulting proofs, the article will move to the latest issue of the ERJOR online. Please open or download the PDF to view this article.Conflict of interest: W.J. Randerath reports speaking fees and travel grants from Philips Respironics, Heinen und Löwenstein, Resmed, Bioprojet, Bayer Vital and Vanda Pharma outside the submitted work.Conflict of interest: Dr. Herkenrath has nothing to disclose.Conflict of interest: Dr. Treml has nothing to disclose.Conflict of interest: Dr. Grote reports grants from Bayer, Philips Respironics Foundation, Resmed Foundation for the ESADA network during the conduct of the study; non-financial support and other from Itamar Medical, Resmed, Philips, Astra Zeneca, Breas outside the submitted work; In addition. Dr. Grote has a patent on sleep apnea therapy licensed.Conflict of interest: Dr. Hedner reports grants from Bayer AG, the European Respiratory Society for Database maintenence and grants from Desitin GmbH, outside the submitted work; In addition, Dr. Hedner has a patent issued on pharmacological therapy of OSA.Conflict of interest: Dr. BONSIGNORE has nothing to disclose.Conflict of interest: Dr. Pépin reports and Grants and research funds from.Conflict of interest: Dr. Ryan has nothing to disclose.Conflict of interest: Dr. Schiza has nothing to disclose.Conflict of interest: J. Verbraecken reports an educational grant and an advisory board fee from ResMed; a consultancy fee from Philips; lecture fees from Sanofi and Agfa-Gevaert; an educational grant and an advisory board fee from Bioprojet; an educational grant from and study participation for Jazz Pharmaceutics; an educational grant from AirLiquide; a lecture fee from Springer; an educational grant from Westfalen Medical; an educational grant and a lecture fee from SomnoMed; educational grants from Vivisol, Total Care, Medidis, Fisher & Paykel, Wave Medical, OSG, Mediq Tefa, NightBalance and Heinen & Löwenstein; lecture fees from AstraZeneca; and educational grants from Accuramed, Bekaert Deslee Academy and UCB Pharma, all outside the submitted work.Conflict of interest: Dr. McNicholas has nothing to disclose.Conflict of interest: Dr. Pataka has nothing to disclose.Conflict of interest: Dr. Sliwinski has nothing to disclose.Conflict of interest: Dr. Basoglu has nothing to disclose. ER -