Hypoxic Burden Variability Index: A Novel Metric for Quantifying Hypoxia Severity in Obstructive Sleep Apnea

Given that conventional metrics for assessing obstructive sleep apnea (OSA) severity fail to capture the complex, dynamic nature of intermittent hypoxia, we developed a novel, multidimensional Hypoxic Burden Variability Index (HBVI) by integrating nonlinear and morphological features of oxygen saturation sequences using a generalized additive model. Our findings further demonstrate that HBVI correlates significantly with standard polysomnographic indices and key clinical phenotypes, including anthropometric measures and hypertension prevalence. Crucially, HBVI exhibited superior predictive value for identifying severe OSA, particularly in male patients with comorbid hypertension, highlighting its potential for precision screening.