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ORIGINAL RESEARCH article

Front. Physiol.

Sec. Respiratory Physiology and Pathophysiology

The dose-effect and clinical prediction of the longest apnea duration driving the decrease of blood oxygen: A large sample OSA study with 34-second and 52-second cut-off values was established

Provisionally accepted
Xiaobo  ZhouXiaobo Zhou1Simin  GaoSimin Gao2*Ping  ZengPing Zeng2Lin  LiLin Li2
  • 1Sichuan Academy of Medical Sciences and Sichuan People's Hospital, Chengdu, China
  • 2Sichuan University, Chengdu, China

The final, formatted version of the article will be published soon.

Objective To quantify the relationship between the longest apnea duration (LAD) and the lowest oxygen saturation (LSaO2) in patients with obstructive sleep apnea (OSA) and to develop a predictive model for the risk of LSaO2 decline. Methods A total of 1716 OSA patients were enrolled and grouped by severity (236 non-OSA, 395 mild, 365 moderate, and 720 severe). Multiple linear regression was used to analyze the dose-effect relationship between LAD and LSaO2. A logistic regression model was developed to predict LSaO2 grade, with the dataset partitioned into a training set (n=1372) and a testing set (n=344) using random sampling. Results (1) For every 1-second increase in LAD, LSaO2 decreased by 0.280% (95% CI: -0.291%~-0.269%) in a univariate model and still decreased by 0.183% (95% CI: -0.197%~-0.170%) after adjusting for sex, age, BMI, and AHI; (2) Critical points were identified: LSaO2 was 85% when LAD was 34.20 seconds and 80% when LAD was 52.07 seconds; (3) The predictive model showed excellent identification performance for severe (AUC = 0.93) and moderate-severe LSaO2 (AUC = 0.96). normal 删除[WPS_422965835]: 字体: (默认)Times New Roman, 11 磅 设置格式[WPS_422965835]: Conclusions The study first quantifies the dose-response relationship between LAD and LSaO2 and establishes relevant clinical thresholds. The developed model can accurately identify patients at risk of severe and moderate-severe hypoxia, offering a new tool for individualized intervention.

Keywords: Dose - response relationship, hypoxia, Longest apnea duration, Lowest Oxygen Saturation, obstructive sleep apnea, predictive model

Received: 26 Aug 2025; Accepted: 08 Dec 2025.

Copyright: © 2025 Zhou, Gao, Zeng and Li. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence: Simin Gao

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