The modified Baveno classification for obstructive sleep apnoea management

<bold>Aim:</bold> The Baveno classification for obstructive sleep apnoea (OSA) (2021) incorporates symptoms and comorbidities. We analysed how including cardiovascular disease (CVD) risk and a high apnoea-hypopnoea index (AHI) of ≥30/h affects treatment recommendation. <bold>Method:</bold> 8,548 OSA patients from the European Sleep Apnoea Data Base (ESADA) were retrospectively allocated into both the original Baveno classification and to the modified Baveno classification. In the modified Baveno, AHI ≥30/h equalled high treatment indication. For remaining patients symptoms and CVD risk assessment (using SCORE2 and European Society of Cardiology 2021 guidelines) enabled classification into low, intermediate or high treatment indication group. The differences in resulting treatment indication were compared. <bold>Results:</bold> Figure 1 shows the changes in risk stratification and OSA treatment indication. The modified Baveno puts a further 47.0% of patients into the high treatment indication group compared to the original Baveno, whereas 39.8% of cases did not change. AHI ≥30/h was the main factor driving 36.7% of patients from low or intermediate into the high treatment recommendation group. CVD risk assessment put a further 16.7% of patients into a higher treatment recommendation group. <fig><object-id>erj;64/suppl_68/PA861/F1</object-id><object-id>F1</object-id><object-id>F1</object-id><graphic></graphic></fig> <bold>Discussion:</bold> The modified Baveno identifies different and more high treatment indication cases compared to the original Baveno. A prospective study is needed to assess for clinical relevance.