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To investigate the prevalence of positional obstructive sleep apnea (P-OSA) and rapid eye movement-related OSA (REM-OSA) in children with OSA and identify related factors.This was a cross-sectional study among children aged 2-12 years diagnosed with OSA using overnight polysomnography (PSG) between August 1, 2020, and July 31, 2021. Demographics, anthropometrics, PSG, and OSA-18 questionnaire data were recorded.Data from a total of 474 children were available for analysis. Children had a median age of 4.8 (4.1, 6.4) years, 66.7% were male, and 23.2% were obese. The prevalence of P-OSA was 38.2% and that of REM-OSA was 43.0%. P-OSA was correlated with age and obstructive apnea-hypopnea index (OAHI; odds ratio [OR] = 1.172, 0.947;The prevalence of P-OSA was 38.2% and that of REM-OSA was 43.0% in children with OSA. Age was correlated with both the prevalence of P-OSA and REM-OSA, with an increasing and decreasing prevalence as children grew older, respectively. The severity of OSA was significantly associated with the prevalence of both P-OSA and REM-OSA. Adenoid and tonsil size were correlated with the prevalence of REM-OSA but not P-OSA. Obesity and sex were not associated with the prevalence of P-OSA or REM-OSA.Wu Y, Zheng L, Cui G, Xu Z, Ni X. Subtypes of obstructive sleep apnea in children and related factors.

BACKGROUND The objective of the study was to assess the relationship between autonomic nervous function and low-grade inflammation in children with sleep-disordered breathing. METHODS We enrolled habitually snoring children aged 3-14 years for overnight polysomnography (PSG) and high-sensitivity C-reactive protein (hsCRP) measurement. Low-grade inflammation was defined as hsCRP >1.0 mg/L to

Objective. To analyze the clinical and polysomnographic characteristics in children with mild OSA and respiratory events terminated predominantly with arousal. Methods. Children aged 3–10 yrs who had mild obstructive sleep apnea (OSA) were enrolled. All children underwent polysomnography, and patients’ data were collected by using sleep-related breathing disorders (SRBD) questionnaire and OSA-18 quality of life questionnaire. Results. In total, five hundred and seventy-seven children were eligible. Children in arousal predominant group were younger and showed a lower rate of male and obesity. Compared with that of the nonarousal predominant group, the total arousal index, arousal index related to respiratory event, the percentage of NREM stage 1 (N1%), the fraction of respiratory events that were hypopnea, and the mean and minimum oxygen saturation in the arousal predominant group were significantly greater. The percentage of NREM stage 3 (N%), index of obstructive, central, mixed apnea, the fraction of respiratory events that were obstructive, and central and mixed apnea were significantly lower in arousal predominant group. Conclusion. Children with mild OSA in the arousal predominant group had specific characteristics, including younger age, lower rate of male and obesity, worse sleep architecture, higher rates of hypopnea events, and better oxygenation. This trial is registered with NCT02447614.

The prognosis in children with sleep-disordered breathing (SDB) undergoing adenotonsillectomy (TA), medication, and watchful waiting with supportive care, and the changes of urine cysteinyl leukotriene E4 (uLTE4) at pretreatment and post-treatment are not well studied.Children aged 3-14 yrs suffering from SDB were enrolled. All children underwent polysomnography (PSG), completed OSA-18 Quality of Life questionnaire and uLTE4 levels were measured pre- and post-TA, medication and watchful waiting with supportive care about six months later. Children with obstructive sleep apnea who demonstrated a resolution of disease (OAHI1) were defined as remission. The remission in children with primary snoring (PS) was defined as the absence of snoring at the follow-up. Deterioration was defined as a progression of disease severity, such as PS progressing to OSA, mild OSA progressing to moderate-to-severe OSA, and moderate OSA progressing to severe OSA. All the others were defined as unchanged.A total of 78 children were enrolled. After treatment, 10 (50.0%), 6 (18.2%), and 7 (28.0%) children in TA, medication, and watchful waiting were in remission respectively. PSG variables and OSA-18 Quality of Life scores were significantly improved in the TA group and remission population. The levels of uLTE4 were not significantly different pre- and post-treatment in TA group nor in the remission population.TA can significantly reduce PSG variables and improve the Quality of Life in children with moderate to severe OSA. The levels of uLTE4 did not change after TA nor in the remission population after six-month follow-up.

Objective: To investigate the early outcomes following adenotonsillectomy (TA to explore the role of facial feature and demographic data in predicting early-persistence of obstructive sleep apnea syndrome (OSAS) after T&A in children with moderate to severe OSAS. Method: Children were included from Beijing Children's Hospital. Craniofacial photograph analysis was applied to analyze facial features. Enrolled children obtained overnight pulse oximetry monitoring one day after T&A. Result: There were more children with obesity and age < 3.5 years in persistent OSAS group than those in nonpersistent group. Persistent OSAS children have a narrower and longer lower face, as well as thicker and upturned upper lip. The duration of operation, history of snoring, and mouth breathing were correlated with postoperative ODI4. Conclusion: The rate of early-persistence of OSAS is high after T&A in children with moderate to severe OSAS. Routine postoperative monitoring should be applied for those children with above predictors.

Tungsten (W) alloy is of difficulty in processing for conventional way because of its high melting point. Here, W alloy sample with the addition of 3 wt% Ta was prepared by selective laser melting. The influence of volumetric energy density (VED) on the surface morphology and the relative density was discussed, and microstructure, phase composition, and microhardness were investigated. The results show that a smooth surface and high relative density (95.79%) can be obtained under optimal VED. The W–Ta substitutional solid solution formed because of the replacement of Ta atom. There are strip and block fine grains in the W–3Ta sample with no significant texture. In addition, subgrain structure with a size of around 1 µm formed inside the strip grain, owing to the large thermal gradient and extremely fast cooling rate. Finally, the W–3Ta alloy shows higher microhardness than that obtained by traditional methods.

This study was performed to develop and evaluate a method of detecting pediatric obstructive sleep apnea (OSA) using a multilayer perceptron (MLP) model based on single-channel nocturnal oxygen saturation (SpOPolysomnography data for 888 children with OSA and 417 unaffected children were included. An MLP model was proposed based on the features obtained from SpOThe sensitivity, specificity, PPV, NPV, LR+, LR-, and accuracy of the MLP model for SpOApplication of this MLP model using single-channel SpO

Importance: The incidence of obstructive sleep apnea syndrome (OSAS) in children has increased year by year recently. Blood pressure research of OSAS children can help understand the occurrence of OSAS related complications. Early detection and intervention of blood pressure changes in children with OSAS can reduce the incidence of cardiovascular disease in later adulthood. Objective: To investigate the differences in blood pressure among different groups of snoring children and different sleep stages. Methods: Habitually snoring children (snoring frequency of ≥ 3 nights per week) aged 3 to 11 years were recruited from Beijing Children’s Hospital from 1 January 2017 to 30 June 2018. All children underwent polysomnography, and their blood pressure was monitored and calculated by the pulse transit time. The children were divided into those with primary snoring (PS), mild OSAS, and moderate to severe OSAS according to their obstructive apnea-hypopnea index (OAHI). Results: In total, 140 children were included. Ninety-seven had PS, 24 had mild OSAS, and 19 had moderate to severe OSAS. There were no differences in age, sex, or body mass index z-score among the groups. Statistically significant differences were found in the OAHI, oxygen desaturation index 3%, respiratory arousal index, and lowest oxygen saturation among the three groups. Children with moderate to severe OSAS had higher systolic and diastolic blood pressure than those with mild OSAS and PS (P < 0.001). In all children, systolic and diastolic blood pressure was higher in the rapid eye movement (REM) sleep stage than in the non-REM sleep stage (P < 0.05). Interpretation: Children with moderate to severe OSAS had higher blood pressure than those with PS and mild OSAS in all sleep stages. Blood pressure in the REM sleep stage was higher than that in other sleep stages in all groups of children. Key words: Obstructive sleep apnea syndrome (OSAS); Blood pressure; Children

Introduction: Congenital central hypoventilation syndrome (CCHS) is a rare disorder characterized by alveolar hypoventilation and autonomic system dysregulation secondary to mutations of the PHOX2B gene. Treatment consists of assisted ventilation using positive-pressure ventilators via tracheostomy, bi-level positive airway pressure (BPAP) via a noninvasive interface, negative-pressure ventilators, or diaphragm pacing. The long-term use of BPAP in younger children at home has been less frequently reported. Case presentation: We present a case of a 2-month-old infant with CCHS who was successfully managed by BPAP without the need for tracheostomy and followed up for 7 years. Conclusion: CCHS is a rare disease that manifests as nocturnal desaturation and carbon dioxide retention in early life. Noninvasive ventilation can be successfully used in young infants via an appropriate mask. Key words: Congenital central hypoventilation syndrome; PHOX2B gene; Noninvasive ventilation

To evaluate endothelial function in a large cohort of children clinically referred for suspected obstructive sleep apnea syndrome (OSAS), and to identify risk factors contributing to the presence of endothelial dysfunction (ED).Habitually snoring children (age range, 3-11 years) were recruited. All participants underwent overnight polysomnography (PSG). Endothelial function test used peripheral arterial tonometry (PAT) to derive the reactive hyperemia index (RHI). Subjects were then divided into mild OSA, moderate-severe OSA and primary snorers (PS), according to their obstructive apnea-hypopnea index (OAHI).A total of 355 subjects were recruited. There were no differences in age, gender, or BMI z score among the three groups. Both mild and moderate-severe OSA groups had lower RHI than PS (P 0.001, P = 0.001, respectively). Linear regression analysis revealed that RHI was positively correlated with age (r = 0.17, P = 0.002), BMI z score (r = 0.14, P = 0.008) and oxygen saturation nadir (r = 0.15, P = 0.006), but negatively correlated with oxygen desaturation index (ODIChildren with OSA are at increased risk for abnormal endothelial function than habitually snoring children. Furthermore, in addition to age and BMI, which are well-established factors affecting endothelial function, both intermittent hypoxia and sleep fragmentation during sleep also emerge as candidate risk factors contributing to endothelial dysfunction in snoring children.Follow up of PS and OSAHS in Chinese children, https://clinicaltrials.gov/, Clinical number: NCT02447614.

Congenital central hypoventilation syndrome (CCHS) is characterized by an alteration of the ventilatory response to hypercapnia and hypoxia, and is classically presented in neonates with abnormalities of the autonomic nervous system. Here, we generated human induced pluripotent stem cell (iPSC) lines from peripheral blood mononuclear cells (PBMCs) isolated from a male patient clinically diagnosed with CCHS. These iPSC lines carry a heterozygous RET mutation (c.2608-125C > T), express pluripotency markers, have the capacity to differentiate into the normal teratoma tissue, retain the RET mutation and display the normal karyotype, which will also provide a useful resource to study the pathogenesis of CCHS.

Additional file 1 : Supplementary Table 1. Logistic regression analyses of the association of grip and ALM quartiles with MetS. Supplementary Table 2. Logistic regression analyses of the association of SMI quartiles with MetS in obese and non- obese population.

Background: This study aims at verifying the effect of non-coding RNA SNHG16 on promotes NPC cell progression via binding miR-23b-3p.Methods: The expression of non-coding RNA SNHG16 was detected by qRT-PCR in cell lines including c666-1 and HONE-1. Si-MCM6 and si-SNHG16 are transfected to cells to verify their effects on cell proliferation and apoptosis. MTT is used to measure cell viability while flow cytometry assay and transwell assay were used for cell apoptosis, cell cycle and invasion respectively. The expression level of MCM6 was determined by western blot. Relationships between mRNA MCM6 and lncRNA SNHG16 were explored by qRT-PCR and nude mouse tumorigenicity assay.Results: The MCM6 was overexpressed in NPC tissues and lncRNA SNHG16 showed the same trend. Those two factors were correlated with high cancer stage. The expression of MCM6 was decreased after si-SNHG16 and dual luciferase reporter system demonstrated their combine with miR-23b-3p. Further we explored the down-regulation of lncRNA SNHG16 could inhibit NPC cell proliferation, colony formation and also accelerate cell apoptosis rate. And this result could be altered by adding miR-23b-3p inhibitor.Conclusion: The lncRNA SNHG16 is able to promote the NPC proliferation via binding miR-23b-3p, which has potential for future treatment.

We assessed the influence of allergic rhinitis (AR) on sleep disordered breathing (SDB) in children with adenotonsillar hypertrophy (ATH), and compared sleep quality and polysomnographic data in habitually snoring children with or without AR.Children with snoring resulting from adenoid/tonsils hypertrophy were recruited between Jan 1st, 2018 and Jun 30th, 2018. The exclusion criteria were congenital disorders, metabolic disorders, neurological disorders and pulmonary diseases, such as, asthma etc. Overnight polysomnography (PSG) and Sleep Questionnaire (SQ) were assessed on each participant to identify children with obstructive sleep apnea (OSA). Cross-sectional study design was used to examine PSG and SQ data. The diagnosis of AR was based upon history of allergies and positive clinical examinations, then confirmed by allergen test. Participants were categorized into four groups (AR and Non-OSA group; AR and OSA group; Non-AR and Non-OSA group; Non-AR and OSA group). Non-parametric rank sum test was used for statistical analysis.Six hundred and sixty children (age between 3yrs and 14yrs) with SDB were enrolled in the study (mean age 6.7 ± 2.1yrs, 67.4% male). The number of children diagnosed with OSA was 495 (74.3%). The prevalence of AR among all participating SDB children was 25.8%, and AR with OSA was19.4%. The behavioral problems scores in SQ showed significant difference among SDB children with AR (P.0001). No difference was observed in the OAHI (obstructive apnea-hypopnea index) and AHI (apnea-hypopnea index) between the groups of children with and without AR regardless whether OSA was coexisting. The percentage of time spent in the rapid eye movement (REM) sleep stage was shortened among children with AR without OSA (P = 0.031), however, the percentage of time spent in the REM sleep stage was not different among children with OSA (P = 0.98). The total sleep time was shorter among children with AR (OSA P = 0.02; without OSA P = 0.03).Despite the high prevalence of AR in patients with SDB, AR is not an aggravating factor for the severity of AHI. High risk behavioral problems link to SDB with AR. AR is associated with shortened REM sleep stage in children with SDB without sleep apnea, and shortened total sleep time in children with SDB.

Background The known risk factors of childhood OSAS include tonsillar and adenoidhypertrophy, obesity, craniofacial anomalies, neuromuscular disorders and African-American (AA) ancestry. Whether other factors such as allergic rhinitis (AR), premature, environmental tobacco smoking (ETS) are associated with OSAS are inconsistent in different studies. Our study enrolled children of a broad age range and included potential risk factors of OSAS derived from previous studies and our own experience. Our objective is to identify risk factors of OSAS in children in a clinical setting. Methods Children between 2 and 15 years of age exhibiting snoring symptoms who visited the sleep center for polysomnography (PSG) were enrolled. All children completed a questionnaire, physical examination and PSG. The questionnaire included demographic data and information related to potential risk factors for sleep disorders. A physical examination included measurements of height, weight, neck circumference, waist and hip ratio, visual evaluation of the tonsils and the degree of adenoid obstruction. Children with obstructive apnea-hypopnea index (OAHI) ≥ 1 were defined as OSAS. Results A total of 1578 children were enrolled and1009 children exhibited OSAS. Univariate analyses showed that snoring occurring for ≥ 3 months, male gender, preterm birth, breastfeeding, obesity, neck circumference ≥ 30 cm, waist/hip ratio ≥ 0.95, tonsillar hypertrophy, and adenoid hypertrophy were associated with OSAS. The proportion of low educational level was higher in parents who breastfed their babies than those who didn’t. Multivariate analysis showed that snoring for ≥ 3 months, male gender, obesity, breastfeeding, tonsillar hypertrophy, and adenoid hypertrophy were associated with OSAS. Confounders such as socioeconomic status, parental occupation, and health-related behaviors should be explored further to investigate the relationship between breastfeeding and OSAS. Conclusion The independent risk factors for OSAS in children included snoring ≥ 3 months, male gender, obesity, breastfeeding, tonsillar and adenoid hypertrophy. The study was registered on Clinical Trials government (NCT02447614). The name of the trial is “Follow-up Studies of Primary Snoring (PS) and Obstructive Sleep Apnea Hypopnea Syndrome (OSAHS) in Chinese Children” and the URL is https://clinicaltrials.gov/.

Background: It is known that short sleep duration adversely affects children’s behavior and physical development. This study aimed to investigate the status of sleep duration in 3–14-year-old children in Beijing and explore the related factors of sleep loss with them. Methods: In this study, a cross-sectional study of random stratified cluster sampling was conducted on 3–14-year-old children and adolescents in Beijing. According to the proportion of children in each district and school, the final cohort included a total of 11 kindergartens, 7 primary schools, and 8 junior high schools from 7 districts of Beijing. Children of sampled classes were included, and their parents were invited to fill a series of questionnaires including the simplified Chinese version of Pediatric Sleep Questionnaire, Sleep Questionnaire Scale, and Hong Kong-Children Sleep Questionnaire about the performance of the last 6 months. Results: Out of the total 11,420 questionnaires, 9198 questionnaires were valid and effective with the response rate of 80.54%. The age of the investigated children was 8.8 ± 3.8 years, including 4736 males and 4462 females. The daily sleep duration of children in Beijing was 9.7 ± 0.7 h. The prevalence of sleep loss (

The preparation of refractory tungsten and tungsten alloys has always been challenging due to their inherent properties. Selective laser melting (SLM) offers a choice for preparing tungsten and tungsten alloys. In this work, 90W-7Ni-3Fe samples were prepared by selective laser melting and investigated. Different process parameter combinations were designed according to the Taguchi method, and volumetric energy density (VED) was defined. Subsequently, the effects of process parameters on densification, phase composition, microstructure, tensile properties, and microhardness were investigated. Nearly a full densification sample (&ge, 99%) was obtained under optimized process parameters, and the value of VED was no less than 300 J/mm3. Laser power had a dominant influence on densification behavior compared with other parameters. The main phases of 90W-7Ni-3Fe are W and &gamma, (Ni-Fe), dissolved with partial W. In addition, 90W-7Ni-3Fe showed a high tensile strength (UTS = 1121 MPa) with poor elongation (&lt, 1%). A high average microhardness (&gt, 400 HV0.3) was obtained, but the microhardness presented a fluctuation along building direction due to the inhomogeneous microstructure.

Objective This study aimed to identify the heterogeneity of obstructive sleep apnea syndrome clinical presentation in children. Participants Children who were 3–14 years old and with obstructive sleep apnea syndrome after polysomnography monitoring (apnea and hypopnea index>5 or obstructive apnea index>1) in the sleep center of Beijing Children's Hospital were included. Methods A sleep disorder questionnaire including different combinations of symptoms and co-morbidities of obstructive sleep apnea syndrome in children was used. A cluster analysis was used to classify the data. Results The apnea hypopnea index alone is not adequate to predict clinical phenotypes. Based on symptoms and co-morbidities of obstructive sleep apnea syndrome, three distinct clusters were identified. They were “nocturnal snoring and daytime sleepiness group” (cluster 1), “hyperactivity group” (cluster 2), and “minimally symptomatic group” (cluster 3). A prediction model was built according to eight variables which showed statistical significance by pairwise comparison among clusters. Overall accuracy of the prediction model could reach 86%. Both the sensitivity and specificity of cluster 2 and 3 prediction were around 90%. Conclusion Children with obstructive sleep apnea syndrome have different patterns of clinical presentation and the identification of the different clinical profiles of obstructive sleep apnea syndrome can provide clues for more personalised diagnoses and therapies.

Objective The objectives of this study were to characterise age-specific normal polysomnography values in healthy children and to establish reference values for paediatric sleep studies. Methods Healthy children and adolescents aged 3–14 years were recruited from families of hospital employees. The subjects were divided into young (three to five years old) and old (6–14 years old) groups. Each child was subjected to overnight polysomnography. The polysomnographic parameters of sleep architecture, respiratory events and oxygen saturations of the two groups were compared. Results Ninety-nine subjects, including 33 3–5 year olds and 66 6–14 years olds, were recruited. The old group yielded a higher per cent of N2 sleep and lower per cent of R sleep than the young group. Sleep efficiency and latency were similar between the two groups. The average of the total apnoea/hypopnoea index (AHI) was different between the two groups (1.02 ± 0.99 vs 0.51 ± 0.57, p = 0.007). The average central apnoea index (CAI) in the young group was higher than that of the old group (0.7 ± 0.82 vs 0.28 ± 0.42, p = 0.001), with 97.5 percentile of 3.8 and 1.4, respectively. The obstructive apnoea index (OAI) and obstructive apnoea hypopnoea index(OAHI) were similar in the two groups (OAI: 0.08 ± 0.12 and 0.07 ± 0.14, and OAHI: 0.18 ± 0.21 and 0.19 ± 0.26, respectively). The mean lowest SaO 2 in the young group was significantly lower than that of the old group because of central apnoea events. Conclusions The findings were consistent with previously published data regarding sleep architecture, oxygen saturations, and relative rarity of respiratory events in normal children. The occurrence of central apnoea varied with age. Therefore, it is suggested that different normal cut-off values be used for children in different age groups.

Introduction This study was performed to investigate the differences in blood pressure among different groups of snoring children and among different sleep stages.In recent years, the incidence of OSAS in children has increased year by year. Blood pressure research of OSAS children can better understand the occurrence of OSAS related complications. Early detection and intervention of blood pressure changes in children with OSAS can effectively reduce the incidence of cardiovascular disease in adulthood and lower the disease burden. Methods Habitually snoring children (snoring frequency of ≥3 nights per week) aged 3to 11 years were recruited from Beijing Children’s Hospital, Capital Medical University from 1 January 2017 to 30 June 2018. All children underwent polysomnography, and their blood pressure was monitored and calculated by the pulse transit time. The children were divided into those with primary snoring (PS), mild obstructive sleep apnea syndrome (OSAS), and moderate to severe OSAS according to their obstructive apnea-hypopnea index (OAHI). Results In total, 140 children were recruited. Ninety-seven had PS, 24 had mild OSAS, and 19 had moderate to severe OSAS. There were no differences in age, sex, or body mass index z-score among the groups. Statistically significant differences were found in the OAHI, oxygen desaturation index 3%, respiratory arousal index, and lowest oxygen saturation among the three groups. Children with moderate to severe OSAS had higher systolic and diastolic blood pressure than those with mild OSAS and PS (P < 0.001). In all children, systolic and diastolic blood pressure was higher in the rapid eye movement (REM) sleep stage than in the non-REM sleep stage (P < 0.05). Conclusion Children with moderate to severe OSAS had higher blood pressure than those with PS and mild OSAS. Blood pressure in the REM sleep stage was higher than that in other sleep stages in all groups of children. Support The Pediatric Medical Coordinated Development Center of Beijing Hospitals Authority (XTYB201807);Capital Health Research and Development of Special Funding (2018-1-2091);National Key Research and Development Plan (2017YFC0112502)

The selective laser melting (SLM) has always been a challenge due to the characteristics of extremely rapid melting and solidification in the micro melt pool. Therefore, a three-dimensional finite element model was developed to investigate the thermal history and solidification parameters in the SLM process. The model presents the temperature distribution, molten region dimensions under different process parameters. The width, depth and length of molten region are inversely proportional to the laser power and scan speed. And then, the variations of solidification parameters with different laser power and scan speeds was discussed. The temperature gradient is mainly affected by laser power and decreases with the increase of laser power; the solidification rate is proportional to the scan speed. The cooling rate decreases progressively with the increase of the linear energy density while solidification morphology parameter is inversely proportional to laser power and scan speed, but fluctuates with the change of linear energy density. Single-track experiments demonstrate the accuracy and effectiveness of the model. Besides, surface quality can be improved with the increase of linear energy input in a certain range.

In order to predict the duration of traffic congestion, this paper established a traffic congestion evaluation model based on cumulative ratio Logistic regression and a traffic congestion time prediction model based on BP neural network. Combining Pearson test, numerical combination, standard deviation method and other methods to solve the problem. Based on the measured data of Jinshui Road in Zhengzhou, the average error is 0.019m/ s and the prediction error rate is 0.15%, both within a reasonable range. The model can improve the accuracy of congestion time prediction and provide some help to real life.

This study aimed to evaluate the application of time- and frequency-domain analysis of heart rate variability (HRV) to screen obstructive sleep apnea–hypopnea syndrome (OSAHS) from snorers in children. Snoring children who were more than 3 years old were recruited and simultaneously underwent standard polysomnography (PSG) and 24 h ambulatory electrocardiography. The HRV variables of the two groups were compared, and a threshold value of the most significant variables was determined to obtain better separation power between OSAHS and non-OSAHS conditions. PSG was made as a gold standard to evaluate the capacity of HRV analysis to screen OSAHS from snorers in children. PSG results showed that 58 children manifested OSAHS and 37 were non-OSAHS snorers. LF/HFn ≥ 0.845 has the highest sensitivity of screening OSAHS from snorers with limited specificity, so the use of this ratio should not be overestimated.