Abstract
Study Objectives A recent study of patients with moderate-severe obstructive sleep apnea (OSA) in Iceland identified three clinical clusters based on symptoms and comorbidities. We sought to verify this finding in a new cohort in Iceland and examine the generalizability of OSA clusters in an international ethnically diverse cohort. Methods Using data on 972 patients with moderate-severe OSA (apnea-hypopnea index [AHI] ≥ 15 events per hour) recruited from the Sleep Apnea Global Interdisciplinary Consortium (SAGIC), we performed a latent class analysis of 18 self-reported symptom variables, hypertension, cardiovascular disease, and diabetes. Results The original OSA clusters of disturbed sleep, minimally symptomatic, and excessively sleepy replicated among 215 SAGIC patients from Iceland. These clusters also generalized to 757 patients from five other countries. The three clusters had similar average AHI values in both Iceland and the international samples, suggesting clusters are not driven by OSA severity; differences in age, gender, and body mass index were also generally small. Within the international sample, the three original clusters were expanded to five optimal clusters: three were similar to those in Iceland (labeled disturbed sleep, minimal symptoms, and upper airway symptoms with sleepiness) and two were new, less symptomatic clusters (labeled upper airway symptoms dominant and sleepiness dominant). The five clusters showed differences in demographics and AHI, although all were middle-aged (44.6-54.5 years), obese (30.6-35.9 kg/m 2), and had severe OSA (42.0-51.4 events per hour) on average. Conclusions Results confirm and extend previously identified clinical clusters in OSA. These clusters provide an opportunity for a more personalized approach to the management of OSA.
Original language | English |
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Journal | Sleep |
Volume | 41 |
Issue number | 3 |
DOIs | |
Publication status | Published - 2018 Mar 1 |
Bibliographical note
Funding Information:Research at the University of Pennsylvania was supported by a Program Project Grant from the National Institutes of Health (P01 HL094307). Dr. Bittencourt has a grant number 401569/2016-0 from Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq). The project was also supported by Award Number Grant UL1TR001070 from the National Center For Advancing Translational Sciences; the content is solely the responsibility of the authors and does not necessarily represent the official views of the National Center For Advancing Translational Sciences or the National Institutes of Health.
Publisher Copyright:
© Sleep Research Society 2018.
Keywords
- disease subtypes
- excessive sleepiness
- insomnia
- minimally symptomatic
- obstructive sleep apnea
- personalized medicine
ASJC Scopus subject areas
- General Medicine