Recognizable clinical subtypes of obstructive sleep apnea across international sleep centers: a cluster analysis

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dc.citation.issue3
dc.citation.volumev. 41
dc.contributor.authorKeenan, Brendan T.
dc.contributor.authorKim, Jinyoung
dc.contributor.authorSingh, Bhajan
dc.contributor.authorBittencourt, Lia [UNIFESP]
dc.contributor.authorChen, Ning-Hung
dc.contributor.authorCistulli, Peter A.
dc.contributor.authorMagalang, Ulysses J.
dc.contributor.authorMcArdle, Nigel
dc.contributor.authorMindel, Jesse W.
dc.contributor.authorBenediktsdottir, Bryndis
dc.contributor.authorArnardottir, Erna Sif
dc.contributor.authorProchnow, Lisa Kristin
dc.contributor.authorPenzel, Thomas
dc.contributor.authorSanner, Bernd
dc.contributor.authorSchwab, Richard J.
dc.contributor.authorShin, Chol
dc.contributor.authorSutherland, Kate
dc.contributor.authorTufik, Sergio [UNIFESP]
dc.contributor.authorMaislin, Greg
dc.contributor.authorGislason, Thorarinn
dc.contributor.authorPack, Allan I.
dc.coverageCary
dc.date.accessioned2020-07-20T16:31:22Z
dc.date.available2020-07-20T16:31:22Z
dc.date.issued2018
dc.description.abstractStudy 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 severityen
dc.description.abstractdifferences 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.en
dc.description.affiliationUniv Penn, Ctr Sleep & Circadian Neurobiol, Philadelphia, PA USA
dc.description.affiliationUniv Penn, Sch Nursing, Philadelphia, PA 19104 USA
dc.description.affiliationSir Charles Gairdner Hosp, Western Australian Sleep Disorders Res Inst, Nedlands, WA, Australia
dc.description.affiliationUniv Fed Sao Paulo, Dept Psychobiol, Sao Paulo, Brazil
dc.description.affiliationChang Gung Mem Hosp, Div Pulm Crit Care & Sleep Med, Taoyuan, Taiwan
dc.description.affiliationUniv Sydney, Northern Clin Sch, Royal North Shore Hosp, Sydney, NSW, Australia
dc.description.affiliationUniv Sydney, Charles Perkins Ctr, Sydney, NSW, Australia
dc.description.affiliationOhio State Univ, Wexner Med Ctr, Div Pulm Allergy Crit Care & Sleep Med, Columbus, OH 43210 USA
dc.description.affiliationLandspitali Univ Hosp, Dept Sleep, Reykjavik, Iceland
dc.description.affiliationUniv Iceland, Fac Med, Reykjavik, Iceland
dc.description.affiliationCharite, Interdisciplinary Ctr Sleep Med, Berlin, Germany
dc.description.affiliationAgaples Bethesda Krankenhaus Wuppertal, Dept Pulm Med, Wuppertal, Germany
dc.description.affiliationKorea Univ, Med Ctr, Ansan Hosp, Pulm Crit Care & Sleep Disorder Ctr, Seoul, South Korea
dc.description.affiliationUnifespUniv Fed Sao Paulo, Dept Psychobiol, Sao Paulo, Brazil
dc.description.sourceWeb of Science
dc.description.sponsorshipNational Institutes of Health
dc.description.sponsorshipConselho Nacional de Desenvolvimento Cientifico e Tecnologico (CNPq)
dc.description.sponsorshipNational Center For Advancing Translational Sciences
dc.description.sponsorshipIDNIH: P01 HL094307
dc.description.sponsorshipIDCNPq: 401569/2016-0
dc.description.sponsorshipIDNCATS: UL1TR001070
dc.format.extent-
dc.identifierhttp://dx.doi.org/10.1093/sleep/zsx214
dc.identifier.citationSleep. Cary, v. 41, n. 3, p. -, 2018.
dc.identifier.doi10.1093/sleep/zsx214
dc.identifier.issn1550-9109
dc.identifier.urihttps://repositorio.unifesp.br/handle/11600/55920
dc.identifier.wosWOS:000427123100003
dc.language.isoeng
dc.publisherOxford Univ Press Inc
dc.relation.ispartofSleep
dc.rightsinfo:eu-repo/semantics/openAccess
dc.subjectobstructive sleep apneaen
dc.subjectdisease subtypesen
dc.subjectpersonalized medicineen
dc.subjectexcessive sleepinessen
dc.subjectinsomniaen
dc.subjectminimally symptomaticen
dc.titleRecognizable clinical subtypes of obstructive sleep apnea across international sleep centers: a cluster analysisen
dc.typeinfo:eu-repo/semantics/article
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