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Cited 125 time in webofscience Cited 136 time in scopus
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Recognizable clinical subtypes of obstructive sleep apnea across international sleep centers: a cluster analysis

Authors
Keenan, Brendan T.Kim, JinyoungSingh, BhajanBittencourt, LiaChen, Ning-HungCistulli, Peter A.Magalang, Ulysses J.McArdle, NigelMindel, Jesse W.Benediktsdottir, BryndisArnardottir, Erna SifProchnow, Lisa KristinPenzel, ThomasSanner, BerndSchwab, Richard J.Shin, CholSutherland, KateTufik, SergioMaislin, GregGislason, ThorarinnPack, Allan I.
Issue Date
Mar-2018
Publisher
The American Academy of Sleep Medicine
Keywords
obstructive sleep apnea; disease subtypes; personalized medicine; excessive sleepiness; insomnia; minimally symptomatic
Citation
Sleep, v.41, no.3
Indexed
SCI
SCIE
SCOPUS
Journal Title
Sleep
Volume
41
Number
3
URI
https://scholarworks.korea.ac.kr/kumedicine/handle/2020.sw.kumedicine/3778
DOI
10.1093/sleep/zsx214
ISSN
0161-8105
1550-9109
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.
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Shin, Chol
Ansan Hospital (Department of Pulmonary, Allergy, and Critical Care Medicine, Ansan Hospital)
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