Baseline clusters and the response to positive airway pressure treatment in obstructive sleep apnoea patients: longitudinal data from the European Sleep Apnea Database cohort
Ashraf Yassen, Katrin Coboeken, Sébastien Bailly, Rolf Burghaus, Jitka Buskova, Zoran Dogas, Marta Drummond, Haralampos Gouveris, Pavol Joppa, Joerg Lippert, Carolina Lombardi, Stefan Mihaicuta, Jean Louis Pépin, Ding Zou, Jan Hedner, Ludger Grote
Source: ERJ Open Res, 8 (4) 00132-2022; 10.1183/23120541.00132-2022
Abstract
Introduction
The European Sleep Apnea Database was used to identify distinguishable obstructive sleep apnoea (OSA) phenotypes and to investigate the clinical outcome during positive airway pressure (PAP) treatment.
Method
Prospective OSA patient data were recruited from 35 sleep clinics in 21 European countries. Unsupervised cluster analysis (anthropometrics, clinical variables) was performed in a random sample (n=5000). Subsequently, all patients were assigned to the clusters using a conditional inference tree classifier. Responses to PAP treatment change in apnoea severity and Epworth sleepiness scale (ESS) were assessed in relation to baseline patient clusters and at short- and long-term follow-up.
Results
At baseline, 20?164 patients were assigned (mean age 54.1±12.2 years, 73% male, median apnoea–hypopnoea index (AHI) 27.3 (interquartile range (IQR) 14.1–49.3) events·h-1, and ESS 9.8±5.3) to seven distinct clusters based on anthropometrics, comorbidities and symptoms. At PAP follow-up (median 210 [IQR 134–465] days), the observed AHI reduction (n=1075) was similar, whereas the ESS response (n=3938) varied: largest reduction in cluster 3 (young healthy symptomatic males) and 6 (symptomatic males with psychiatric disorders, -5.0 and -5.1 units, respectively (all p<0.01), limited reduction in clusters 2 (obese males with systemic hypertension) and 5 (elderly multimorbid obese males, -4.2 (p<0.05) and -3.7 (p<0.001), respectively). Residual sleepiness in cluster 5 was particularly evident at long-term follow-up (p<0.05).
Conclusion
OSA patients can be classified into clusters based on clinically identifiable features. Importantly, these clusters may be useful for prediction of both short- and long-term responses to PAP intervention.
Rating:
You must login to grade this presentation.
Share or cite this content
Citations should be made in the following way:
Ashraf Yassen, Katrin Coboeken, Sébastien Bailly, Rolf Burghaus, Jitka Buskova, Zoran Dogas, Marta Drummond, Haralampos Gouveris, Pavol Joppa, Joerg Lippert, Carolina Lombardi, Stefan Mihaicuta, Jean Louis Pépin, Ding Zou, Jan Hedner, Ludger Grote. Baseline clusters and the response to positive airway pressure treatment in obstructive sleep apnoea patients: longitudinal data from the European Sleep Apnea Database cohort. ERJ Open Res, 8 (4) 00132-2022; 10.1183/23120541.00132-2022
You must login to share this Presentation/Article on Twitter, Facebook, LinkedIn or by email.
Member's Comments
Related content which might interest you:
|
|