The different clinical faces of obstructive sleep apnoea: a cluster analysis

Ye, Lichuan; Pien, Grace W.; Ratcliffe, Sarah J.; Björnsdóttir, Erla; Arnardóttir, Erna Sif; Pack, Allan I.; Benediktsdóttir, Bryndís; Gíslason, Þórarinn

doi:10.1183/09031936.00032314

Cited by 364 publications

(309 citation statements)

References 39 publications

Supporting

Mentioning

280

Contrasting

Unclassified

Order By: Relevance

“…We have identified these distinct clusters of patients with OSA, which suggests that identifying clusters based on both symptoms and comorbidities can more fully capture the spectrum of OSA rather than relying on the severity of the disease as measured by AHI and ODI. 31 The relationship between depression and daytime sleepiness is bidirectional because depression can also be a risk factor for excessive daytime sleepiness, 11 which further supports the need of evaluating mental health among sleepy subjects with OSA. Furthermore, there is a strong association of obesity and daytime sleepiness, regardless of OSA, 11 which suggests a need for a broader focus on interventions aimed at improving mental health and supporting weight loss among patients with OSA as well as pointing out the importance of assessing depression and obesity among sleepy subjects without OSA.…”

Section: Discussionmentioning

confidence: 94%

The Prevalence of Depression among Untreated Obstructive Sleep Apnea Patients Using a Standardized Psychiatric Interview

Björnsdóttir

Benediktsdóttir

Pack

et al. 2016

Journal of Clinical Sleep Medicine

Self Cite

View full text Add to dashboard Cite

Study Objectives: The aims of this study were: (1) to use a standardized psychiatric interview, conducted by a trained psychologist to assess the prevalence of depression among patients with untreated OSA, and (2) to identify if OSA severity or other comorbid disorders (insomnia, hypertension, and diabetes) are related to depression among patients with untreated OSA. Methods: Participants were newly diagnosed patients with OSA (n = 284) waiting to start positive airway pressure (PAP) treatment. The Mini International Neuropsychiatric Interview (MINI) was used to assess depression. Results: Overall, 15.5% of the sample met the diagnosis for dysthymia. Women had a significantly higher prevalence (29.5% versus 11.7% among men, p < 0.001). The prevalence of major depression was 6% in the overall sample and there was no difference in the prevalence among sexes (5.8% among men versus 6.6 % among women). Obesity, daytime sleepiness, low physical activity, initial and late insomnia, low quality of life, and sleep medication and antidepressant use were all related to depression, whereas OSA severity, as measured by apnea-hypopnea index or oxygen desaturation index, was not. Daytime sleepiness, initial insomnia, and sleep medication use were the strongest predictors of depression in multivariable analyses. Conclusions: Sleep medication use, daytime sleepiness, and symptoms of initial insomnia were independently related to depression but OSA severity was not. Increased awareness of the relationship between depression and OSA and the appropriate use of assessment tools might substantially improve diagnostic accuracy as well as treatment outcome for both disorders.

show abstract

Section: Discussionmentioning

confidence: 94%

The Prevalence of Depression among Untreated Obstructive Sleep Apnea Patients Using a Standardized Psychiatric Interview

Björnsdóttir

Benediktsdóttir

Pack

et al. 2016

Journal of Clinical Sleep Medicine

Self Cite

View full text Add to dashboard Cite

show abstract

“…The first cluster analysis on OSA clinical phenotypes was published by the Icelandic Sleep Apnea Cohort (ISAC) research group, in >800 consecutive patients with newly diagnosed moderate-to-severe OSA [87]. Three main clusters were identified, corresponding to the "disturbed sleep", the "minimally symptomatic" and the "excessive daytime sleepiness (EDS)" phenotypes.…”

Section: Clinical Phenotypes Of Osamentioning

confidence: 99%

Personalised medicine in sleep respiratory disorders: focus on obstructive sleep apnoea diagnosis and treatment

et al. 2017

View full text Add to dashboard Cite

In all fields of medicine, major efforts are currently dedicated to improve the clinical, physiological and therapeutic understanding of disease, and obstructive sleep apnoea (OSA) is no exception. The personalised medicine approach is relevant for OSA, given its complex pathophysiology and variable clinical presentation, the interactions with comorbid conditions and its possible contribution to poor outcomes. Treatment with continuous positive airway pressure (CPAP) is effective, but CPAP is poorly tolerated or not accepted in a considerable proportion of OSA patients. This review summarises the available studies on the physiological phenotypes of upper airway response to obstruction during sleep, and the clinical presentations of OSA ( phenotypes and clusters) with a special focus on our changing attitudes towards approaches to treatment. Such major efforts are likely to change and expand treatment options for OSA beyond the most common current choices (i.e. CPAP, mandibular advancement devices, positional treatment, lifestyle changes or upper airway surgery). More importantly, treatment for OSA may become more effective, being tailored to each patient's need.

show abstract

“…El conocimiento de la presentación clínica del SAHOS ha sido uno de los objetivos principales de nuestro estudio. El abordaje más completo probablemente sea el que utiliza el método estadístico de análisis de conglomerados (25) . En esa línea de investigación se inscribe la búsqueda de fenotipos fisiopatológicos o conductuales (26) , que puedan explicar las causas no anatómicas del SA-HOS.…”

Section: Discussionunclassified