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

• Published in: The European respiratory journal Vol. 44; no. 6; pp. 1600 - 1607
• Main Authors: Ye, Lichuan, Pien, Grace W., Ratcliffe, Sarah J., Björnsdottir, Erla, Arnardottir, Erna Sif, Pack, Allan I., Benediktsdottir, Bryndis, Gislason, Thorarinn
• Format: Journal Article
• Language: English
• Published: Leeds Maney 01.12.2014
• Subjects: Adult; Aged; Asthma - epidemiology; Biological and medical sciences; Body Mass Index; Cardiovascular Diseases - epidemiology; Cluster Analysis; Cohort Studies; Comorbidity; Diabetes Mellitus - epidemiology; Female; Humans; Hypertension - epidemiology; Iceland - epidemiology; Male; Medical sciences; Middle Aged; Pneumology; Pulmonary Disease, Chronic Obstructive - epidemiology; Respiratory system : syndromes and miscellaneous diseases; Severity of Illness Index; Sleep Apnea, Obstructive - classification; Sleep Apnea, Obstructive - epidemiology; Sleep Wake Disorders - epidemiology; Snoring - epidemiology; Iceland; Cluster analysis; Nervous system diseases; Automatic classification; Sleep apnea syndrome; Face; Respiratory disease
• ISSN: 0903-1936; 1399-3003; 1399-3003
• DOI: 10.1183/09031936.00032314

Although commonly observed in clinical practice, the heterogeneity of obstructive sleep apnoea (OSA) clinical presentation has not been formally characterised. This study was the first to apply cluster analysis to identify subtypes of patients with OSA who experience distinct combinations of symptoms and comorbidities. An analysis of baseline data from the Icelandic Sleep Apnoea Cohort (822 patients with newly diagnosed moderate-to-severe OSA) was performed. Three distinct clusters were identified. They were classified as the “disturbed sleep group” (cluster 1), “minimally symptomatic group” (cluster 2) and “excessive daytime sleepiness group” (cluster 3), consisting of 32.7%, 24.7% and 42.6% of the entire cohort, respectively. The probabilities of having comorbid hypertension and cardiovascular disease were highest in cluster 2 but lowest in cluster 3. The clusters did not differ significantly in terms of sex, body mass index or apnoea–hypopnoea index. Patients with OSA have different patterns of clinical presentation, which need to be communicated to both the lay public and the professional community with the goal of facilitating care-seeking and early identification of OSA. Identifying distinct clinical profiles of OSA creates a foundation for offering more personalised therapies in the future.