Clinical phenotypes and comorbidity in European sleep apnoea patients

Maria Rosaria Bonsignore, Pataka, Cristina Esquinas, Ulla Anttalainen, Gabriel Roisman, Parati, Vrints, Jean-Louis Pépin, Maria R. Bonsignore, Walter T. Mcnicholas, Pawel Sliwinski, Varoneckas, John Arthur Kvamme, Steiropoulos, Bielicki, Kurki, Marta Kumor, Tkacova, Lynda Hayes, BasogluZuzana Dorkova, Escourrou, Schulz, Vitols, Josep M. Montserrat, Thomas Penzel, Varoneckas, Gianfranco Parati, Oreste Marrone, Renata L. Riha, Staats, Martin Pretl, Plywaczewski, Tarja Saaresranta, Johan Verbraecken, Lena Lavie, Masa, Marrone, Fietze, Jan Hedner, Thomas Penzel, Rodenstein, Ludger Grote, Barbé, Carolina Lombardi, Lavie, Levy, Zielinski, Silke Ryan

Risultato della ricerca: Articlepeer review

71 Citazioni (Scopus)

Abstract

Background Clinical presentation phenotypes of obstructive sleep apnoea (OSA) and their association with comorbidity as well as impact on adherence to continuous positive airway pressure (CPAP) treatment have not been established. Methods A prospective follow-up cohort of adult patients with OSA (apnoea-hypopnoea index (AHI) of ≥5/h) from 17 European countries and Israel (n = 6,555) was divided into four clinical presentation phenotypes based on daytime symptoms labelled as excessive daytime sleepiness ("EDS") and nocturnal sleep problems other than OSA (labelled as "insomnia"): 1) EDS (daytime+/nighttime-), 2) EDS/insomnia (daytime+/nighttime+), 3) non-EDS/noninsomnia (daytime-/nighttime-), 4) and insomnia (daytime-/nighttime+) phenotype. Results The EDS phenotype comprised 20.7%, the non-EDS/non-insomnia type 25.8%, the EDS/ insomnia type 23.7%, and the insomnia phenotype 29.8% of the entire cohort. Thus, clinical presentation phenotypes with insomnia symptoms were dominant with 53.5%, but only 5.6% had physician diagnosed insomnia. Cardiovascular comorbidity was less prevalent in the EDS and most common in the insomnia phenotype (48.9% vs. 56.8%, p<0.001) despite more severe OSA in the EDS group (AHI 35.0±25.5/h vs. 27.9±22.5/h, p<0.001, respectively). Psychiatric comorbidity was associated with insomnia like OSA phenotypes independent of age, gender and body mass index (HR 1.5 (1.188-1.905), p<0.001). The EDS phenotype tended to associate with higher CPAP usage (22.7 min/d, p = 0.069) when controlled for age, gender, BMI and sleep apnoea severity. Conclusions Phenotypes with insomnia symptoms comprised more than half of OSA patients and were more frequently linked with comorbidity than those with EDS, despite less severe OSA. CPAP usage was slightly higher in phenotypes with EDS.
Lingua originaleEnglish
pagine (da-a)e0163439-
Numero di pagine15
RivistaPLoS One
Volume11
Stato di pubblicazionePublished - 2016

All Science Journal Classification (ASJC) codes

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  • ???subjectarea.asjc.1100.1100???
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