Baseline clusters and the response to PAP treatment in obstructive sleep apnea patients – longitudinal data from the ESADA cohort

What is it about?

In this large OSA patient population from the ESADA multinational database, we identified seven distinct OSA subtypes differing in terms of age, gender, comorbidities and symptoms despite a similar degree of sleep apnea severity. Two clusters were dominated by females, three clusters had a high prevalence of hypertension whereas three additional clusters had a low prevalence of cardiometabolic comorbidities. Clinic follow up data showed a high PAP adherence (75% with PAP usage ≥4 hours/day) across clusters. Interestingly, the daytime sleepiness response to PAP therapy varied between clusters despite a homogenous reduction of sleep apnea. OSA patients in two clusters characterized by high cardiovascular comorbidity showed less improvement of daytime sleepiness. The use of cluster methods appeared to be useful to identify specific phenotypes of OSA patients and potentially to predict response to therapy.

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