Changing Faces of Obstructive Sleep Apnea: Treatment Effects by Cluster Designation in the Icelandic Sleep Apnea Cohort

2.50
Hdl Handle:
http://hdl.handle.net/2336/620555
Title:
Changing Faces of Obstructive Sleep Apnea: Treatment Effects by Cluster Designation in the Icelandic Sleep Apnea Cohort
Authors:
Pien, Grace W; Ye, Lichuan; Keenan, Brendan T; Maislin, Greg; Björnsdóttir, Erla; Arnardottir, Erna Sif; Benediktsdottir, Bryndis; Gislason, Thorarinn; Pack, Allan I ( 0000-0002-2879-0484 )
Citation:
Changing Faces of Obstructive Sleep Apnea: Treatment Effects by Cluster Designation in the Icelandic Sleep Apnea Cohort 2018 Sleep
Issue Date:
2-Jan-2018
Abstract:
STUDY OBJECTIVES: Distinct clinical phenotypes of obstructive sleep apnea (OSA) have been identified: Disturbed Sleep, Minimally Symptomatic, and Sleepy. Determining whether these phenotypes respond differently to standard treatment helps us to create a foundation for personalized therapies. We compared responses to positive airway pressure (PAP) therapy in these clinical OSA phenotypes. METHODS: The study sample included 706 patients from the Icelandic Sleep Apnea Cohort with moderate-to-severe OSA who were prescribed PAP. Linear and logistic mixed models were used to compare 2-year changes in demographics, comorbid diseases, and sleep-related health issues within and across OSA clinical phenotypes. Relationships between changes in symptoms and PAP adherence were also examined. RESULTS: Overall, effect sizes were moderate to large when comparing sleepiness, insomnia-related, and apneic symptom changes in the Sleepy group with changes in other two groups, especially those in the Minimally Symptomatic group. Within the Disturbed Sleep group, PAP users and nonusers demonstrated similar changes in insomnia-related symptoms. The Minimally Symptomatic group remained relatively asymptomatic, but reported significant decreases in daytime sleepiness and physical fatigue; PAP users generally had larger improvements. The Sleepy group had reductions in nearly all measured symptoms, including large reductions in drowsy driving; almost all of these improvements were greater among PAP users than nonusers. CONCLUSIONS: OSA treatment response patterns differed by initial clinical phenotype and PAP adherence. Individuals with insomnia-related symptoms may require additional targeted therapy for these complaints. These findings underscore the need for a personalized approach to management that recognizes patients with a range of OSA presentations.
Description:
To access publisher's full text version of this article click on the hyperlink below
Additional Links:
https://academic.oup.com/sleep/advance-article/doi/10.1093/sleep/zsx201/4782667; https://www.ncbi.nlm.nih.gov/pmc/journals/369/
Rights:
Archived with thanks to Sleep

Full metadata record

DC FieldValue Language
dc.contributor.authorPien, Grace Wen
dc.contributor.authorYe, Lichuanen
dc.contributor.authorKeenan, Brendan Ten
dc.contributor.authorMaislin, Gregen
dc.contributor.authorBjörnsdóttir, Erlaen
dc.contributor.authorArnardottir, Erna Sifen
dc.contributor.authorBenediktsdottir, Bryndisen
dc.contributor.authorGislason, Thorarinnen
dc.contributor.authorPack, Allan Ien
dc.date.accessioned2018-05-07T13:39:54Z-
dc.date.available2018-05-07T13:39:54Z-
dc.date.issued2018-01-02-
dc.date.submitted2018-
dc.identifier.citationChanging Faces of Obstructive Sleep Apnea: Treatment Effects by Cluster Designation in the Icelandic Sleep Apnea Cohort 2018 Sleepen
dc.identifier.issn0161-8105-
dc.identifier.issn1550-9109-
dc.identifier.doi10.1093/sleep/zsx201-
dc.identifier.urihttp://hdl.handle.net/2336/620555-
dc.descriptionTo access publisher's full text version of this article click on the hyperlink belowen
dc.description.abstractSTUDY OBJECTIVES: Distinct clinical phenotypes of obstructive sleep apnea (OSA) have been identified: Disturbed Sleep, Minimally Symptomatic, and Sleepy. Determining whether these phenotypes respond differently to standard treatment helps us to create a foundation for personalized therapies. We compared responses to positive airway pressure (PAP) therapy in these clinical OSA phenotypes. METHODS: The study sample included 706 patients from the Icelandic Sleep Apnea Cohort with moderate-to-severe OSA who were prescribed PAP. Linear and logistic mixed models were used to compare 2-year changes in demographics, comorbid diseases, and sleep-related health issues within and across OSA clinical phenotypes. Relationships between changes in symptoms and PAP adherence were also examined. RESULTS: Overall, effect sizes were moderate to large when comparing sleepiness, insomnia-related, and apneic symptom changes in the Sleepy group with changes in other two groups, especially those in the Minimally Symptomatic group. Within the Disturbed Sleep group, PAP users and nonusers demonstrated similar changes in insomnia-related symptoms. The Minimally Symptomatic group remained relatively asymptomatic, but reported significant decreases in daytime sleepiness and physical fatigue; PAP users generally had larger improvements. The Sleepy group had reductions in nearly all measured symptoms, including large reductions in drowsy driving; almost all of these improvements were greater among PAP users than nonusers. CONCLUSIONS: OSA treatment response patterns differed by initial clinical phenotype and PAP adherence. Individuals with insomnia-related symptoms may require additional targeted therapy for these complaints. These findings underscore the need for a personalized approach to management that recognizes patients with a range of OSA presentations.en
dc.description.sponsorshipNational Institutes of Healthen
dc.language.isoenen
dc.publisherOxford University Pressen
dc.relation.urlhttps://academic.oup.com/sleep/advance-article/doi/10.1093/sleep/zsx201/4782667en
dc.relation.urlhttps://www.ncbi.nlm.nih.gov/pmc/journals/369/en
dc.rightsArchived with thanks to Sleepen
dc.subjectKæfisvefnen
dc.subjectPAD12en
dc.subjectNAF12en
dc.subject.meshSleep Apnea, Obstructiveen
dc.titleChanging Faces of Obstructive Sleep Apnea: Treatment Effects by Cluster Designation in the Icelandic Sleep Apnea Cohorten
dc.typeArticleen
dc.contributor.department1 ] Johns Hopkins Univ, Sch Med, Div Pulm & Crit Care Med, Baltimore, MD 21224 USA Show more [ 2 ] Northeastern Univ, Sch Nursing, Bouve Coll Hlth Sci, Boston, MA 02115 USA Show more [ 3 ] Univ Penn, Perelman Sch Med, Ctr Sleep & Circadian Neurobiol, Philadelphia, PA 19104 USA [ 4 ] Landspitali, Dept Sleep, Reykjavik, Iceland Show more [ 5 ] Univ Iceland, Sch Hlth Sci, Fac Med, Reykjavik, Iceland Show more [ 6 ] Univ Penn, Dept Med, Div Sleep Med, Perelman Sch Med, Philadelphia, PA 19104 USAen
dc.identifier.journalSleepen
dc.rights.accessNational Consortium - Landsaðganguren
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