TY - JOUR T1 - Baseline clusters and the response to positive airway pressure treatment in obstructive sleep apnoea patients: longitudinal data from the European Sleep Apnea Database cohort JF - ERJ Open Research JO - erjor DO - 10.1183/23120541.00132-2022 VL - 8 IS - 4 SP - 00132-2022 AU - Ashraf Yassen AU - Katrin Coboeken AU - Sébastien Bailly AU - Rolf Burghaus AU - Jitka Buskova AU - Zoran Dogas AU - Marta Drummond AU - Haralampos Gouveris AU - Pavol Joppa AU - Joerg Lippert AU - Carolina Lombardi AU - Stefan Mihaicuta AU - Jean Louis Pépin AU - Ding Zou AU - Jan Hedner AU - Ludger Grote AU - the ESADA collaborators AU - P. Steiropoulos AU - J. Verbraecken AU - E. Petiet AU - G. Trakada AU - I. Fietze AU - T. Penzel AU - N. Laharnar AU - O. Ludka AU - I. Bouloukaki AU - S. Schiza AU - W.T. McNicholas AU - S. Ryan AU - R.L. Riha AU - J.A. Kvamme AU - L. Grote AU - J. Hedner AU - D. Zou AU - D. Pevernagie AU - S. Bailly AU - J.L. Pépin AU - R. Tamisier AU - H. Hein AU - O.K. Basoglu AU - M.S. Tasbakan AU - J. Buskova AU - P. Joppa AU - R. Staats AU - D. Testelmans AU - H. Gouveris AU - K. Ludwig AU - C. Lombardi AU - G. Parati AU - M.R. Bonsignore AU - F. Fanfulla AU - M. Petitjean AU - G. Roisman AU - M. Drummond AU - M. van Zeller AU - M. Treml AU - W. Randerath AU - Z. Dogas AU - R. Pecotic AU - A. Pataka AU - S. Mihaicuta AU - U. Anttalainen AU - T. Saaresranta AU - S. Sliwinski Y1 - 2022/10/01 UR - http://openres.ersjournals.com/content/8/4/00132-2022.abstract N2 - Introduction The European Sleep Apnea Database was used to identify distinguishable obstructive sleep apnoea (OSA) phenotypes and to investigate the clinical outcome during positive airway pressure (PAP) treatment.Method Prospective OSA patient data were recruited from 35 sleep clinics in 21 European countries. Unsupervised cluster analysis (anthropometrics, clinical variables) was performed in a random sample (n=5000). Subsequently, all patients were assigned to the clusters using a conditional inference tree classifier. Responses to PAP treatment change in apnoea severity and Epworth sleepiness scale (ESS) were assessed in relation to baseline patient clusters and at short- and long-term follow-up.Results At baseline, 20 164 patients were assigned (mean age 54.1±12.2 years, 73% male, median apnoea–hypopnoea index (AHI) 27.3 (interquartile range (IQR) 14.1–49.3) events·h−1, and ESS 9.8±5.3) to seven distinct clusters based on anthropometrics, comorbidities and symptoms. At PAP follow-up (median 210 [IQR 134–465] days), the observed AHI reduction (n=1075) was similar, whereas the ESS response (n=3938) varied: largest reduction in cluster 3 (young healthy symptomatic males) and 6 (symptomatic males with psychiatric disorders, −5.0 and −5.1 units, respectively (all p<0.01), limited reduction in clusters 2 (obese males with systemic hypertension) and 5 (elderly multimorbid obese males, −4.2 (p<0.05) and −3.7 (p<0.001), respectively). Residual sleepiness in cluster 5 was particularly evident at long-term follow-up (p<0.05).Conclusion OSA patients can be classified into clusters based on clinically identifiable features. Importantly, these clusters may be useful for prediction of both short- and long-term responses to PAP intervention.20 164 patients from the European Sleep Apnea Database were assigned to seven phenotypic clusters at baseline. A limited reduction in daytime sleepiness following positive airway pressure treatment was shown in two out of seven clusters. https://bit.ly/3byAUHe ER -