Obstructive sleep apnea: A categorical cluster analysis and visualization

• Type: Article in International Scientific Journal
• Date: 2021

Authors

Ferreira Santos, D (Author) FMUP; Pedro Pereira Rodrigues (Author) FMUP

Journal

Title: Pulmonology

ISSN: 2531-0429

Publisher: Taylor & Francis

Indexing

ISI Web of Knowledge - 0 Citations

Scopus - 1 Citation

Other information

Authenticus ID: P-00V-RZS

DOI: 10.1016/j.pulmoe.2021.10.003

Abstract (EN): Introduction and Objectives: Obstructive sleep apnea (OSA) is a prevalent sleep condition which is very heterogeneous although not formally characterized as such, resulting in missed or delayed diagnosis. Cluster analysis has been used in different clinical domains, particularly within sleep disorders. We aim to understand OSA heterogeneity and provide a variety of cluster visualizations to communicate the information clearly and efficiently. Materials and Methods: We applied an extension of k-means to be used in categorical variables: k-modes, to identify OSA patients¿ groups, based on demographic, physical examination, clinical history, and comorbidities characterization variables (n = 40) obtained from a derivation and validation cohorts (211 and 53, respectively) from the northern region of Portugal. Missing values were imputed with k-nearest neighbours (k-NN) and a chi-square test was held for feature selection. Results: Thirteen variables were inserted in phenotypes, resulting in the following three clusters: Cluster 1, middle-aged males reporting witnessed apneas and high alcohol consumption before sleep; Cluster 2, middle-aged women with increased neck circumference (NC), non-repairing sleep and morning headaches; and Cluster 3, obese elderly males with increased NC, witnessed apneas and alcohol consumption. Patients from the validation cohort assigned to different clusters showed similar proportions when compared with the derivation cohort, for mild (C1: 56 vs 75%, P = 0.230; C2: 61 vs 75%, P = 0.128; C3: 45 vs 48%, P = 0.831), moderate (C1: 24 vs 25%; C2: 20 vs 25%; C3: 25 vs 19%) and severe (C1: 20 vs 0%; C2: 18 vs 0%; C3: 29 vs 33%) levels. Therefore, the allocation supported the validation of the obtained clusters. Conclusions: Our findings suggest different OSA patients¿ groups, creating the need to rethink these patients¿ stereotypical baseline characteristics. © 2021 Sociedade Portuguesa de Pneumologia

Language: English

Type (Professor's evaluation): Scientific