{"title":"女性阻塞性睡眠呼吸暂停的表型:真实生活队列研究","authors":"","doi":"10.1016/j.sleep.2024.07.016","DOIUrl":null,"url":null,"abstract":"<div><h3>Objective</h3><p>Obstructive sleep apnea (OSA) is a complex, heterogeneous disease. Categorizing the disorder into phenotypes can help us better understand its pathology and guide us toward more personalized treatment approaches. Nevertheless, most of the previous cluster analysis (CA) studies in OSA predominantly included middle-aged to older men and may not adequately represent the heterogeneity of OSA phenotypes in women. Our aim is to identify these phenotypes in women using an extensive, exclusively female cohort.</p></div><div><h3>Methods</h3><p>Cross-sectional study of 1886 women diagnosed with OSA (apnea-hypopnea index >5 events/h) by PSG (polysomnography) and RP (respiratory polygraphy) at a tertiary hospital Sleep Unit. A CA was performed including general data, clinical variables, comorbidities and sleep study results.</p></div><div><h3>Results</h3><p>Four phenotypic subtypes were identified: <strong>Cluster 1</strong> “Middle-aged paucisymptomatic women without cardiovascular risk factors” (507 patients, 27 %); <strong>Cluster 2</strong> “Older paucisymptomatic women with established cardiovascular disease and severe OSA” (228 patients, 12 %); <strong>Cluster 3</strong> “Middle-aged women with “classic” symptoms and cardiovascular risk factors” (892 patients, 47 %), and <strong>Cluster 4</strong> ″Middle-aged women with mood disorders, nonrestorative sleep and cardiovascular risk factors” (259 patients, 14 %).</p></div><div><h3>Conclusions</h3><p>Conducting a CA exclusively within a female cohort reveals a heterogeneous presentation of OSA in women, similar to what has been previously reported in the literature for men. The “classical” presentation is notably the most prevalent, while the “atypical” presentation, which was previously more frequently associated with women, is less prevalent. Additionally, paucisymptomatic presentations, with or without associated comorbidities, are also present.</p></div>","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":null,"pages":null},"PeriodicalIF":3.8000,"publicationDate":"2024-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Phenotypes of obstructive sleep apnea in women: A real-life cohort study\",\"authors\":\"\",\"doi\":\"10.1016/j.sleep.2024.07.016\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Objective</h3><p>Obstructive sleep apnea (OSA) is a complex, heterogeneous disease. Categorizing the disorder into phenotypes can help us better understand its pathology and guide us toward more personalized treatment approaches. Nevertheless, most of the previous cluster analysis (CA) studies in OSA predominantly included middle-aged to older men and may not adequately represent the heterogeneity of OSA phenotypes in women. Our aim is to identify these phenotypes in women using an extensive, exclusively female cohort.</p></div><div><h3>Methods</h3><p>Cross-sectional study of 1886 women diagnosed with OSA (apnea-hypopnea index >5 events/h) by PSG (polysomnography) and RP (respiratory polygraphy) at a tertiary hospital Sleep Unit. A CA was performed including general data, clinical variables, comorbidities and sleep study results.</p></div><div><h3>Results</h3><p>Four phenotypic subtypes were identified: <strong>Cluster 1</strong> “Middle-aged paucisymptomatic women without cardiovascular risk factors” (507 patients, 27 %); <strong>Cluster 2</strong> “Older paucisymptomatic women with established cardiovascular disease and severe OSA” (228 patients, 12 %); <strong>Cluster 3</strong> “Middle-aged women with “classic” symptoms and cardiovascular risk factors” (892 patients, 47 %), and <strong>Cluster 4</strong> ″Middle-aged women with mood disorders, nonrestorative sleep and cardiovascular risk factors” (259 patients, 14 %).</p></div><div><h3>Conclusions</h3><p>Conducting a CA exclusively within a female cohort reveals a heterogeneous presentation of OSA in women, similar to what has been previously reported in the literature for men. The “classical” presentation is notably the most prevalent, while the “atypical” presentation, which was previously more frequently associated with women, is less prevalent. 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引用次数: 0
摘要
目的阻塞性睡眠呼吸暂停(OSA)是一种复杂的异质性疾病。将这种疾病分为不同的表型有助于我们更好地了解其病理,并指导我们采用更个性化的治疗方法。然而,之前大多数有关 OSA 的聚类分析(CA)研究主要包括中老年男性,可能无法充分代表女性 OSA 表型的异质性。我们的目的是利用一个广泛的、专门针对女性的队列来确定女性的这些表型。方法在一家三级医院的睡眠科对1886名通过PSG(多导睡眠图)和RP(呼吸多导图)确诊为OSA(呼吸暂停-低通气指数>5事件/小时)的女性进行横断面研究。结果确定了四种表型亚型:第一组 "无心血管风险因素的中年无症状女性"(507 名患者,占 27%);第二组 "有心血管疾病和严重 OSA 的老年无症状女性"(228 名患者,占 12%);第三组 "有'典型'症状和心血管风险因素的中年女性"(892 名患者,占 47%);第四组″有情绪障碍、非恢复性睡眠和心血管风险因素的中年女性"(259 名患者,占 14%)。结论专门在女性人群中进行CA分析,发现女性OSA的表现形式多种多样,与之前文献中报道的男性OSA表现形式相似。其中,"典型 "表现最为普遍,而以前更常见于女性的 "非典型 "表现则较少见。此外,还有一些无症状的表现,无论是否伴有相关的合并症。
Phenotypes of obstructive sleep apnea in women: A real-life cohort study
Objective
Obstructive sleep apnea (OSA) is a complex, heterogeneous disease. Categorizing the disorder into phenotypes can help us better understand its pathology and guide us toward more personalized treatment approaches. Nevertheless, most of the previous cluster analysis (CA) studies in OSA predominantly included middle-aged to older men and may not adequately represent the heterogeneity of OSA phenotypes in women. Our aim is to identify these phenotypes in women using an extensive, exclusively female cohort.
Methods
Cross-sectional study of 1886 women diagnosed with OSA (apnea-hypopnea index >5 events/h) by PSG (polysomnography) and RP (respiratory polygraphy) at a tertiary hospital Sleep Unit. A CA was performed including general data, clinical variables, comorbidities and sleep study results.
Results
Four phenotypic subtypes were identified: Cluster 1 “Middle-aged paucisymptomatic women without cardiovascular risk factors” (507 patients, 27 %); Cluster 2 “Older paucisymptomatic women with established cardiovascular disease and severe OSA” (228 patients, 12 %); Cluster 3 “Middle-aged women with “classic” symptoms and cardiovascular risk factors” (892 patients, 47 %), and Cluster 4 ″Middle-aged women with mood disorders, nonrestorative sleep and cardiovascular risk factors” (259 patients, 14 %).
Conclusions
Conducting a CA exclusively within a female cohort reveals a heterogeneous presentation of OSA in women, similar to what has been previously reported in the literature for men. The “classical” presentation is notably the most prevalent, while the “atypical” presentation, which was previously more frequently associated with women, is less prevalent. Additionally, paucisymptomatic presentations, with or without associated comorbidities, are also present.
期刊介绍:
Sleep Medicine aims to be a journal no one involved in clinical sleep medicine can do without.
A journal primarily focussing on the human aspects of sleep, integrating the various disciplines that are involved in sleep medicine: neurology, clinical neurophysiology, internal medicine (particularly pulmonology and cardiology), psychology, psychiatry, sleep technology, pediatrics, neurosurgery, otorhinolaryngology, and dentistry.
The journal publishes the following types of articles: Reviews (also intended as a way to bridge the gap between basic sleep research and clinical relevance); Original Research Articles; Full-length articles; Brief communications; Controversies; Case reports; Letters to the Editor; Journal search and commentaries; Book reviews; Meeting announcements; Listing of relevant organisations plus web sites.