Symptom Subtypes of Obstructive Sleep Apnea Predict Incidence of Cardiovascular Outcomes
Why is this work in the frame?
A frame that forgets how it found something cannot be audited. These are the routes that admitted this work.
No Canadian affiliation. An affiliation-only frame — the usual design — would never have seen this work. It is one of the works that make the case for inverting the frame.
Machine scores (provisional)
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
- Teacher spread
- 0.292 · how far apart the two teachers sit on this one work
- Validation status
score_only:v0-immature-baseline· verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it
Abstract
Abstract Rationale Symptom subtypes have been described in clinical and population samples of patients with obstructive sleep apnea (OSA). It is unclear whether these subtypes have different cardiovascular consequences. Objectives To characterize OSA symptom subtypes and assess their association with prevalent and incident cardiovascular disease in the Sleep Heart Health Study. Methods Data from 1,207 patients with OSA (apnea–hypopnea index ≥ 15 events/h) were used to evaluate the existence of symptom subtypes using latent class analysis. Associations between subtypes and prevalence of overall cardiovascular disease and its components (coronary heart disease, heart failure, and stroke) were assessed using logistic regression. Kaplan-Meier survival analysis and Cox proportional hazards models were used to evaluate whether subtypes were associated with incident events, including cardiovascular mortality. Measurements and Main Results Four symptom subtypes were identified (disturbed sleep [12.2%], minimally symptomatic [32.6%], excessively sleepy [16.7%], and moderately sleepy [38.5%]), similar to prior studies. In adjusted models, although no significant associations with prevalent cardiovascular disease were found, the excessively sleepy subtype was associated with more than threefold increased risk of prevalent heart failure compared with each of the other subtypes. Symptom subtype was also associated with incident cardiovascular disease (P < 0.001), coronary heart disease (P = 0.015), and heart failure (P = 0.018), with the excessively sleepy again demonstrating increased risk (hazard ratios, 1.7–2.4) compared with other subtypes. When compared with individuals without OSA (apnea–hypopnea index < 5), significantly increased risk for prevalent and incident cardiovascular events was observed mostly for patients in the excessively sleepy subtype. Conclusions OSA symptom subtypes are reproducible and associated with cardiovascular risk, providing important evidence of their clinical relevance.
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The record
- Venue
- American Journal of Respiratory and Critical Care Medicine
- Topic
- Obstructive Sleep Apnea Research
- Field
- Medicine
- Canadian institutions
- —
- Funders
- National Heart, Lung, and Blood InstituteAmerican Academy of Sleep Medicine FoundationCase Western Reserve UniversityYork UniversityJohns Hopkins UniversityUniversity of Washington
- Keywords
- MedicineInternal medicineHeart failureHazard ratioObstructive sleep apneaProportional hazards modelSleep apneaCardiologyStroke (engine)Incidence (geometry)PopulationMyocardial infarctionDiseaseApnea–hypopnea indexApneaPolysomnographyConfidence interval
- Has abstract in OpenAlex
- yes