Obstructive Sleep Apnea Syndrome Comorbidity Phenotypes in Primary Health Care Patients in Northern Greece

Panagiota K Ntenta; Georgios D Vavougios; Sotirios G Zarogiannis; Konstantinos I Gourgoulianis

doi:10.3390/healthcare10020338

Obstructive Sleep Apnea Syndrome Comorbidity Phenotypes in Primary Health Care Patients in Northern Greece

Healthcare (Basel). 2022 Feb 10;10(2):338. doi: 10.3390/healthcare10020338.

Authors

Panagiota K Ntenta¹, Georgios D Vavougios¹, Sotirios G Zarogiannis^{1

2}, Konstantinos I Gourgoulianis¹

Affiliations

¹ Department of Respiratory Medicine, Faculty of Medicine, School of Health Sciences, University of Thessaly, 41500 Larissa, Greece.
² Department of Physiology, Faculty of Medicine, School of Health Sciences, University of Thessaly, 41500 Larissa, Greece.

Abstract

Background: Obstructive sleep apnea syndrome (OSAS) is a significant public health issue. In the general population, the prevalence varies from 10% to 50%. We aimed to phenotype comorbidities in OSAS patients referred to the primary health care (PHC) system.

Methods: We enrolled 1496 patients referred to the PHC system for any respiratory- or sleep-related issue from November 2015 to September 2017. Some patients underwent polysomnography (PSG) evaluation in order to establish OSAS diagnosis. The final study population comprised 136 patients, and the Charlson comorbidity index was assessed. Categorical principal component analysis and TwoStep clustering was used to identify distinct clusters in the study population.

Results: The analysis revealed three clusters: the first with moderate OSAS, obesity and a high ESS score without significant comorbidities; the second with severe OSAS, severe obesity with comorbidities and the highest ESS score; and the third with severe OSAS and obesity without comorbidities but with a high ESS score. The clusters differed in age (p < 0.005), apnea-hypopnea index, oxygen desaturation index, arousal index and respiratory and desaturation arousal index (p < 0.001).

Conclusions: Predictive comorbidity models may aid the early diagnosis of patients at risk in the context of PHC and pave the way for personalized treatment.

Keywords: Greece; OSAS; comorbidities; phenotyping; primary health care.