Clinical Subtypes Of Obstructive Sleep Apnea Hypopnea Syndrome Based On Cluster Analysis

Objective:To analyze subtypes of the main clinical presentation and polysomnography?PSG?parameters of obstructive sleep apnea hypopnea syndrome?OSAHS?by cluster analysis and to explore its clinical subtypes.Methods:A retrospective analysis was performed on the data of adult0SAHS patients,which were diagnosed in Guangxi Sleep Respiratory Disease Diagnosis and Treatment Center,The People's Hospital of Guangxi Zhuang Autonomous Region from July 2012 to November 2015.Clinical manifestations,risk factors,comorbidities and PSG parameters were included in the cluster analysis and analysis of characteristics of each cluster was then performed after category.Snoring,sleep suffocating,nocturnal urine,sleepiness scale?ESS?,smoking,drinking,hypertension,coronary heart disease,cerebrovascular disease,diabetes,age,BMI,AHI,SpO₂ less than 90%of the time,minimum SpO₂,N3 sleep and other parameters were included in cluster analysis.In addition to the above variables included in cluster analysis,the gender composition and snoring years of the patients were analyzed.Results:A total of 1748 patients who were 18⁸7 years old with a mean age of?46.19±12.58?.There were 1491 males?85.30%?and 257 females?14.70%?.Patients were classified as three distinct clusters.They were identified as fewer comorbidities type?type I?,more comorbidities type?type II?and daytime excessive sleepiness but fewer comorbidities type?type III?,consisting of 509 cases?29.1%?,563 cases?32.2%?and 676 cases?38.7%?of the entire cohort.The characteristics of type?were as follows:the age of the patients was younger?38.87±9.67 years?,the day and night symptoms were the least,the ESS score was 7.91±5.70,SPO ₂ was less than 90%,smoking and drinking were fewer risk factors and comorbidities were less.The age of the patients was longer than that of the other two types?53.28±13.28 years?.The ESS score was9.11±6.73.Coronary heart disease,cerebrovascular disease,diabetes mellitus and other comorbidities were the most common in the patients with coronary heart disease?CHD?,cerebrovascular disease?CVD?and diabetes mellitus?DM?.Characteristics of daytime excessive sleepiness but fewer comorbidities?type??:patients with OSAHS had the most severe symptoms,but they had fewer comorbidities,the the patients was 45.79±10.49 years old,the daytime somnolence was the most serious?ESS 10.29±6.62?,the number of nocturnal suffocations was more,and the BMI,AHI,was the most severe.The time of SpO₂ less than 90%was longer than that of the other two types?all P<0.0125?,and the proportion of risk factors such as smoking and drinking was higher than those of the other two types.Conclusion:Cluster analysis can cluster the patients with similar subjective clinical manifestation and objective examination index of OSAHS into the same subtype,which fully reflects the characteristics of subtypes.It is of great significance for the in-depth study and treatment of the pathogenesis of various subtypes of OSAHS.In this study,there were three subtypes of OSAHS:fewer comorbidity type,more comorbidity type,daytime excessive sleepiness but fewer comorbidity type.