Clinical Patterns of Obstructive Sleep Apnea and Its Comorbid Conditions: A Data Mining Approach

Abstract

ScIENTIfIc INvESTIgATIONSObjectives: Obstructive sleep apnea often results in a wide range of comorbid conditions. Although some conditions have been clearly identified as comorbid, a full clinical pattern of associated diseases has not been systematically documented. This research aimed to reveal the full pattern of comorbid conditions associated with OSA by employing a data mining technique. Methods: A large data repository (the New South Wales Inpatient Data Collection) collected between 1999 and 2004 was mined, and all clinical diagnoses were coded with ICD-10-AM codes. Results: A total of 60,197 cases (4% of total records) were identified as related to OSA (72.2% males, 27.8% females). OSA occurrence showed 2 peaks at 0-4 years and 55-59 years. A strikingly low occurrence was observed for the adolescent years. Conditions comorbid with OSA in adults by descending frequency were essential hypertension, obesity, hypercholesterolemia, type 2 diabetes, past or current tobacco use, and ischemic heart conditions. Obesity and OSA showed a similar time course of onset, with a latent period of 5 years for hypertension and type 2 diabetes and 15 years for chronic ischemic heart conditions. Comorbid conditions were predominantly of the cardiovascular, endocrine/metabolic and respiratory systems. The data also indicated OSA patients are high users of health services. conclusions: The data mining technique confirms the prevalence of the disease, describes the age distribution patterns and time courses of disease development from obesity and OSA to comorbid conditions, and implicates possible interrelationships among these conditions and high cost of treating OSA patients.

Obstructive sleep apnea hypopnea syndrome and metabolic syndrome: A synergistic cardiovascular risk factor

“…Peled et al (2007) found a positive association between OSAHS severity and insulin resistance as well as the number of metabolic syndrome components present in a subject, namely obesity, hypertension, high triglycerides, and low high‐density lipoprotein (HDL) cholesterol. As previously noted, Huang et al (2008) reported an increased incidence of diabetes within 5–7 years after the onset of OSAHS. Marshall, Wong, Phillips, Liu, Knuiman, & Grunstein (2009) reported similar results from the population based longitudinal Busselton Sleep Study conducted in 1990.…”

“…OSAHS is associated with several components of the metabolic syndrome including hypertension, obesity, dyslipidemia, and type 2 diabetes (Huang, Qin, Zhang, & Chow, 2008). Huang et al (2008) reviewed 60,000 cases of OSAHS and found that the onset of obesity and OSAHS occurred nearly simultaneously. Hypertension and diabetes tended to develop 5–7 years after the onset of OSAHS, and ischemic heart disease developed 15 years later.…”

Cardiovascular and respiratory responses to chronic intermittent hypoxia in adult female rats

“…Studies by Hermans et al (2014), for example, found no sexual dimorphism in the prevalence of hypertension in diabetic patients with OSA, while Laaban et al (2010) observed that hypertension is more prevalent in women than in men with OSA (Laaban et al 2010). On the contrary, Huang et al (2008) documented a lower prevalence of hypertension in female OSA patients compared with men. Therefore, the prevalence of cardiovascular disease in men and women with OSA remains unsettled, most probably due to different characteristics of the populations studied, age and confounding comorbidities, such as obesity and diabetes.…”

Asthma and obesity as predictors of severe obstructive sleep apnea in an adolescent pediatric population

“…1,2 Other epidemiological factors commonly cited include race; socioeconomic status 3 ; and the presence of diseases such as asthma, gastroesophageal reflux disease (GERD), and allergic rhinitis. 4,5 Various explanations have been described concerning the relationships between obesity, asthma, and OSA. For example, obesity has been implicated in OSA even after adenotonsillectomy, 6 as well as in the development of asthma.…”