Cluster analysis of upper airway stimulation adherence patterns and implications on clinical care

Sleep

article

Soose, Ryan J¹  Araujo, Matheus²  Faber, Kevin³  Roy, Asim⁴  Lee, Kent⁵  Ni, Quan⁵  Srivastava, Jaideep²  Strollo, Patrick J⁶ 

[1] UPMC Department of Otolaryngology, University of Pittsburgh;Department of Computer Science and Engineering, University of Minnesota;Sanford Health, Sleep Medicine;Ohio Sleep Medicine Institute;Inspire Medical Systems;UPMC Division of Pulmonary Allergy and Critical Care Medicine, University of Pittsburgh

关键词: cluster analysis;    obstructive sleep apnea;    upper airway stimulation;    hypoglossal nerve stimulation;   

DOI  :  10.1093/sleep/zsac049

学科分类：生理学

来源: American Academy of Sleep Medicine

【 摘 要 】

Study Objectives Upper airway stimulation (UAS) therapy is effective for a subset of obstructive sleep apnea (OSA) patients with continuous positive airway pressure (CPAP) intolerance. While overall adherence is high, some patients have suboptimal adherence, which limits efficacy. Our goal was to identify therapy usage patterns during the first 3 months of therapy to enable targeted strategies for improved adherence.Methods Therapy data was retrieved from 2098 patients for three months after device activation. Data included mean and standard deviation (SD) of hours of use, therapy pauses, hours from midnight the therapy was turned ON and OFF, percentage of missing days, and stimulation amplitude. Cluster analysis was performed using Gaussian mixture models that categorized patients into six main groups.Results6 hours per night.Conclusions Cluster analysis of early UAS usage patterns identified six distinct groups that may enable personalized interventions for improved long-term management. Differentiation of the patient clusters may have clinical implications with regard to sleep hygiene education, therapy discomfort, comorbid insomnia, and other conditions that impact adherence.

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