Clinical Phenotypes and Comorbidity in European Sleep Apnoea Patients
Open accessAbstract
BACKGROUND: Clinical presentation phenotypes of obstructive sleep apnoea (OSA) and their association with comorbidity as well as impact on adherence to continuous positive airway pressure (CPAP) treatment have not been established. METHODS: A prospective follow-up cohort of adult patients with OSA (apnoea-hypopnoea index (AHI) of ≥5/h) from 17 European countries and Israel (n = 6,555) was divided into four clinical presentation phenotypes based on daytime symptoms labelled as excessive daytime sleepiness ("EDS") and nocturnal sleep problems other than OSA (labelled as "insomnia"): 1) EDS (daytime+/nighttime-), 2) EDS/insomnia (daytime+/nighttime+), 3) non-EDS/non-insomnia (daytime-/nighttime-), 4) and insomnia (daytime-/nighttime+) phenotype. RESULTS: The EDS phenotype comprised 20.7%, the non-EDS/non-insomnia type 25.8%, the EDS/insomnia type 23.7%, and the insomnia phenotype 29.8% of the entire cohort. Thus, clinical presentation phenotypes with insomnia symptoms were dominant with 53.5%, but only 5.6% had physician diagnosed insomnia. Cardiovascular comorbidity was less prevalent in the EDS and most common in the insomnia phenotype (48.9% vs. 56.8%, p<0.001) despite more severe OSA in the EDS group (AHI 35.0±25.5/h vs. 27.9±22.5/h, p<0.001, respectively). Psychiatric comorbidity was associated with insomnia like OSA phenotypes independent of age, gender and body mass index (HR 1.5 (1.188-1.905), p<0.001). The EDS phenotype tended to associate with higher CPAP usage (22.7 min/d, p = 0.069) when controlled for age, gender, BMI and sleep apnoea severity. CONCLUSIONS: Phenotypes with insomnia symptoms comprised more than half of OSA patients and were more frequently linked with comorbidity than those with EDS, despite less severe OSA. CPAP usage was slightly higher in phenotypes with EDS.
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In contrast, the disturbed sleep or "insomnia" subtype, a predominant cluster in a survey of ESADA, was more frequently linked with cardiovascular comorbidity than the sleepy phenotype, despite lower mean AHI values.
“In contrast, the disturbed sleep or “insomnia” subtype, a predominant cluster in a survey of ESADA, was more frequently linked with cardiovascular comorbidity than the sleepy phenotype, despite lower mean AHI values (Saaresranta et al., 2016).”
From Obstructive sleep apnea: transition from pathophysiology to an integrative disease model (2022) · cites this paper as Saaresranta et al., 2016
Reliance on the single historical OSA profile does not represent all OSA sufferers.
“reliance on this single profile clearly does not represent all OSA sufferers [26,27,28].”
From Co-morbid insomnia and sleep apnea (COMISA): Prevalence, consequences, methodological considerations, and recent randomized controlled trials (2019) · cites this paper as [26]
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Cites
A New Method for Measuring Daytime Sleepiness: The Epworth Sleepiness Scale
Johns, M. W. (1991) · Sleep · doi:10.1093/sleep/14.6.540 · Cited by 17,364 · see citing works
(2007) · Cited by 6,530 · see citing works
Marin, J. M., Carrizo, S. J., Vicente, E., & Agusti, A. G. (2005) · The Lancet · doi:10.1016/s0140-6736(05)71141-7 · Cited by 4,678 · see citing works
Guilleminault, C., Tilkian, A., & Dement, W. C. (1976) · Annual Review of Medicine · doi:10.1146/annurev.me.27.020176.002341 · Cited by 1,812 · see citing works
Defining Phenotypic Causes of Obstructive Sleep Apnea. Identification of Novel Therapeutic Targets
Eckert, D. J., White, D. P., Jordan, A. S., Malhotra, A., & Wellman, A. (2013) · American Journal of Respiratory and Critical Care Medicine · doi:10.1164/rccm.201303-0448oc · Cited by 1,173 · see citing works
McNicholas, W. T., Bonsignore, M. R., & the Management Committee of EU COST ACTION B26 (2007) · European Respiratory Journal · doi:10.1183/09031936.00027406 · Cited by 911 · see citing works
Self-citationThe different clinical faces of obstructive sleep apnoea: a cluster analysis
Ye, L., Pien, G. W., Ratcliffe, S. J., Björnsdottir, E., Arnardottir, E. S., Pack, A. I., Benediktsdottir, B., & Gislason, T. (2014) · European Respiratory Journal · doi:10.1183/09031936.00032314 · Cited by 474 · see citing works
Increased incidence of coronary artery disease in sleep apnoea: a long-term follow-up
Peker, Y., Carlson, J. T., & Hedner, J. A. (2006) · European Respiratory Journal · doi:10.1183/09031936.06.00107805 · Cited by 444 · see citing works
Self-citationCampos-Rodriguez, F., Martinez-Garcia, M. A., de la Cruz-Moron, I., Almeida-Gonzalez, C., Catalan-Serra, P., & Montserrat, J. M. (2012) · Annals of Internal Medicine · doi:10.7326/0003-4819-156-2-201201170-00006 · Cited by 379 · see citing works
Comorbid insomnia and obstructive sleep apnea: Challenges for clinical practice and research
Luyster, F. S., Buysse, D. J., & Strollo, P. J. (2010) · Journal of Clinical Sleep Medicine · doi:10.5664/jcsm.27772 · Cited by 374 · see citing works
Disorders of glucose metabolism in sleep apnea
Punjabi, N. M., & Polotsky, V. Y. (2005) · Journal of Applied Physiology · doi:10.1152/japplphysiol.00695.2005 · Cited by 373 · see citing works
Prevalence of Insomnia Symptoms in Patients With Sleep-Disordered Breathing
Krakow, B., Melendrez, D., Ferreira, E., Clark, J., Warner, T. D., Sisley, B., & Sklar, D. (2001) · Chest · doi:10.1378/chest.120.6.1923 · Cited by 313 · see citing works
Quantifying the ventilatory control contribution to sleep apnoea using polysomnography
Terrill, P. I., Edwards, B. A., Nemati, S., Butler, J. P., Owens, R. L., Eckert, D. J., White, D. P., Malhotra, A., Wellman, A., & Sands, S. A. (2015) · European Respiratory Journal · doi:10.1183/09031936.00062914 · Cited by 289 · see citing works
Chai‐Coetzer, C. L., Luo, Y., Antic, N. A., Zhang, X., Chen, B.-Y., He, Q.-Y., Heeley, E. L., Huang, S., Anderson, C. S., Zhong, N., et al. (2013) · SLEEP · doi:10.5665/sleep.3232 · Cited by 245 · see citing works
Diabetes Mellitus Prevalence and Control in Sleep-Disordered Breathing
Kent, B. D., Grote, L., Ryan, S., Pépin, J., Bonsignore, M. R., Tkáčová, R., Saaresranta, T., Verbraecken, J. A., Levy, P. A., Hedner, J. A., et al. (2014) · CHEST Journal · doi:10.1378/chest.13-2403 · Cited by 243 · see citing works
Self-citationDepression and anxiety in obstructive sleep apnea syndrome: a review
Saunamäki, T., & Jehkonen, M. (2007) · Acta Neurologica Scandinavica · doi:10.1111/j.1600-0404.2007.00901.x · Cited by 216 · see citing works
Frequency of insomnia report in patients with obstructive sleep apnoea hypopnea syndrome (OSAHS)
Smith, S. S., Sullivan, K. A., Hopkins, W., & Douglas, J. A. (2004) · Sleep Medicine · doi:10.1016/j.sleep.2004.03.005 · Cited by 187 · see citing works
Obstructive Sleep Apnea: A Cluster Analysis at Time of Diagnosis
Bailly, S., Destors, M., Grillet, Y., Richard, P., Stach, B., Vivodtzev, I., Timsit, J., Levy, P. A., Tamisier, R., & Pépin, J. (2016) · PLoS ONE · doi:10.1371/journal.pone.0157318 · Cited by 185 · see citing works
Sleep apnoea is a common occurrence in females
Franklin, K. A., Sahlin, C., Stenlund, H., & Lindberg, E. (2013) · European Respiratory Journal · doi:10.1183/09031936.00212711 · Cited by 183 · see citing works
Björnsdóttir, E., Janson, C., Sigurdsson, J. F., Gehrman, P., Perlis, M., Juliusson, S., Arnardottir, E. S., Kuna, S. T., Pack, A. I., Gislason, T., et al. (2013) · Sleep · doi:10.5665/sleep.3226 · Cited by 174 · see citing works
Tkacova, R., McNicholas, W. T., Javorsky, M., Fietze, I., Sliwinski, P., Parati, G., Grote, L., & Hedner, J. (2014) · European Respiratory Journal · doi:10.1183/09031936.00225113 · Cited by 156 · see citing works
Self-citationThe European Sleep Apnoea Database (ESADA): report from 22 European sleep laboratories
Hedner, J. A., Grote, L., Bonsignore, M. R., McNicholas, W. T., Lavie, P., Parati, G., Śliwiński, P., Barbé, F., Backer, W. D., Escourrou, P., et al. (2011) · European Respiratory Journal · doi:10.1183/09031936.00046710 · Cited by 151 · see citing works
Self-citationOwens, R. L., Edwards, B. A., Eckert, D. J., Jordan, A. S., Sands, S. A., Malhotra, A., White, D. P., Loring, S. H., Butler, J. P., & Wellman, A. (2015) · SLEEP · doi:10.5665/sleep.4750 · Cited by 138 · see citing works
Thorpy, M. J., Chesson, A. L., Ferber, R. A., Kader, G. A.-E., Millman, R. P., Reite, M. L., Smith, P. L., & Wooten, V. D. (1994) · SLEEP · Cited by 138 · see citing works
Metabolic syndrome, insulin resistance and sleepiness in real-life obstructive sleep apnoea
Bonsignore, M. R., Esquinas, C., Barceló, A., Sánchez‐de‐la‐Torre, M., Paternò, A., Durán‐Cantolla, J., Marín, J. M., & Barbé, F. (2011) · European Respiratory Journal · doi:10.1183/09031936.00151110 · Cited by 120 · see citing works
Self-citationInsomnia symptoms influence CPAP compliance
Pieh, C., Bach, M., Popp, R., Jara, C., Crönlein, T., Hajak, G., & Geisler, P. (2013) · Sleep And Breathing · doi:10.1007/s11325-012-0655-9 · Cited by 107 · see citing works
Vavougios, G. D., Natsios, G., Pastaka, C., Zarogiannis, S. G., & Gourgoulianis, K. I. (2016) · Journal of Sleep Research · doi:10.1111/jsr.12344 · Cited by 104 · see citing works
Refractory Insomnia and Sleep-Disordered Breathing: A Pilot Study
Krakow, B. J., Melendrez, D. C., Lee, S. A., Warner, T. D., Clark, J. O., & Sklar, D. P. (2004) · Sleep And Breathing · doi:10.1007/s11325-004-0015-5 · Cited by 103 · see citing works
Differences in the symptoms of men and women with obstructive sleep apnoea
Ambrogetti, A., Olson, L. G., & Saunders, N. A. (1991) · Australian and New Zealand Journal of Medicine · doi:10.1111/j.1445-5994.1991.tb01408.x · Cited by 102 · see citing works
Lee, R. W. W., Sutherland, K., Chan, A. S. L., Zeng, B., Grunstein, R. R., Darendeliler, M. A., Schwab, R. J., & Cistulli, P. A. (2010) · SLEEP · doi:10.1093/sleep/33.9.1249 · Cited by 87 · see citing works
Kent, B. D., Grote, L., Bonsignore, M. R., Saaresranta, T., Verbraecken, J. A., Levy, P. A., Śliwiński, P., Tkáčová, R., Kvamme, J. A., Fietze, I., et al. (2014) · European Respiratory Journal · doi:10.1183/09031936.00162713 · Cited by 81 · see citing works
Self-citationTaranto‐Montemurro, L., Floras, J. S., Picton, P. E., Kasai, T., Alshaer, H., Gabriel, J. M., & Bradley, T. D. (2014) · Journal of Clinical Sleep Medicine · doi:10.5664/jcsm.3526 · Cited by 66 · see citing works
Management of obstructive sleep apnea in Europe
Fietze, I., Penzel, T., Alonderis, A., Barbé, F., Bonsignore, M. R., Calverly, P., Backer, W. D., Diefenbach, K., Donič, V., & Eijsvogel, M. (2010) · Sleep Medicine · doi:10.1016/j.sleep.2010.10.003 · Cited by 58 · see citing works
Self-citationCo-Morbidity between Cardiovascular Pathology and Depression: Role of Inflammation
Halaris, A. E. (2013) · Modern trends in psychiatry · doi:10.1159/000343981 · Cited by 53 · see citing works
Nocturnal cardiac autonomic profile in young primary insomniacs and good sleepers
de Zambotti, M., Cellini, N., Baker, F. C., Colrain, I. M., Sarlo, M., & Stegagno, L. (2014) · International Journal of Psychophysiology · doi:10.1016/j.ijpsycho.2014.06.014 · Cited by 53 · see citing works
Pedrosa, R. P., de Barros, I. M. L., Drager, L. F., Bittencourt, M. S., Medeiros, A. K. L., Carvalho, L. L., Lustosa, T. C., de Carvalho, M. M. B., Ferreira, M. N. L., Lorenzi‐Filho, G., et al. (2014) · CHEST Journal · doi:10.1378/chest.14-0097 · Cited by 50 · see citing works
Krakow, B., Melendrez, D., Sisley, B., Warner, T. D., Krakow, J., Leahigh, L., & Lee, S. (2006) · Sleep And Breathing · doi:10.1007/s11325-005-0037-7 · Cited by 45 · see citing works
Krakow, B. J., Ulibarri, V. A., Melendrez, D. C., Kikta, S., Togami, L., & Haynes, P. L. (2008) · Journal of Clinical Sleep Medicine · doi:10.5664/jcsm.27183 · Cited by 38 · see citing works
Unrecognised obstructive sleep apnoea is common in severe peripheral arterial disease
Utriainen, K. T., Airaksinen, J. K. E., Polo, O. J., Raitakari, O. T., Pietilä, M., Scheinin, H., Helenius, H. Y. M., Leino, K. A., Kentala, E., Jalonen, J. R., et al. (2012) · European Respiratory Journal · doi:10.1183/09031936.00227611 · Cited by 34 · see citing works
Reimbursed drugs in patients with sleep-disordered breathing: A static-charge-sensitive bed study
Anttalainen, U., Polo, O. J., Vahlberg, T. J., & Saaresranta, T. (2009) · Sleep Medicine · doi:10.1016/j.sleep.2008.12.015 · Cited by 15 · see citing works
Self-citationSleep-Related Respiratory Disorders
Lugaresi, E., & Vela‐Bueno, A. (1987) · Seminars in Neurology · doi:10.1055/s-2008-1041426 · Cited by 5 · see citing works
Refractory Insomnia and Sleep-Disordered Breathing: A Pilot Study
Krakow, B., Melendrez, D., Lee, S. A., Warner, T. D., Clark, J. O., & Sklar, D. (2004) · Sleep And Breathing · doi:10.1055/s-2004-822850 · Cited by 3 · see citing works
Flagged first, then by citations
2 of the 45 references couldn’t be matched to a known paper.
Cited by
Sorted by citations
Metrics of sleep apnea severity: beyond the apnea-hypopnea index
Malhotra, A., Ayappa, I., Ayas, N., Collop, N., Kirsch, D., Mcardle, N., Mehra, R., Pack, A. I., Punjabi, N., White, D. P., et al. (2021) · SLEEP · doi:10.1093/sleep/zsab030 · Cited by 489 · see citing works
Sex differences in obstructive sleep apnoea
Bonsignore, M. R., Saaresranta, T., & Riha, R. L. (2019) · European Respiratory Review · doi:10.1183/16000617.0030-2019 · Cited by 345 · see citing works
Self-citationSleep and Sleep Disorders in the Menopausal Transition
Baker, F. C., Lampio, L., Saaresranta, T., & Polo‐Kantola, P. (2018) · Sleep Medicine Clinics · doi:10.1016/j.jsmc.2018.04.011 · Cited by 321 · see citing works
Self-citationSweetman, A., Lack, L., & Bastien, C. (2019) · Brain Sciences · doi:10.3390/brainsci9120371 · Cited by 253 · see citing works
“Between 2013 and 2018, a number of large cluster analyses of OSA samples also identified that 32%–54% of OSA patients indicate symptoms of ‘disturbed sleep’, characterized by nocturnal insomnia symptoms, more frequent use of sedative-hypnotic medications, and lower use of CPAP therapy [26,27,41,42].”
BackgroundRanderath, W., Bassetti, C. L., Bonsignore, M. R., Farre, R., Ferini-Strambi, L., Grote, L., Hedner, J., Kohler, M., Martinez-Garcia, M.-A., Mihaicuta, S., et al. (2018) · European Respiratory Journal · doi:10.1183/13993003.02616-2017 · Cited by 245 · see citing works
Self-citationKeenan, B. T., Kim, J., Singh, B., Bittencourt, L., Chen, N., Cistulli, P. A., Magalang, U. J., McArdle, N., Mindel, J. W., Benediktsdóttir, B., et al. (2018) · SLEEP · doi:10.1093/sleep/zsx214 · Cited by 243 · see citing works
Self-citationZhang, Y., Ren, R., Lei, F., Zhou, J., Zhang, J., Wing, Y.-K., Sanford, L. D., & Tang, X. (2019) · Sleep Medicine Reviews · doi:10.1016/j.smrv.2019.01.004 · Cited by 238 · see citing works
Léger, D., & Stepnowsky, C. J. (2020) · Sleep Medicine Reviews · doi:10.1016/j.smrv.2020.101275 · Cited by 175 · see citing works
Pien, G. W., Ye, L., Keenan, B. T., Maislin, G., Björnsdóttir, E., Arnardóttir, E. S., Benediktsdóttir, B., Gíslason, Þ., & Pack, A. I. (2018) · SLEEP · doi:10.1093/sleep/zsx201 · Cited by 170 · see citing works
Sweetman, A., Lack, L., Catcheside, P. G., Antic, N. A., Smith, S., Chai-Coetzer, C. L., Douglas, J., O’grady, A., Dunn, N., Robinson, J., et al. (2019) · Sleep · doi:10.1093/sleep/zsz178 · Cited by 149 · see citing works
Obstructive sleep apnea: transition from pathophysiology to an integrative disease model
McNicholas, W. T., & Pevernagie, D. (2022) · Journal of Sleep Research · doi:10.1111/jsr.13616 · Cited by 153 · see citing works
Self-citationGarbarino, S., Scoditti, E., Lanteri, P., Conte, L., Magnavita, N., & Toraldo, D. M. (2018) · Frontiers in Neurology · doi:10.3389/fneur.2018.00505 · Cited by 92 · see citing works
Ong, J. C., Crawford, M., & Wallace, D. M. (2020) · CHEST Journal · doi:10.1016/j.chest.2020.12.002 · Cited by 94 · see citing works
Comorbid Insomnia and Obstructive Sleep Apnea (COMISA): Current Concepts of Patient Management
Ragnoli, B., Pochetti, P., Raie, A., & Malerba, M. (2021) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph18179248 · Cited by 91 · see citing works
A Meta-analysis of Voxel-based Brain Morphometry Studies in Obstructive Sleep Apnea
Shi, Y., Chen, L., Chen, T., Li, L., Dai, J., Lui, S., Huang, X., Sweeney, J. A., & Gong, Q. (2017) · Scientific Reports · doi:10.1038/s41598-017-09319-6 · Cited by 81 · see citing works
Bonsignore, M. R., Suarez-Giron, M. C., Marrone, O., Castrogiovanni, A., & Montserrat, J. M. (2017) · European Respiratory Review · doi:10.1183/16000617.0069-2017 · Cited by 78 · see citing works
Self-citationOng, J. C., Crawford, M. R., Dawson, S. C., Fogg, L. F., Turner, A. D., Wyatt, J. K., Crisostomo, M. I., Chhangani, B. S., Kushida, C. A., Edinger, J. D., et al. (2020) · Sleep · doi:10.1093/sleep/zsaa041 · Cited by 74 · see citing works
Bailly, S., Grote, L., Hedner, J., Schiza, S., McNicholas, W. T., Basoglu, O. K., Lombardi, C., Dogas, Z., Roisman, G., Pataka, A., et al. (2021) · Respirology · doi:10.1111/resp.13969 · Cited by 74 · see citing works
Self-citationRyan, S., Cummins, E. P., Farré, R., Gileles‐Hillel, A., Jun, J. C., Oster, H., Pépin, J., Ray, D. W., Reutrakul, S., Sánchez‐de‐la‐Torre, M., et al. (2020) · European Respiratory Journal · doi:10.1183/13993003.02295-2019 · Cited by 70 · see citing works
Insomnia disorder: clinical and research challenges for the 21st century
Ferini‐Strambi, L., Auer, R., Bjorvatn, B., Castronovo, V., Franco, O. H., Gabutti, L., Galbiati, A., Hajak, G., Khatami, R., Kitajima, T., et al. (2021) · European Journal of Neurology · doi:10.1111/ene.14784 · Cited by 77 · see citing works
Randerath, W. J., Herkenrath, S. D., Treml, M., Grote, L., Hedner, J. A., Bonsignore, M. R., Pépin, J., Ryan, S., Schiza, S. E., Verbraecken, J. A., et al. (2021) · ERJ Open Research · doi:10.1183/23120541.00928-2020 · Cited by 68 · see citing works
Self-citationNovel avenues to approach non-CPAP therapy and implement comprehensive obstructive sleep apnoea care
Pépin, J., Eastwood, P. R., & Eckert, D. J. (2021) · European Respiratory Journal · doi:10.1183/13993003.01788-2021 · Cited by 67 · see citing works
Sweetman, A., McEvoy, R. D., Smith, S., Catcheside, P. G., Antic, N. A., Chai-Coetzer, C. L., Douglas, J., O’Grady, A., Dunn, N., Robinson, J., et al. (2020) · Sleep · doi:10.1093/sleep/zsaa002 · Cited by 62 · see citing works
Measures of cardiovascular autonomic activity in insomnia disorder: A systematic review
Nano, M.-M., Fonseca, P. M., Vullings, R., & Aarts, R. M. (2017) · PLoS ONE · doi:10.1371/journal.pone.0186716 · Cited by 63 · see citing works
Sex differences in sleep and sleep-disordered breathing
Schwarz, E. I., & Schiza, S. E. (2024) · Current Opinion in Pulmonary Medicine · doi:10.1097/mcp.0000000000001116 · Cited by 60 · see citing works
Challenges in obstructive sleep apnoea
McNicholas, W. T., Bassetti, C. L., Ferini‐Strambi, L., Pépin, J., Pevernagie, D., Verbraecken, J. A., Randerath, W. J., McNicholas, W. T., Bassetti, C. L., Ferini‐Strambi, L., et al. (2018) · The Lancet Respiratory Medicine · doi:10.1016/s2213-2600(18)30059-6 · Cited by 60 · see citing works
Self-citationCai, G., Theorell‐Haglöw, J., Janson, C., Svartengren, M., Elmståhl, S., Lind, L., & Lindberg, E. (2018) · Sleep Medicine · doi:10.1016/j.sleep.2018.03.009 · Cited by 57 · see citing works
Update on Oral Appliance Therapy for OSA
Marklund, M. (2017) · Current Sleep Medicine Reports · doi:10.1007/s40675-017-0080-5 · Cited by 56 · see citing works
Quan, W., Zheng, D., McEvoy, R. D., Barbé, F., Chen, R., Liu, Z., Loffler, K. A., Lorenzi‐Filho, G., Luo, Y., Mukherjee, S., et al. (2018) · EClinicalMedicine · doi:10.1016/j.eclinm.2018.09.002 · Cited by 53 · see citing works
Role of menopause and hormone replacement therapy in sleep-disordered breathing
Lindberg, E., Bonsignore, M. R., & Polo‐Kantola, P. (2019) · Sleep Medicine Reviews · doi:10.1016/j.smrv.2019.101225 · Cited by 56 · see citing works
Self-citationMcNicholas, W. T., & Korkalainen, H. (2023) · Frontiers in Neurology · doi:10.3389/fneur.2023.1239016 · Cited by 54 · see citing works
Self-citationWallace, D. M., & Wohlgemuth, W. K. (2019) · Journal of Clinical Sleep Medicine · doi:10.5664/jcsm.8094 · Cited by 51 · see citing works
Androgens modulate chronic intermittent hypoxia effects on brain and behavior
Snyder, B., Duong, P., Trieu, J., & Cunningham, R. L. (2018) · Hormones and Behavior · doi:10.1016/j.yhbeh.2018.09.005 · Cited by 48 · see citing works
Comorbid Insomnia and Sleep Apnea
Sweetman, A., Lack, L. C., Crawford, M., & Wallace, D. M. (2022) · Sleep Medicine Clinics · doi:10.1016/j.jsmc.2022.07.006 · Cited by 50 · see citing works
Ensemble-learning regression to estimate sleep apnea severity using at-home oximetry in adults
Gutiérrez‐Tobal, G. C., Álvarez, D., Vaquerizo-Villar, F., Crespo, A., Gozal, D., Gozal, D., del Campo, F., & Hornero, R. (2021) · Applied Soft Computing · doi:10.1016/j.asoc.2021.107827 · Cited by 44 · see citing works
Comorbid insomnia and sleep apnea in Veterans with post-traumatic stress disorder
El-Solh, A. A., Adamo, D., & Kufel, T. (2018) · Sleep And Breathing · doi:10.1007/s11325-017-1618-y · Cited by 42 · see citing works
Frangopoulos, F., Zannetos, S., Nicolaou, I., Economou, N.-T., Adamide, T. A., Georgiou, A., Nikolaidis, P. Τ., Rosemann, T. J., Knechtle, B., & Trakada, G. (2021) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2021.630162 · Cited by 43 · see citing works
Defining obstructive sleep apnoea syndrome: a failure of semantic rules
Riha, R. L. (2021) · Breathe · doi:10.1183/20734735.0082-2021 · Cited by 41 · see citing works
Self-citationRosenberg, R. P., Hirshkowitz, M., Rapoport, D. M., & Kryger, M. H. (2019) · Sleep Medicine · doi:10.1016/j.sleep.2019.01.014 · Cited by 40 · see citing works
Multimorbidity in COPD, does sleep matter?
Vanfleteren, L. E. G. W., Beghé, B., Andersson, A., Hansson, D., Fabbri, L. M., & Grote, L. (2020) · European Journal of Internal Medicine · doi:10.1016/j.ejim.2019.12.032 · Cited by 39 · see citing works
Self-citationSleep Apnea, Sleepiness, and Driving Risk
Bonsignore, M. R., Marrone, O., & Fanfulla, F. (2019) · Sleep Medicine Clinics · doi:10.1016/j.jsmc.2019.08.001 · Cited by 40 · see citing works
Self-citationDonovan, L. M., Shah, A., Chai-Coetzer, C. L., Barbé, F., Ayas, N. T., & Kapur, V. K. (2020) · Chest · doi:10.1016/j.chest.2019.10.002 · Cited by 36 · see citing works
Romero-Peralta, S., Rio, F. G., Barrio, P. R., Viejo-Ayuso, E., Izquierdo-Alonso, J. L., Sabroso, R., Castelao, J., Francés, J. F., & Mediano, O. (2021) · Archivos de Bronconeumología · doi:10.1016/j.arbres.2021.02.022 · Cited by 34 · see citing works
Bonsignore, M. R., Lombardi, C., Lombardo, S., & Fanfulla, F. (2022) · Journal of Clinical Medicine · doi:10.3390/jcm11133691 · Cited by 32 · see citing works
Self-citationExcessive daytime sleepiness in obstructive sleep apnea: implications for driving licenses
Garbarino, S. (2019) · Sleep And Breathing · doi:10.1007/s11325-019-01903-6 · Cited by 32 · see citing works
Andrade, L., & Paiva, T. (2018) · Journal of Clinical Sleep Medicine · doi:10.5664/jcsm.7264 · Cited by 29 · see citing works
Andrés-Blanco, A. M., Álvarez, D., Crespo, A., Arroyo, C. A., Cerezo-Hernández, A., Gutiérrez-Tobal, G. C., Hornero, R., & del Campo, F. (2017) · PLOS ONE · doi:10.1371/journal.pone.0188094 · Cited by 28 · see citing works
Luyster, F. S., Baniak, L. M., Imes, C. C., Jeon, B., Morris, J. L., Orbell, S. L., & Scott, P. W. (2024) · Sleep Health · doi:10.1016/j.sleh.2024.03.001 · Cited by 28 · see citing works
Sex and Sleep Disruption as Contributing Factors in Alzheimer’s Disease
Johnson, C. E., Duncan, M. J., & Murphy, M. P. (2023) · Journal of Alzheimer s Disease · doi:10.3233/jad-230527 · Cited by 34 · see citing works
Collaborators, O. B. O. T. E. S., Anttalainen, U., Grote, L., Fietze, I., Riha, R. L., Ryan, S., Staats, R., Hedner, J. A., & Saaresranta, T. (2018) · Sleep And Breathing · doi:10.1007/s11325-018-1757-9 · Cited by 28 · see citing works
Self-citationConte, L., Tafuri, B., Portaluri, M. G. A., Galiano, A., Maggiulli, E., & Nunzio, G. D. (2020) · Applied Sciences · doi:10.3390/app10176109 · Cited by 26 · see citing works
Sex differences in sleep apnea and comorbid neurodegenerative diseases
Snyder, B., & Cunningham, R. L. (2017) · Steroids · doi:10.1016/j.steroids.2017.12.006 · Cited by 25 · see citing works
Randerath, W. J., Grote, L., Stenlöf, K., Fietze, I., Chevts, J., Buntinx, E., Albares, J. B., Kuhn, K., Hansen, C., Völp, A., et al. (2025) · The Lancet · doi:10.1016/s0140-6736(25)01196-1 · Cited by 26 · see citing works
Self-citationSleep Deficiency in Obstructive Sleep Apnea
Adekolu, O., & Zinchuk, A. V. (2022) · Clinics in Chest Medicine · doi:10.1016/j.ccm.2022.02.013 · Cited by 24 · see citing works
Liu, K., Geng, S., Shen, P., Zhao, L., Zhou, P., & Liu, W. (2024) · Frontiers in Big Data · doi:10.3389/fdata.2024.1353469 · Cited by 22 · see citing works
Olaithe, M., Pushpanathan, M. E., Hillman, D. R., Eastwood, P. R., Hunter, M. L., Skinner, T. C., James, A. L., Wesnes, K. A., & Bucks, R. S. (2020) · Journal of Clinical Sleep Medicine · doi:10.5664/jcsm.8564 · Cited by 21 · see citing works
Future Treatment of Sleep Disorders
Pevernagie, D. (2021) · Sleep Medicine Clinics · doi:10.1016/j.jsmc.2021.05.005 · Cited by 20 · see citing works
Obstructive Sleep Apnea, Sleepiness, and Glycemic Control in Type 2 Diabetes
Aurora, R. N., & Punjabi, N. M. (2019) · Journal of Clinical Sleep Medicine · doi:10.5664/jcsm.7768 · Cited by 21 · see citing works
Social timing influences sleep quality in patients with sleep disorders
Reis, C., Pilz, L. K., Keller, L. K., Paiva, T., & Roenneberg, T. (2020) · Sleep Medicine · doi:10.1016/j.sleep.2020.02.019 · Cited by 22 · see citing works
Multimorbidity and overall comorbidity of sleep apnoea: a Finnish nationwide study
Palomäki, M., Saaresranta, T., Anttalainen, U., Partinen, M., Keto, J., & Linna, M. (2022) · ERJ Open Research · doi:10.1183/23120541.00646-2021 · Cited by 20 · see citing works
Self-citationNon-sleepy obstructive sleep apnoea: to treat or not to treat?
Altıntaş, N., & Riha, R. L. (2019) · European Respiratory Review · doi:10.1183/16000617.0031-2019 · Cited by 19 · see citing works
Self-citationTopîrceanu, A., Udrescu, L., Udrescu, M., & Mihaicuta, S. D. (2020) · Journal of Clinical Medicine · doi:10.3390/jcm9124025 · Cited by 18 · see citing works
Determinants of Sleepiness at Wheel and Missing Accidents in Patients With Obstructive Sleep Apnea
Fanfulla, F., Pinna, G. D., Marrone, O., Lupo, N. D., Arcovio, S., Bonsignore, M. R., & Morrone, E. (2021) · Frontiers in Neuroscience · doi:10.3389/fnins.2021.656203 · Cited by 19 · see citing works
Self-citationDrug-Induced Sleep-Disordered Breathing and Ventilatory Impairment
Grote, L. (2018) · Sleep Medicine Clinics · doi:10.1016/j.jsmc.2018.03.003 · Cited by 18 · see citing works
Self-citationTopîrceanu, A., Udrescu, M., Udrescu, L., Ardelean, C. L., Dan, R., Reisz, D., & Mihaicuta, S. D. (2018) · PLoS ONE · doi:10.1371/journal.pone.0202042 · Cited by 18 · see citing works
Sleep apnoea phenotypes in women: A cluster analysis from the ESADA cohort
Pataka, A., Pepin, J. L., Bonsignore, M. R., Schiza, S. E., Saaresranta, T., Bouloukaki, I., Steiropoulos, P., Trakada, G., Riha, R. L., Dogas, Z., et al. (2024) · Sleep Medicine · doi:10.1016/j.sleep.2024.10.015 · Cited by 17 · see citing works
Self-citationObstructive Sleep Apnea Phenotypes and Markers of Vascular Disease: A Review
Ramos, A. R., Figueredo, P., Shafazand, S., Chediak, A. D., Abreu, A. R., Dib, S. I., Torre, C. A., & Wallace, D. M. (2017) · Frontiers in Neurology · doi:10.3389/fneur.2017.00659 · Cited by 18 · see citing works
Kim, S., Alnakhli, W. M., Alfaraj, A. S., Kim, S. W., Liu, S. Y., & Liu, S. Y. (2020) · Sleep And Breathing · doi:10.1007/s11325-020-02062-9 · Cited by 17 · see citing works
Simple and Unbiased OSA Prescreening: Introduction of a New Morphologic OSA Prediction Score
Laharnar, N., Herberger, S., Prochnow, L., Chen, N., Cistulli, P. A., Pack, A. I., Schwab, R. J., Keenan, B. T., Mazzotti, D. R., Fietze, I., et al. (2021) · Nature and Science of Sleep · doi:10.2147/nss.s333471 · Cited by 16 · see citing works
Self-citationHagmeyer, L., Herkenrath, S.-D., Treml, M., Pietzke-Calcagnile, A., Anduleit, N., & Randerath, W. J. (2022) · Sleep And Breathing · doi:10.1007/s11325-022-02686-z · Cited by 16 · see citing works
Mediano, O., Pumarega, I. C., Sánchez‐de‐la‐Torre, M., Alonso-Álvarez, M. L., Troncoso, M. F., Rio, F. G., Egea, C., Durán‐Cantolla, J., Téran‐Santos, J., Barbé, F., et al. (2019) · Archivos de Bronconeumología · doi:10.1016/j.arbres.2019.05.017 · Cited by 17 · see citing works
Dieltjens, M., Verbraecken, J. A., Hedner, J., Vanderveken, O. M., Steiropoulos, P., Kvamme, J. A., Saaresranta, T., Tkáčová, R., Marrone, O., Dogas, Z., et al. (2018) · Sleep Medicine · doi:10.1016/j.sleep.2018.10.028 · Cited by 15 · see citing works
Self-citationSleep and Stroke: New Updates on Epidemiology, Pathophysiology, Assessment, and Treatment
Lau, H. L., Rundek, T., & Ramos, A. R. (2019) · Current Sleep Medicine Reports · doi:10.1007/s40675-019-00142-1 · Cited by 17 · see citing works
Bonsignore, M. R., & Hedner, J. A. (2018) · European Respiratory Journal · doi:10.1183/13993003.01666-2018 · Cited by 15 · see citing works
Self-citationThe negative health effects of having a combination of snoring and insomnia
Hägg, S. A., Ilieva, E., Ljunggren, M. E., Franklin, K. A., Middelveld, R. J. M., Lundbäck, B., Janson, C., & Lindberg, E. (2021) · Journal of Clinical Sleep Medicine · doi:10.5664/jcsm.9764 · Cited by 16 · see citing works
Neurotransmitter modulation of sleep-wake States: From molecular mechanisms to therapeutic potential
Ye, X., Pang, S., Ren, X., Wang, H., & Chen, M. (2025) · Sleep Medicine · doi:10.1016/j.sleep.2025.106547 · Cited by 17 · see citing works
Prevalence of chronic insomnia in patients with obstructive sleep apnea
Stelzer, F. G., García, E., Schorr, F., Barea, L. M., & Barros, H. T. (2020) · Brazilian Journal of Psychiatry · doi:10.1590/1516-4446-2019-0814 · Cited by 13 · see citing works
Lammintausta, A., Anttalainen, U., Başoğlu, Ö. K., Bonsignore, M. R., Gouveris, H. T., Grote, L., Hedner, J. A., Ludka, O., Mihaicuta, S. D., Pataka, A., et al. (2023) · ERJ Open Research · doi:10.1183/23120541.00506-2022 · Cited by 12 · see citing works
Self-citationCharacteristics of Patients with Obstructive Sleep Apnea at High Risk for Cardiovascular Disease
Bouloukaki, I., Fanaridis, M., Stathakis, G., Ermidou, C., Kallergis, E. M., Moniaki, V., Mauroudi, E., & Schiza, S. E. (2021) · Medicina · doi:10.3390/medicina57111265 · Cited by 12 · see citing works
Gabryelska, A., Turkiewicz, S., Białasiewicz, P., Grzybowski, F., Strzelecki, D., & Sochal, M. (2024) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2024.1303778 · Cited by 10 · see citing works
Serino, M., Cardoso, C. G., Cordeiro, R. J., Ferra, J. R. M., Aguiar, F. L., Rodrigues, E. D., Redondo, M., van Zeller, M., & Drummond, M. (2021) · Sleep Medicine · doi:10.1016/j.sleep.2021.09.010 · Cited by 11 · see citing works
Kairaitis, K., Madut, A., Subramanian, H., Trivedi, R., Man, H., Mather, M., Brand, A. H., Elder, E., Howle, J. R., Mann, G. J., et al. (2022) · Journal of Sleep Research · doi:10.1111/jsr.13588 · Cited by 9 · see citing works
Profile of CPAP treated patients in Ontario, Canada, 2006–2013: a population-based cohort study
Povitz, M., Kendzerska, T., Hanly, P. J., Jenkyn, K. B., Allen, B. N., George, C. F., & Shariff, S. Z. (2018) · Sleep Medicine · doi:10.1016/j.sleep.2018.06.005 · Cited by 10 · see citing works
Gautier‐Veyret, E., Pépin, J., & Stanke‐Labesque, F. (2017) · Pharmacology & Therapeutics · doi:10.1016/j.pharmthera.2017.12.006 · Cited by 9 · see citing works
Medical data exploration based on the heterogeneous data sources aggregation system
Opaliński, A., Regulski, K., Mrzygłód, B., Głowacki, M., Kania, A., Nastałek, P., Celejewska‐Wójcik, N., Bochenek, G., & Sładek, K. (2019) · Annals of Computer Science and Information Systems · doi:10.15439/2019f258 · Cited by 9 · see citing works
Svedmyr, S., Hedner, J. A., Bonsignore, M. R., Lombardi, C., Parati, G., Ludka, O., Zou, D., Grote, L., & the European Sleep Apnea Database (ESADA) study group (full collaborator list in E‐supplement) (2022) · Journal of Sleep Research · doi:10.1111/jsr.13811 · Cited by 9 · see citing works
Self-citationDiagnostic criteria for obstructive sleep apnea: time for reappraisal
McNicholas, W. T. (2018) · Journal of Thoracic Disease · doi:10.21037/jtd.2017.12.91 · Cited by 8 · see citing works
Self-citationArdelean, C. L., Pescariu, S., Lighezan, D., Pleava, R. M., Ursoniu, S., Nădășan, V., & Mihaicuta, S. D. (2019) · Medicina · doi:10.3390/medicina55080449 · Cited by 8 · see citing works
A nationwide study on the prevalence and contributing factors of obstructive sleep apnea in Iran
Sadeghniiat‐Haghighi, K., Akbarpour, S., Behkar, A., Moradzadeh, R., Alemohammad, Z. B., Forouzan, N., Mouseli, A., Amirifard, H., & Najafi, A. (2023) · Scientific Reports · doi:10.1038/s41598-023-44229-w · Cited by 8 · see citing works
Liu, J., Zang, C., Yi, M., & Zhang, Y. (2024) · Behavioral Sleep Medicine · doi:10.1080/15402002.2024.2324361 · Cited by 7 · see citing works
Challenges in Obstructive Sleep Apnea Management in Elderly Patients
Joskin, A., & Bruyneel, M. (2024) · Journal of Clinical Medicine · doi:10.3390/jcm13247718 · Cited by 9 · see citing works
Mediano, O., Pumarega, I. C., Sánchez‐de‐la‐Torre, M., Alonso-Álvarez, M. L., Troncoso, M. F., Rio, F. G., Egea, C., Durán‐Cantolla, J., Téran‐Santos, J., Barbèc, F., et al. (2020) · Archivos de Bronconeumología · doi:10.1016/j.arbr.2019.05.020 · Cited by 7 · see citing works
Ferreira‐Santos, D., & Rodrigues, P. P. (2021) · JMIR Medical Informatics · doi:10.2196/25124 · Cited by 6 · see citing works
Obstructive sleep apnoea in adult patients post-tonsillectomy
Riha, R. L., Kotoulas, S., Pataka, A., Kvamme, J. A., Joppa, P., Hedner, J. A., Anttalainen, U., Barbé, F., Bonsignore, M. R., Başoğlu, Ö. K., et al. (2020) · Sleep Medicine · doi:10.1016/j.sleep.2020.11.024 · Cited by 6 · see citing works
Self-citationPeker, Y., Başoğlu, Ö. K., Fırat, H., & the TURKAPNE Study Group (2018) · Turkish Thoracic Journal · doi:10.5152/turkthoracj.2018.18097 · Cited by 5 · see citing works
Obstruktív alvási apnoéban szenvedő betegek jellemzői hazai beteganyagon
Bikov, A., Mészáros, M., & Kunos, L. (2020) · Orvosi Hetilap · doi:10.1556/650.2020.31880 · Cited by 5 · see citing works
Sleep Deficiency in Obstructive Sleep Apnea
Adekolu, O., Ahsan, M., Anwar, A. I., & Zinchuk, A. V. (2024) · Sleep Medicine Clinics · doi:10.1016/j.jsmc.2024.08.002 · Cited by 4 · see citing works
Toward Patient-Centric Digital Monitoring of Obstructive Sleep Apnea: Mixed Methods Study
Timmis, J. K., Schorr, K. A., Yüksel, R., van den Broek, T., Overeem, S., Smid, D. J., van den Brink, W. J., & Haring, N. L. (2025) · Journal of Medical Internet Research · doi:10.2196/82460 · Cited by 4 · see citing works
Ntenta, P., Vavougios, G. D., Zarogiannis, S. G., & Gourgoulianis, K. I. (2022) · Healthcare · doi:10.3390/healthcare10020338 · Cited by 4 · see citing works
Gozal, D. (2018) · European Respiratory Journal · doi:10.1183/13993003.00802-2018 · Cited by 4 · see citing works
- Authors
- Saaresranta, T., Hedner, J., Bonsignore, M. R., Riha, R. L., McNicholas, W. T., Penzel, T., Anttalainen, U., Kvamme, J. A., Pretl, M., Sliwinski, P., Verbraecken, J., Grote, L., & ESADA Study Group
- Affiliations
- University of Turku (FI)
- Sahlgrenska University Hospital (SE)
- Istituto di Biomedicina e di Immunologia Molecolare Alberto Monroy (IT)
- Edinburgh Royal Infirmary (GB)
- University College Dublin (IE)
- International Clinical Research Center, St. Anne's University Hospital Brno (CZ)
- Helse Førde (NO)
- Charles University (CZ)
- University of Antwerp (BE)
- Corresponding author
- Saaresranta, Tarja
- ORCID
- Venue
- PLOS ONE
- Publisher
- Public Library of Science (PLoS)
- Published
- 2016-10-04
- Volume
- 11
- Issue
- 10
- Pages
- e0163439
- ISSN
- 1932-6203 (ISSN-L)
- PMC
- PMC5049787
- OpenAlex
- W2529555766
- Cited by
- 154
- References
- 45
- Citations by year
- 2026: 9 · 2025: 12 · 2024: 16 · 2023: 11 · 2022: 13 · 2021: 20 · 2020: 19 · 2019: 20 · 2018: 24 · 2017: 10
- FWCI
- 14.49
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- PLoS ONE (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Repositori ObertUDL (University of Lleida) (publishedVersion, other-oa)
- UTUPub (University of Turku) (submittedVersion)
- BOA (University of Milano-Bicocca) (submittedVersion, other-oa)
- Digital Access to Libraries (Université catholique de Louvain (UCL), l'Université de Namur (UNamur) and the Université Saint-Louis (USL-B)) (submittedVersion, other-oa)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Figshare (submittedVersion, cc-by)
- Nova Science Publishers (Nova Science Publishers, Inc.) (submittedVersion, other-oa)
- Edinburgh Research Explorer (University of Edinburgh) (submittedVersion, cc-by)
- RECERCAT (Consorci de Serveis Universitaris de Catalunya) (submittedVersion, cc-by)
- Funders
- European Respiratory Society
- Sleep Research Society
- ResMed
- Ege Üniversitesi
- Università degli Studi di Palermo
- Turun Yliopisto
- Sahlgrenska Universitetssjukhuset
- Universiteit Antwerpen
- Filha
- Turun Yliopistollinen Keskussairaala
- Topics
- Health Sciences › Medicine › Physiology › Obstructive Sleep Apnea Research
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Chronic Obstructive Pulmonary Disease (COPD) Research
- Keywords
- obstructive sleep apnea, clinical phenotype, comorbidities, excessive daytime sleepiness, insomnia, cardiovascular comorbidity, psychiatric comorbidity, CPAP adherence, apnea-hypopnea index, European patients
- MeSH terms
- Adolescent, Adult, Aged, Aged, 80 and over, Female, Follow-Up Studies, Humans, Male, Middle Aged, Phenotype, Prospective Studies, Risk Factors, Sleep Apnea Syndromes, Comorbidity, Prevalence, White People, Young Adult
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