Differences in the prevalence of cardiovascular and metabolic diseases coinciding with clinical subtypes of obstructive sleep apnea

Clin Cardiol. 2023 Jan;46(1):92-99. doi: 10.1002/clc.23941. Epub 2022 Nov 20.


Background: It is unclear about the cardiovascular and metabolic diseases (CMD) among Chinese patients with different clinical subtypes of obstructive sleep apnea (OSA).

Hypothesis: The prevalence of CMD varies among OSA patients of different clinical subtypes.

Methods: A total of 1483 Chinese patients with OSA were assessed to evaluate the existence of clinical subtypes of OSA using latent class analysis. We compared the differences in demographic characteristics and prevalence of CMD using ANOVA and χ2 tests. Associations between clinical subtypes and disease prevalence were assessed using adjusted logistic regression.

Results: We identified prevalent CMD in Chinese patients with the four subtypes of OSA: excessively sleepy (ES), moderately sleepy with disturbed sleep (ModSwDS), moderately sleepy (ModS), and minimally symptomatic (MinS). The ES subtype had a higher body mass index, average Epworth Sleepiness Scale score, Apnea-hypopnea index, and oxyhemoglobin saturation below 90% compared with the other subtypes (p < .05). The MinS subtype had the lowest mean ESS score (p < .05). We found a significant difference in the prevalence of CMD among the four subtypes, with the highest proportion of cases of CMD in the ES subtype. In adjusted models, significant associations with CMD were also found. ES, ModSwDS, ModS, and MinS subtypes are very high-risk, high-risk, medium-risk, and low-risk in prevalent CMD.

Conclusions: This study identified four clinical subtypes of OSA in Chinese patients. Each clinical subtype corresponds with a different level of prevalence of CMD; this finding is helpful for the more precise treatment of patients with different clinical manifestations.

Keywords: cardiovascular and metabolic diseases; clinical subtypes; latent cluster analysis; obstructive sleep apnea.

MeSH terms

  • Cardiovascular Diseases* / complications
  • Cardiovascular Diseases* / diagnosis
  • Cardiovascular Diseases* / epidemiology
  • Humans
  • Metabolic Diseases* / complications
  • Prevalence
  • Sleep Apnea, Obstructive* / complications
  • Sleep Apnea, Obstructive* / diagnosis
  • Sleep Apnea, Obstructive* / epidemiology