Clinical phenotypes of obstructive sleep apnea in a sample of Saudi population

Obstructive sleep apnea (OSA) presents with diverse clinical manifestations, complicating its diagnosis and management. Cluster-based phenotyping has emerged as a promising approach to improve diagnostic precision and guide individualized therapy; however, such data are lacking in Saudi Arabia. To address this gap, we used clinical OSA clusters from a previous clustering analysis to determine their prevalence in the Saudi population.

We reviewed the records of 650 adult patients with OSA from a single sleep laboratory in Saudi Arabia. Participants were classified into sleepy, insomniac, or minimal symptomatic clusters based on their chief complaint. Demographics, anthropometrics, medical history, Epworth Sleepiness Scale (ESS), and polysomnography measurements were compared between groups.

The sleepy, insomnia, and minimally symptomatic clusters comprised 41%, 30%, and 29% of the cohort, respectively. The minimally symptomatic group was significantly younger than the sleepy and insomniac groups (47±15 vs. 50±16 vs. 52±15 years, respectively; p=0.01). The insomniac group had a lower BMI than the sleepy and minimally symptomatic groups (34±9 vs. 37±9 vs. 39±11 kg/m2, respectively; p<0.001). The sleepy group had higher ESS than the insomniac and minimally symptomatic groups (14±5 vs. 8±6 and 10±6, respectively; p<0.001). The proportion of patients with a high risk of OSA was greater in the sleepy group than in the insomniac and minimally symptomatic groups (75%, 62%, and 67%, respectively; p=0.03).

The clinical clusters from international cohorts of sleepiness, insomnia, and minimal symptoms were applicable in patient with OSA in the Saudi population.