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Volume 14 No. 03
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Accepted Papers

Scientific Investigations

Symptom-Based Subgroups of Koreans With Obstructive Sleep Apnea

Jinyoung Kim, PhD, RN1,2; Brendan T. Keenan, MS2; Diane C. Lim, MD, MTR2,3,4; Seung Ku Lee, PhD5; Allan I. Pack, MB ChB, PhD2,3; Chol Shin, MD, PhD5,6
1University of Pennsylvania School of Nursing, Philadelphia, Pennsylvania; 2Center for Sleep and Circadian Neurobiology, University of Pennsylvania, Philadelphia, Pennsylvania; 3Division of Sleep Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania; 4Department of Medicine, Corporal Michael J. Crescenz Veterans Affairs Medical Center, Philadelphia, Pennsylvania; 5Institute of Human Genomic Study, Korea University Ansan Hospital, Ansan, Korea; 6School of Medicine, Korea University, Seoul, Korea

Study Objectives:

Recently, the Icelandic Sleep Apnea Cohort (ISAC) identified three subgroups in patients with obstructive sleep apnea (OSA) recruited from the sleep clinic based on clinical symptoms and comorbidities: excessively sleepy, minimally symptomatic, and disturbed sleep. This study sought to determine whether the three OSA subgroups are applicable to a population-based cohort in Korea.


Study subjects are participants of an ongoing cohort study in Korea. Of the 2,918 participants, 422 new moderate to severe OSA cases (apneahypopnea index [AHI] ≥ 15 events/h) were diagnosed by home sleep studies. All participants completed a detailed questionnaire on sleep-related symptoms, comorbidities, medication, and other information. A latent class analysis was performed.


When examining solutions for up to 10 clusters, the a priori three-cluster solution was the optimal clustering solution. The three-cluster solution demonstrated a subgroup presentation similar to the clusters identified in the ISAC. The minimally symptomatic subgroup was most prevalent (55.7%) in the Korean cohort. Among the three subgroups, there were no differences in mean AHI and body mass index; however, the disturbed sleep subgroup was older and had more females.


Combined with the ISAC data, we suggest that the three-symptom cluster solution for patients with OSA may be more widely applicable, irrespective of ethnicity and study population.


Kim J, Keenan BT, Lim DC, Lee SK, Pack AI, Shin C. Symptom-based subgroups of koreans with obstructive sleep apnea. J Clin Sleep Med. 2018;14(3):437–443.

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