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- W4379163516 abstract "Obstructive sleep apnea (OSA) and type 2 diabetes (T2Dia) is a frequent clinical association. Beyond OSA-related hypoxic burden, increased respiratory effort (RE) is one of the main features of OSA and contributes to sympathetic overactivity that in turn might participate to glucose homeostasis dysregulation. The independent contribution of RE to the OSA-T2Dia pathogenesis remains to be demonstrated. The study aims to determine the impact of metrics assessing sleep respiratory effort (RE) derived from the sleep mandibular jaw movements (MJM) signal on the prevalence of T2Dia in a large cohort of patients addressed for in laboratory conventional polysomnography (PSG) with the suspicion of OSA. A machine learning model was built to predict T2Dia from clinical data, PSG indices, and MJM-derived parameters (including the time spent in increased RE, %TST). The analysis included 1128 subjects, randomly assigned to training (n=853) and validation (n=275) subsets with equal T2Dia prevalence of 10%. The risk stratification model based on eighteen input features including increased RE (Figure) showed good performance for predicting prevalent T2Dia (sensitivity=0.81, specificity=0.89). Post-hoc interpretation using the Shapley additive explanation (SHAP) method revealed that increased RE was the most important risk factor of T2Dia after classical clinical factors for T2Dia (i.e. age, sex, BMI) and longer desaturation time, ahead of standard PSG metrics (including the apnea-hypopnea index and oxygen desaturation index). These findings suggested that the proportion of sleep time spent with increased RE automatically derived from MJM is a potential new reliable metric to predict prevalent T2Dia in patients with OSA." @default.
- W4379163516 created "2023-06-03" @default.
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- W4379163516 date "2023-04-20" @default.
- W4379163516 modified "2023-10-18" @default.
- W4379163516 title "Respiratory Effort During Sleep And Prevalent Diabetes In Obstructive Sleep Apnea" @default.
- W4379163516 doi "https://doi.org/10.1183/23120541.sleepandbreathing-2023.78" @default.
- W4379163516 hasPublicationYear "2023" @default.
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