OSA patients not treated with PAP - evolution 5 years ahead according to Baveno classification

Abstract

Introduction: Obstructive sleep apnea (OSA) patients (pts) are at increased risk of morbimortality. Recently, Baveno’s classification, a multicomponent grading system, integrating symptoms, comorbidities and end-organ damage (EOD) was proposed. Studies on the long-term evolution of OSA pts not candidates for PAP therapy at diagnosis are scarce. We evaluated the temporal variation of the Baveno’s Classification Group from OSA diagnosis to 5-years ahead.

Methods: Of the 79-pts diagnosed with OSA in 2015, not candidates for PAP therapy, 76 were included. A phone questionnaire, including anthropometric measures, symptoms and comorbidities, was performed. Patients were classified into groups, according to Baveno’s classification, at diagnosis and 5 years later.

Results: There were 76 pts (57.9% male, mean age of 51.9±10.1 years), with a median AHI of 9.0 (5.8-11.8); 43.4% were classified in group A and 56.6% in group B. After 5 years, the reclassification was: 56.6% in group A, 32.9% in group B, 2.6% in group C and 7.9% in group D. Half of the pts remained in the same group, 10.5% developed EOD. Pts with EOD were significantly older (p=0.007). There was a statistically significant relation between EOD and diabetes, dyslipidemia and HT. There weren’t significant differences regarding symptoms or PSG results between pts that developed or not EOD. A logistic regression model was built to predict the development of EOD over 5 years; older age and diabetes significantly predicted it.

Conclusions: After 5 years, 50% of pts, not candidates for PAP at diagnosis, remained in the same Baveno group, and 10.5% developed EOD. Older age and diabetes were the most important factors to predict EOD.