Executive Summary
The problem
Obstructive sleep apnea (OSA) is a highly prevalent condition in Western countries, associated with reduced quality of life, cardiovascular and metabolic morbidities, among others. Nocturnal polysomnography (PSG) monitors various body systems during sleep and is the standard method used to determine the presence and severity of OSA.
Substantial discrepancies between PSG results and the presence of comorbidities suggest the existence of different phenotypes of the disease. These phenotypes, not yet fully defined, could be identified through the combined information from sociodemographic, clinical, and anthropometric characteristics, as well as data extracted from various nocturnal biomedical signals recorded during PSG.
Between the Northern region of Portugal and Castilla y León, the number of patients diagnosed with OSA is approximately half a million. However, OSA is an underdiagnosed condition, with the actual number of patients estimated to be double
OSA phenotyping has never been systematically implemented in clinical practice, leaving room for improvement in the personalization of healthcare services provided.
The identification of new phenotypes of OSA is possible through the combination of sociodemographic and anthropometric variables with an in-depth analysis of the nocturnal signals recorded during PSG.
Is it possible to define a clinical protocol for the automatic identification of OSA phenotypes that combines information derived from PSG analysis with data from demographic, clinical, and anthropometric variables?
Main objective
The general objective of the project is to stimulate a cross-border collaborative R&D network for the collection and analysis of information necessary to define new clinically useful phenotypes of obstructive sleep apnea associated with various comorbidities.
Specific objectives
Obtain the clinical, demographic, and anthropometric data, as well as the polysomnographic signal records of the individuals participating in the study.
To carry out data collection from participants, the four consortium members will collaborate following a sampling strategy aimed at ensuring the participation of a total of 600 subjects (50% in Porto and 50% in Valladolid).
To evaluate the clinical, demographic, and anthropometric data, as well as the polysomnographic signal records for their characterization according to the different OSA groups.
The profiles of the participants will be obtained from the collected data, on one hand, through the analysis of clinical, demographic, and anthropometric data, and on the other hand, through the processing and characterization of polysomnographic signals.
To define new clinically useful phenotypes of obstructive sleep apnea associated with different comorbidities and levels of treatment effectiveness.
New OSA phenotypes will be defined to provide better and more effective, personalized, and patient-adapted treatment through three actions: i) the identification of the most useful characteristics for phenotyping based solely on clinical, demographic, and anthropometric information; ii) the determination of the most useful characteristics for phenotyping based solely on information derived from polysomnographic signals; and iii) the identification of phenotypes based on the characteristics that have been determined to be most relevant in the first two actions.
To design the automatic tool to identify the specific phenotype of each patient, assisting in the diagnosis of OSA
The design of the automatic tool will be carried out to identify the specific phenotype of each patient, based on the combination of clinical, anthropometric, and demographic information, as well as polysomnographic signals.
To analyze the results obtained and draw conclusions
An integral assessment of the results obtained will be carried out, with particular attention to the feasibility of transferring the actions derived from the project, analyzing the characteristics of comprehensive phenotyping and diagnostic tools in routine practice.
Partnership
The Biomedical Engineering Group (GIB) at the University of Valladolid is a research group primarily composed of engineers and doctors from various specialties (pulmonology, ophthalmology, neurology, neurophysiology, and psychiatry), who work together on different research lines. In particular, it has extensive experience in the analysis of polysomnographic signals to assist in the diagnosis of OSA. The multiple projects it has participated in and its growing scientific production of high impact demonstrate the group's strong research capabilities.
The Faculty of Medicine of the University of Porto (FMUP) is one of the most prestigious higher education institutions in Portugal, both nationally and internationally. FMUP has supported 250 clinical trials and produced over 6,000 articles in journals indexed on the Web of Science. It is home to the R&D unit Health Technologies and Services Research Center (CINTESIS), with extensive experience in the analysis of clinical, demographic, and anthropometric data of patients with OSA.
Pedro Pereira Rodrigues
Co-principal investigator of CINTESIS
Daniela Ferreira Santos
Co-principal investigator of CINTESIS
The Regional Health Management of Castilla y León (GRS) is the organization responsible for managing public health services and healthcare in the autonomous community of Castilla y León. Among its main functions is promoting scientific research and the application of new technologies in the healthcare sector. It is the cornerstone for providing public healthcare services in Castilla y León, ensuring the well-being and health of its citizens. Similarly, the Río Hortega University Hospital (HURH) has adequate technical resources for the project, such as laboratories and a sleep unit.
Tomás Ruiz Albi
Head of the Pulmonology Unit at HURH
The Centro Hospitalar Universitário de São João (CHUSJ) is a national reference center in 15 distinct areas and a member of 7 European reference networks. Its professionals participate in clinical, epidemiological, and laboratory research studies in accordance with good clinical practices and current legislation. Its members have extensive experience in the diagnosis of OSA and the clinical manifestation of different subgroups within the disease.
Marta Drummond
Neumologist at CHUSJ
