{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,31]],"date-time":"2026-10-31T05:08:11Z","timestamp":1793423291623,"version":"4.5.0"},"reference-count":16,"publisher":"Oxford University Press (OUP)","issue":"11","license":[{"start":{"date-parts":[[2022,3,5]],"date-time":"2022-03-05T00:00:00Z","timestamp":1646438400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,11,9]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Study Objectives<\/jats:title>\n                  <jats:p>Upper airway stimulation (UAS) therapy is effective for a subset of obstructive sleep apnea (OSA) patients with continuous positive airway pressure (CPAP) intolerance. While overall adherence is high, some patients have suboptimal adherence, which limits efficacy. Our goal was to identify therapy usage patterns during the first 3 months of therapy to enable targeted strategies for improved adherence.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Therapy data was retrieved from 2098 patients for three months after device activation. Data included mean and standard deviation (SD) of hours of use, therapy pauses, hours from midnight the therapy was turned ON and OFF, percentage of missing days, and stimulation amplitude. Cluster analysis was performed using Gaussian mixture models that categorized patients into six main groups.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>The six groups and their prevalence can be summarized as Cluster 1A: Excellent Use (34%); Cluster 1B: Excellent Use with variable timing (23%); Cluster 2A: Good Use with missing days and late therapy ON (16%), Cluster 2B: Good Use with missing days, late therapy ON, and early therapy OFF (12%); Cluster 3A: Variable Use with frequent missing days (8%); Cluster 3B: Variable Use with frequent pauses (7%). Most patients (85%) are excellent or good users with mean therapy use &amp;gt;6 hours per night.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Cluster analysis of early UAS usage patterns identified six distinct groups that may enable personalized interventions for improved long-term management. Differentiation of the patient clusters may have clinical implications with regard to sleep hygiene education, therapy discomfort, comorbid insomnia, and other conditions that impact adherence.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/sleep\/zsac049","type":"journal-article","created":{"date-parts":[[2022,3,5]],"date-time":"2022-03-05T00:33:10Z","timestamp":1646440390000},"source":"Crossref","is-referenced-by-count":20,"title":["Cluster analysis of upper airway stimulation adherence patterns and implications on clinical care"],"prefix":"10.1093","volume":"45","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5200-1505","authenticated-orcid":false,"given":"Ryan J","family":"Soose","sequence":"first","affiliation":[{"name":"UPMC Department of Otolaryngology, University of Pittsburgh , Pittsburgh, PA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matheus","family":"Araujo","sequence":"additional","affiliation":[{"name":"Department of Computer Science and Engineering, University of Minnesota , Minneapolis, MN , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kevin","family":"Faber","sequence":"additional","affiliation":[{"name":"Sanford Health, Sleep Medicine , Fargo, ND , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Asim","family":"Roy","sequence":"additional","affiliation":[{"name":"Ohio Sleep Medicine Institute , Columbus, OH , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kent","family":"Lee","sequence":"additional","affiliation":[{"name":"Inspire Medical Systems , Golden Valley, MN , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Quan","family":"Ni","sequence":"additional","affiliation":[{"name":"Inspire Medical Systems , Golden Valley, MN , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jaideep","family":"Srivastava","sequence":"additional","affiliation":[{"name":"Department of Computer Science and Engineering, University of Minnesota , Minneapolis, MN , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patrick J","family":"Strollo","sequence":"additional","affiliation":[{"name":"UPMC Division of Pulmonary Allergy and Critical Care Medicine, University of Pittsburgh , Pittsburgh, PA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2022,3,5]]},"reference":[{"issue":"2","key":"2022110907591228200_CIT0001","doi-asserted-by":"crossref","first-page":"139","DOI":"10.1056\/NEJMoa1308659","article-title":"Upper-airway stimulation for obstructive sleep apnea","volume":"370","author":"Strollo","year":"2014","journal-title":"N Engl J Med."},{"issue":"7","key":"2022110907591228200_CIT0002","doi-asserted-by":"crossref","first-page":"1676","DOI":"10.1002\/lary.29396","article-title":"Drug-induced sleep endoscopy and hypoglossal nerve stimulation outcomes: a multicenter cohort study","volume":"131","author":"Huyett","year":"2021","journal-title":"Laryngoscope"},{"key":"2022110907591228200_CIT0003","first-page":"V001T08A003","article-title":"Visualizing telemetry metrics from upper-airway stimulation to enhance sleep therapy management.","volume-title":"Frontiers in Biomedical Devices","author":"Araujo","year":"2020"},{"issue":"1","key":"2022110907591228200_CIT0004","doi-asserted-by":"crossref","first-page":"1801405","DOI":"10.1183\/13993003.01405-2018","article-title":"Post-approval upper airway stimulation predictors of treatment effectiveness in the ADHERE registry","volume":"53","author":"Heiser","year":"2019","journal-title":"Eur Respir J."},{"issue":"4","key":"2022110907591228200_CIT0005","doi-asserted-by":"crossref","first-page":"703","DOI":"10.5664\/jcsm.9008","article-title":"Adherence with positive airway pressure therapy for obstructive sleep apnea in developing vs. developed countries: a big data study","volume":"17","author":"Drager","year":"2021","journal-title":"J Clin Sleep Med"},{"issue":"8","key":"2022110907591228200_CIT0006","doi-asserted-by":"crossref","first-page":"2023","DOI":"10.5664\/jcsm.10038","article-title":"The impact of different CPAP delivery approaches on nightly adherence and discontinuation rate in patients with obstructive sleep apnea","volume":"18","author":"Stanchina","year":"2022","journal-title":"J Clin Sleep Med"},{"issue":"1","key":"2022110907591228200_CIT0007","doi-asserted-by":"crossref","first-page":"91","DOI":"10.1080\/00273171.2014.958211","article-title":"Identifying Longitudinal Patterns for Individuals and Subgroups: An Example with Adherence to Treatment for Obstructive Sleep Apnea","volume":"50","author":"Babbin","year":"2015","journal-title":"Multivariate Behav Res"},{"issue":"1","key":"2022110907591228200_CIT0008","doi-asserted-by":"crossref","first-page":"288","DOI":"10.1016\/j.chest.2015.09.032","article-title":"Institut de Recherche en Sant\u00e9 Respiratoire des Pays de la Loire Sleep Cohort Group. Relationship Between OSA Clinical Phenotypes and CPAP Treatment Outcomes","volume":"149","author":"Gagnadoux","year":"2016","journal-title":"Chest"},{"issue":"9","key":"2022110907591228200_CIT0009","doi-asserted-by":"crossref","first-page":"1785","DOI":"10.5664\/jcsm.9288","article-title":"Treatment usage patterns of oral appliances for obstructive sleep apnea over the first 60 days: a cluster analysis","volume":"17","author":"Sutherland","year":"2021","journal-title":"J Clin Sleep Med"},{"key":"2022110907591228200_CIT0010","first-page":"2825","article-title":"Scikit-learn: Machine learning in Python","volume":"12","author":"Pedregosa","year":"2011","journal-title":"The Journal of Machine Learning Research"},{"issue":"5","key":"2022110907591228200_CIT0011","doi-asserted-by":"crossref","first-page":"1005","DOI":"10.5664\/jcsm.9100","article-title":"Defining the patterns of PAP adherence in pediatric obstructive sleep apnea: a clustering analysis using real-world data","volume":"17","author":"Weiss","year":"2021","journal-title":"J Clin Sleep Med"},{"issue":"12","key":"2022110907591228200_CIT0012","doi-asserted-by":"crossref","first-page":"505","DOI":"10.1042\/CS20100588","article-title":"Eszopiclone increases the respiratory arousal threshold and lowers the apnoea\/hypopnoea index in obstructive sleep apnoea patients with a low arousal threshold","volume":"120","author":"Eckert","year":"2011","journal-title":"Clin Sci"},{"issue":"4","key":"2022110907591228200_CIT0013","doi-asserted-by":"crossref","first-page":"714","DOI":"10.1177\/0194599819848709","article-title":"Upper airway stimulation response in older adults with moderate to severe obstructive sleep apnea","volume":"161","author":"Withrow","year":"2019","journal-title":"Otolaryngol Head Neck Surg"},{"issue":"7","key":"2022110907591228200_CIT0014","doi-asserted-by":"crossref","first-page":"1079","DOI":"10.1016\/j.pec.2016.01.020","article-title":"Health literacy and adherence to medical treatment in chronic and acute illness: A meta-analysis","volume":"99","author":"Miller","year":"2016","journal-title":"Patient Educ Couns"},{"issue":"12","key":"2022110907591228200_CIT0015","doi-asserted-by":"crossref","first-page":"2477","DOI":"10.5664\/jcsm.9542","article-title":"Improving outcomes of hypoglossal nerve stimulation therapy: current practice, future directions and research gaps. Proceedings of the 2019 International Sleep Surgery Society Research Forum","volume":"17","author":"Suurna","year":"2021","journal-title":"J Clin Sleep Med"},{"key":"2022110907591228200_CIT0016","doi-asserted-by":"crossref","first-page":"580","DOI":"10.1109\/CBMS52027.2021.00104","article-title":"Defining and Monitoring Patient Clusters Based on Therapy Adherence in Sleep Apnea Management.","volume-title":"2021 IEEE 34th International Symposium on Computer-Based Medical Systems (CBMS)","author":"Baddam","year":"2021"}],"container-title":["Sleep"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/sleep\/advance-article-pdf\/doi\/10.1093\/sleep\/zsac049\/45417882\/zsac049.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/sleep\/article-pdf\/45\/11\/zsac049\/46650927\/zsac049.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/sleep\/article-pdf\/45\/11\/zsac049\/46650927\/zsac049.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,11,9]],"date-time":"2022-11-09T07:59:51Z","timestamp":1667980791000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/sleep\/article\/doi\/10.1093\/sleep\/zsac049\/6542728"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,3,5]]},"references-count":16,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2022,3,5]]},"published-print":{"date-parts":[[2022,11,9]]}},"URL":"https:\/\/doi.org\/10.1093\/sleep\/zsac049","relation":{},"ISSN":["0161-8105","1550-9109"],"issn-type":[{"value":"0161-8105","type":"print"},{"value":"1550-9109","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2022,11,1]]},"published":{"date-parts":[[2022,3,5]]},"article-number":"zsac049"}}