{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"institution":[{"name":"medRxiv"}],"indexed":{"date-parts":[[2026,5,30]],"date-time":"2026-05-30T16:04:28Z","timestamp":1780157068188,"version":"3.54.0"},"posted":{"date-parts":[[2026,5,28]]},"group-title":"Epidemiology","reference-count":60,"publisher":"openRxiv","license":[{"start":{"date-parts":[[2026,5,28]],"date-time":"2026-05-28T00:00:00Z","timestamp":1779926400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"crossref","award":["R01HL153805"],"award-info":[{"award-number":["R01HL153805"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/100013981","name":"American Academy of Sleep Medicine Foundation","doi-asserted-by":"crossref","award":["338-SR-24"],"award-info":[{"award-number":["338-SR-24"]}],"id":[{"id":"10.13039\/100013981","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"accepted":{"date-parts":[[2026,5,28]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                <jats:p>Obstructive sleep apnea (OSA) is associated with a wide range of comorbidities, but the extent to which these follow predictable, age-dependent patterns is not well understood. Identifying such patterns could provide insight into OSA heterogeneity and its links to physiological measures of OSA. We trained age-dependent topic models (ATM) on longitudinal electronic health records from 36,426 patients with OSA in the Mass General Brigham Biobank. ATM organizes incident diagnoses into distinct comorbidity \u201ctopics,\u201d whose age-specific disease loadings represent predictive patterns linking related diagnoses across the life course. We applied the trained model to compute individual-level topic scores in independent data: a cohort of 11,689 OSA cases and 22,695 matched controls, and a cohort of 6,220 patients with polysomnography (PSG)-derived physiological measures. We identified 19 distinct age-dependent comorbidity profiles, all significantly associated with OSA case status (FDR-adjusted p&lt;0.05). Topics reflected recognizable clusters including metabolic, neuropsychiatric, and immune-mediated conditions, and several were distinguished by age-of-onset of key comorbidities, such as early- vs late-onset asthma. Seventeen of the 19 topics were significantly associated with at least one of 13 PSG-derived physiological measures, including associations between cardiometabolic topics and the apnea-hypopnea index, sleep apnea specific hypoxic burden, and respiratory event-specific heart rate burden. These findings indicate that age-dependent comorbidity patterns distinguish meaningful OSA subtypes with differing prognoses and endophenotype associations. ATM offers insight into complex OSA comorbidity and suggests that age-informed, topic-based stratification may improve individualized risk assessment, interpretation of PSG findings, and targeting of clinical interventions.<\/jats:p>\n                <jats:sec>\n                  <jats:title>One Sentence Summary<\/jats:title>\n                  <jats:p>Analysis of age-specific patterns in comorbidities of obstructive sleep apnea reveals insights for personalized care and risk stratification.<\/jats:p>\n                <\/jats:sec>","DOI":"10.64898\/2026.05.20.26352336","type":"posted-content","created":{"date-parts":[[2026,5,28]],"date-time":"2026-05-28T20:55:13Z","timestamp":1780001713000},"source":"Crossref","is-referenced-by-count":0,"title":["Distinguishing Age-specific Patterns in Comorbidities of Obstructive Sleep Apnea Using Real-World Data"],"prefix":"10.64898","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3982-7940","authenticated-orcid":false,"given":"Matthew O.","family":"Goodman","sequence":"first","affiliation":[{"name":"Brigham and Women\u2019s Hospital, Harvard Medical School; Boston, United States of America"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raichel M.","family":"Alex","sequence":"additional","affiliation":[{"name":"Brigham and Women\u2019s Hospital, Harvard Medical School; Boston, United States of America"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Scott A.","family":"Sands","sequence":"additional","affiliation":[{"name":"Brigham and Women\u2019s Hospital, Harvard Medical School; Boston, United States of America"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ali","family":"Azarbarzin","sequence":"additional","affiliation":[{"name":"Brigham and Women\u2019s Hospital, Harvard Medical School; Boston, United States of America"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Salma","family":"Batool-Anwar","sequence":"additional","affiliation":[{"name":"Brigham and Women\u2019s Hospital, Harvard Medical School; Boston, United States of America"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Milena K.","family":"Pavlova","sequence":"additional","affiliation":[{"name":"Brigham and Women\u2019s Hospital, Harvard Medical School; Boston, United States of America"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lawrence J.","family":"Epstein","sequence":"additional","affiliation":[{"name":"Brigham and Women\u2019s Hospital, Harvard Medical School; Boston, United States of America"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susan","family":"Redline","sequence":"additional","affiliation":[{"name":"Brigham and Women\u2019s Hospital, Harvard Medical School; Boston, United States of America"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1424-0673","authenticated-orcid":false,"given":"Brian E.","family":"Cade","sequence":"additional","affiliation":[{"name":"Brigham and Women\u2019s Hospital, Harvard Medical School; Boston, United States of America"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"54368","reference":[{"key":"2026053008551294000_2026.05.20.26352336v1.1","doi-asserted-by":"crossref","first-page":"15015","DOI":"10.1038\/nrdp.2015.15","article-title":"Obstructive sleep apnoea syndrome","volume":"1","year":"2015","journal-title":"Nat. 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