More than the sum of the respiratory events

Personalized medicine approaches for obstructive sleep apnea

Bradley A. Edwards, Susan Redline, Scott A. Sands, Robert L. Owens

Research output: Contribution to journalReview ArticleResearchpeer-review

2 Citations (Scopus)

Abstract

Traditionally, the presence and severity of obstructive sleep apnea (OSA) have been defined by the apnea–hypopnea index (AHI). Continuous positive airway pressure is generally first-line therapy despite low adherence, because it reliably reduces the AHI when used, and the response to other therapies is variable. However, there is growing appreciation that the underlying etiology (i.e., endotype) and clinical manifestation (i.e., phenotype) of OSA in an individual are not well described by the AHI. We define and review the important progress made in understanding and measuring physiological mechanisms (or endotypes) that help define subtypes of OSA and identify the potential use of genetics to further refine disease classification. This more detailed understanding of OSA pathogenesis should influence clinical treatment decisions as well as help inform research priorities and clinical study design. In short, treatments could be individualized on the basis of the underlying cause of OSA; patients could better understand which symptoms and outcomes will respond to OSA treatment and by how much; and researchers could select populations most likely to benefit from specific treatment approaches for OSA.

Original languageEnglish
Pages (from-to)691-703
Number of pages13
JournalAmerican Journal of Respiratory and Critical Care Medicine
Volume200
Issue number6
DOIs
Publication statusPublished - 15 Sep 2019

Keywords

  • Endotype
  • Genotype
  • Obstructive sleep apnea
  • Phenotype

Cite this

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More than the sum of the respiratory events : Personalized medicine approaches for obstructive sleep apnea. / Edwards, Bradley A.; Redline, Susan; Sands, Scott A.; Owens, Robert L.

In: American Journal of Respiratory and Critical Care Medicine, Vol. 200, No. 6, 15.09.2019, p. 691-703.

Research output: Contribution to journalReview ArticleResearchpeer-review

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