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The importance of obstructive sleep apnoea and hypopnea pathophysiology for customized therapy

Marcello Bosi1, Andrea De Vito2, Riccardo Gobbi3

  • 1Pneumology Unit, Morgagni-Pierantoni Hospital, Forlì, Italy.

European Archives of Oto-Rhino-Laryngology : Official Journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : Affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery
|July 30, 2016
PubMed

Insights

Identifying key anatomical and non-anatomical factors is crucial for tailoring obstructive sleep apnea hypopnea syndrome (OSAHS) treatments. Understanding these elements enables personalized therapies for better patient outcomes.

Area of Science:

  • Sleep Medicine
  • Respiratory Physiology
  • Otolaryngology

Background:

  • Obstructive Sleep Apnea Hypopnea Syndrome (OSAHS) is a complex disorder with multifactorial pathophysiology.
  • Current treatment approaches often lack personalization, leading to variable success rates.

Purpose of the Study:

  • To emphasize the significance of identifying both anatomical and non-anatomical factors in OSAHS.
  • To underscore the need for customized therapeutic strategies based on individual patient profiles.

Main Methods:

  • A systematic review of relevant literature was conducted.
  • Databases searched included MEDLINE, The Cochrane Library, and EMBASE.
  • 85 abstracts were selected for full-text review from 1242 initial abstracts.

Main Results:

  • OSAHS phenotypes result from combinations of pathophysiological factors.
  • Key factors include pharyngeal airway size, dilator muscle response, ventilatory control (loop gain), and arousal threshold.
  • Distinguishing the predominant factor (anatomical vs. non-anatomical) presents a clinical challenge.

Conclusions:

  • Personalized OSAHS therapy is feasible with accurate identification of individual pathophysiological patterns.
  • Tailored treatments can improve surgical success rates in sleep surgery.
  • A better understanding of surgical failures can be achieved through individualized approaches.
Keywords:
Arousal thresholdCritical passive pressureLoop gainObstructive sleep apnoea hypopnea syndromePathophysiology

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