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Phenotyping-based treatment improves obstructive sleep apnea symptoms and severity: a pilot study
Ludovico Messineo1, Roberto Magri2, Luciano Corda2
1Respiratory Medicine and Sleep Laboratory, Department of Experimental and Clinical Sciences, University of Brescia and Spedali Civili, Piazzale Spedali Civili 1, 25000, Brescia, Italy. ludovico.messineo@yahoo.it.
Personalized therapies for obstructive sleep apnea (OSA) significantly reduced apnea-hypopnea index (AHI) and improved sleepiness. This approach tailors treatment to individual patient traits, offering an alternative to continuous positive airway pressure (CPAP).
Area of Science:
- Sleep Medicine
- Respiratory Medicine
- Personalized Medicine
Background:
- Obstructive sleep apnea (OSA) is a prevalent disorder with diverse causes.
- Continuous positive airway pressure (CPAP) is the standard treatment but suffers from poor patient adherence.
- Current treatment paradigms do not adequately address the heterogeneous pathophysiology of OSA.
Purpose of the Study:
- To investigate the efficacy of personalized therapeutic approaches for OSA patients.
- To tailor treatments based on individual OSA phenotypic traits, moving beyond standard CPAP.
- To evaluate improvements in key sleep apnea metrics following tailored interventions.
Main Methods:
- A pilot study involving eight OSA patients with BMI<35.
- Utilized the CPAP dial down technique to identify patient-specific phenotypic traits.
- Administered personalized combination therapies (behavioral and pharmacological) for two weeks, followed by polygraphy to assess changes in apnea-hypopnea index (AHI).
Main Results:
- Significant reduction in mean AHI from 26 ± 15 at baseline to 9 ± 7 post-treatment (p=0.01).
- Observed a significant decrease in mean oxygen desaturation index (ODI) (p=0.03).
- Reported significant improvement in subjective sleepiness as measured by the Epworth Sleepiness Scale (ESS) (p=0.01).
Conclusions:
- Personalized treatment strategies combining behavioral and pharmacological therapies based on OSA phenotypes significantly improve AHI.
- This tailored approach effectively reduces ODI and subjective sleepiness in OSA patients.
- Phenotype-guided therapy offers a promising alternative for managing OSA, potentially improving treatment adherence and outcomes.
