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Updated: Sep 26, 2025
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Drug-Induced Sleep Endoscopy DISE with Target Controlled Infusion TCI and Bispectral Analysis in Obstructive Sleep Apnea
Published on: December 6, 2016
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Treatment options in obstructive sleep apnea.
Francesco Gambino1, Marta Maria Zammuto1, Alessandro Virzì1
1Division of Pulmonary Medicine, Ospedali Riuniti Villa Sofia-Cervello, Via Trabucco 180, 90146, Palermo, Italy.
Internal and Emergency Medicine
|April 23, 2022
Summary
Continuous Positive Airway Pressure (CPAP) is effective for Obstructive Sleep Apnea (OSA), but adherence varies. Personalized treatments like mandibular advancement devices and hypoglossal nerve stimulation show promise for better OSA management.
Area of Science:
- Sleep Medicine
- Respiratory Medicine
- Otolaryngology
Background:
- Continuous Positive Airway Pressure (CPAP) is the gold standard for Obstructive Sleep Apnea (OSA) treatment, demonstrating significant efficacy in reducing Apnea-Hypopnea Index (AHI), symptoms, and comorbidities.
- Patient adherence to CPAP therapy is generally good in moderate-to-severe OSA but lower in mild OSA, particularly among younger, female, and less symptomatic individuals, especially long-term.
- Emerging research into distinct clinical and pathophysiological phenotypes of OSA is driving the development of personalized alternative therapies beyond CPAP.
Purpose of the Study:
- To conduct a comprehensive review comparing the efficacy, adherence rates, and associated costs of various therapeutic options for Obstructive Sleep Apnea (OSA).
- To evaluate recent evidence on alternative OSA treatments, including lifestyle modifications, mandibular advancement devices (MAD), positional therapy (PT), and hypoglossal nerve stimulation (HSN).
- To provide evidence-based guidance for specialists in selecting personalized OSA treatment strategies.
Main Methods:
- Systematic review of recent scientific literature.
- Comparative analysis of efficacy, adherence, and cost data for different OSA treatment modalities.
- Evaluation of emerging personalized therapies based on OSA phenotypes.
Main Results:
- CPAP remains the most evidence-based treatment for OSA, particularly for moderate-to-severe cases.
- Alternative therapies like weight loss, MAD, PT, and HSN show encouraging preliminary data but require more robust scientific evidence.
- Adherence challenges persist with CPAP, especially in specific patient subgroups, highlighting the need for personalized approaches.
Conclusions:
- Personalized therapeutic strategies are crucial for optimizing Obstructive Sleep Apnea (OSA) management, considering individual patient phenotypes and adherence factors.
- While CPAP is highly effective, alternative treatments are emerging as viable options, necessitating further research to establish their long-term efficacy and cost-effectiveness.
- This review offers guidance for clinicians to navigate the evolving landscape of OSA treatment options.
Keywords:
CPAP adherenceClinical phenotypesNon-PAP treatmentPersonalized medicinePhysiological phenotypesMore Related Videos
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