Current and novel treatment options for obstructive sleep apnoea

Area of Science:

• Sleep Medicine
• Respiratory Medicine
• Otolaryngology

Background:

• Obstructive sleep apnoea (OSA) presents significant challenges impacting quality of life, performance, accident risk, comorbidities, and mortality.
• Research has identified diverse clinical phenotypes and pathophysiological components of OSA.
• These advancements support a shift towards personalized therapeutic strategies tailored to individual patient presentations and pathophysiology.

Purpose of the Study:

• To evaluate the availability and efficacy of therapeutic options for obstructive sleep apnoea beyond positive airway pressure (PAP) therapy alone.
• To determine patient-specific indications for single or combined therapeutic approaches.
• To assess the scientific evidence supporting recommendations for various OSA treatments.

Main Methods:

• Review of current knowledge on positive airway pressure (PAP) and non-PAP therapies for obstructive sleep apnoea.
• Analysis of treatments targeting upper airway collapsibility, muscle responsiveness, arousability, and respiratory drive.
• Inclusion of therapies in clinical use and those in advanced experimental stages.

Main Results:

• A broad and heterogeneous spectrum of therapeutic options for obstructive sleep apnoea exists, including technical and pharmaceutical interventions.
• These options address key pathophysiological components of OSA, such as upper airway collapsibility and respiratory drive.
• Available data indicate a variety of effective treatments beyond the traditional focus on PAP therapy.

Conclusions:

• Personalized therapy is crucial for managing obstructive sleep apnoea, considering individual clinical phenotypes and pathophysiology.
• A range of effective non-PAP therapies should be considered as alternatives or adjuncts to positive airway pressure.
• Further research is needed to optimize single and combined treatment strategies for obstructive sleep apnoea.