Personalized Medicine and Obstructive Sleep Apnea.

Area of Science:

• Sleep Medicine
• Pulmonology
• Cardiology

Background:

• Obstructive sleep apnea (OSA) is prevalent but often underdiagnosed and undertreated.
• Variations in patient morphology, phenotypes, and age-specific differences complicate OSA management.
• A personalized medicine approach is essential for effective clinical practice.

Purpose of the Study:

• To review current concepts and approaches for personalized management of obstructive sleep apnea.
• To highlight the need for individualized diagnosis and treatment strategies.
• To discuss tailoring OSA therapy based on specific patient factors.

Main Methods:

• This narrative review synthesizes current literature on OSA management.
• It examines personalized approaches considering pathophysiology and clinical characteristics.
• The review evaluates treatment options based on patient tolerance and comorbidities.

Main Results:

• Home sleep apnea testing may be more suitable than polysomnography for some patients.
• Treatment decisions should integrate microarousal index, hypoxia effects, and comorbidities, not solely the apnea-hypopnea index.
• Continuous positive airway pressure (CPAP) is a cornerstone but not universally tolerated or affordable.

Conclusions:

• Personalized OSA management requires considering individual pathophysiology, clinical clusters, and patient expectations.
• Combined therapies and alternative treatments should be explored beyond standard CPAP.
• Tailored strategies are necessary to optimize outcomes for diverse OSA patient populations.