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A Phenotypic Approach for Personalised Management of Obstructive Sleep Apnoea

  • SLEEP MEDICINE: Sleep Apnea (K Pang, Section Editor)
  • Published:
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Abstract

Purpose of Review

Obstructive sleep apnoea (OSA) is a common sleep disorder associated with various symptoms and health consequences. In recent years, it has been increasingly recognised that there are different OSA phenotypes relating to risk factors and pathophysiology as well as clinical expression (symptoms and comorbidity). This review provides a narrative of currently investigated OSA phenotypes relating to disease and treatment which could help move the field towards the future vision of personalised management for OSA.

Recent Findings

There is emerging evidenceOSA phenotypes relating to pathophysiology and clinical expression associate with particular consequences, such as cardiovascular risk. The array of current and emerging OSA therapy options (e.g. continuous positive airway pressure, weight loss, positional therapy, oral appliance therapy, surgery, neuromuscular stimulation, pharmaceuticals) have variations in treatment efficacy and usage across individuals. Identification of treatment response phenotypes could impact treatment selection to maximise downstream benefits of therapy..

Summary

A phenotypic approach to matching individuals with OSA to appropriate therapies to mitigate downstream consequences is a framework for personalised management of OSA. Research in this area is ongoing with emergence of potential tools to characterise OSA into anatomical and pathophysiological phenotypes in clinical practice. Enabling technologies and large datasets will aid the advancement towards validated approaches that can be easily applied in the clinical setting, hopefully in the not too distant future.

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Authors and Affiliations

  1. Charles Perkins Centre and Sydney Medical School, University of Sydney, Sydney, NSW, Australia

    Kate Sutherland, Kristina Kairaitis, Philip de Chazal & Peter A. Cistulli

  2. Department Respiratory & Sleep Medicine, Royal North Shore Hospital, 8A, Acute Services Building, Reserve Road, St Leonards, Sydney, NSW, 2065, Australia

    Kate Sutherland & Peter A. Cistulli

  3. Faculty of Medicine & Health, The University of Sydney School of Medicine, Sydney, Australia

    Kate Sutherland, Brendon J. Yee, Kristina Kairaitis, John Wheatley & Peter A. Cistulli

  4. NHMRC Centre for Integrated Research and Understanding of Sleep (CIRUS) and NHMRC NeuroSleep Centre, Woolcock Institute of Medical Research, Sydney, Australia

    Brendon J. Yee

  5. Department of Respiratory and Sleep Medicine, Royal Prince Alfred Hospital, Sydney, Australia

    Brendon J. Yee

  6. Ludwig Engel Centre for Respiratory Research, Westmead Institute for Medical Research, University of Sydney, Sydney, Australia

    Kristina Kairaitis & John Wheatley

  7. Department of Respiratory and Sleep Medicine, Westmead Hospital, Sydney, Australia

    Kristina Kairaitis & John Wheatley

  8. School of Biomedical Engineering, University of Sydney, Sydney, Australia

    Philip de Chazal

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PAC devised the outline of the article. All authors drafted sections of the manuscript and critically revised the work.

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PAC has an appointment to an endowed academic Chair at the University of Sydney that was created from ResMed funding. He receives no personal fees and this relationship is managed by an Oversight Committee of the University. He has received research support from ResMed, SomnoMed, Zephyr Sleep Technologies, and Bayer. He is a consultant / adviser to Zephyr Sleep Technologies, Signifier Medical Technologies, SomnoMed, and ResMed. He has a pecuniary interest in SomnoMed related to a previous role in R&D (2004). He also receives royalties from Quintessence and Wolters Kluwer.

PdC holds an endowed academic chair at the University of Sydney, established through funding from ResMed and has received research support from ResMed and SpaceLabs.

KK reports research funding from the ResMed Foundation.

KS, BJY, and JW declare no conflicts of interest that are relevant to the content of this article.

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This article is part of the Topical collection on SLEEP MEDICINE: Sleep Apnea

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Sutherland, K., Yee, B.J., Kairaitis, K. et al. A Phenotypic Approach for Personalised Management of Obstructive Sleep Apnoea. Curr Otorhinolaryngol Rep 9, 223–237 (2021). https://doi.org/10.1007/s40136-021-00346-6

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