Sleep apnea endotypes and their implications for clinical practise
Bradley A. Edwards, Shane A. Landry, Luke D. J. Thomson, Simon A. Joosten
Abstract
Obstructive sleep apnea (OSA) is now recognized to be a multifactorial disorder caused by several endotypes that differ between individuals and patient populations. In order to understand the current clinical implications of OSA endotypes, this review aims to examine the current state of play in endotype measurements, endotype modification and their impact on clinical outcomes/prognosis. In summary, the field has developed multiple techniques to measure the endotypes over the last few decades. There is now good proof-of-concept evidence that a priori knowledge of an individual’s OSA endotype traits may be useful in helping to guide treatment decisions. However, in order to truly deliver a personalized medicine approach to the treatment of OSA, we need to address critical gaps in: understanding OSA endotype treatment thresholds, and the impact of OSA modification on patient centred outcomes and hard clinical endpoints. Such efforts will benefit from a united, collaborative approach that involve partnerships between academics and consumers (i.e. patients, healthcare providers, industry). • OSA is a disorder caused by several endotypes that differ between individuals. • Multiple techniques now exist to measure these endotypes. • They can be used to help choose a treatment for OSA as well as guide adjunct therapies. • Such efforts are helping make personalized sleep medicine for OSA a clinical reality.