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Review
. 2020 Nov;26(6):609-614.
doi: 10.1097/MCP.0000000000000724.

Endotypes and phenotypes in obstructive sleep apnea

Atul Malhotra  1 , Omar Mesarwi, Jean-Louis Pepin, Robert L Owens
Affiliations
Review

Endotypes and phenotypes in obstructive sleep apnea

Atul Malhotra et al. Curr Opin Pulm Med. 2020 Nov.

Abstract

Purpose of review: The purpose of this review is to describe the variability of obstructive sleep apnea (OSA), both from a standpoint of underlying mechanisms and in terms of clinical manifestations.

Recent findings: Recent data suggest that not all patients with sleep apnea get their disease for the same reason. As such, no one variable is effective at defining which patients do or do not have sleep apnea. Identifying the mechanism(s) underlying OSA for an individual is helpful as it can help to determine whether personalized therapy could be developed based on an individual's characteristics. In addition, these underlying mechanisms may be helpful in predicting response to therapy and prognosticating regarding future complications.

Summary: OSA is a heterogeneous disease with highly varying underlying mechanisms. OSA has variable clinical manifestations with definable subsets having risk of particular complications. Future studies will be helpful to identify mechanisms underlying OSA using clinically accessible tools and then using these data to focus individualized treatment approaches.

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Conflict of interest statement

Conflicts of interest A.M. reports income from Merck and Livanova related to medical education. ResMed provided a philanthropic donation for UC San Diego.

Figures

FIGURE 1.
FIGURE 1.
Three factitious patients to illustrate the potential variability in underlying mechanisms and clinical manifestations of obstructive sleep apnea (BMI, body mass index; CBTI, cognitive behavioral therapy for insomnia; CPAP, continuous positive airway pressure; NIPPV, noninvasive positive pressure ventilation; OSA, obstructive sleep apnea; RLS, restless legs syndrome).
See this image and copyright information in PMC

References

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