Precision medicine approaches in obstructive sleep apnoea: The role of dentist-sleep physician partnerships

Abstract

Obstructive Sleep Apnoea (OSA) is a common heterogenous sleep disorder that is associated with a wide range of comorbidities and consequences, including the development of neurocognitive and cardiometabolic disorders. The heterogeneity of OSA necessitates a precision medicine approach to accurately diagnose this condition and to effectively manage patients. One of the primary models of precision medicine is described by the P4 approach of predicting those who are susceptible to disease, preventing the occurrence of disease, personalizing treatment, and encouraging patients to participate in their individual healthcare journey. Recent advances in oral appliance therapy and OSA monitoring techniques have fostered an exciting opportunity for enhanced collaboration between dentists and sleep physicians to optimize OSA precision medicine care. This review aims to discuss the sources of heterogeneity among OSA patients, provide an overview of the growing applications of oral appliance therapy and tailored monitoring programs for OSA that are shifting treatment to a more personalized and participatory model of care, and outline the pivotal role of dentists in managing patients with OSA.

Keywords: Patient care; mandibular advancement splints; oral appliance therapy; predicting treatment outcomes; risk factors.

Fig. 1

Schematic of the clinical (a) and physiological (b) features typically used to define the phenotypic expressions of obstructive sleep apnoea. OSA, obstructive sleep apnoea; REM, rapid eye movement.

Fig. 2

Management of OSA therapy utilizing P4 model of care.