Phenotypic Approach to Obstructive Sleep Apnea

Abstract

Obstructive sleep apnea (OSA), a common condition observed in clinical practice, is a significant public health concern; however, several patients with OSA remain underdiagnosed and untreated. OSA is not merely anatomically driven but is a heterogeneous disorder attributable to complex pathophysiology. Therefore, anatomically driven therapy such as continuous positive airway pressure (CPAP), dental device use, or upper airway surgery offers limited benefit because these approaches do not consider the various clinical and other pathophysiological contributors to OSA. Poor long-term adherence is a limitation of CPAP, the most effective modality recommended as first-line therapy in patients with OSA. Recent advances in our understanding of the pathophysiology and heterogeneity of OSA have led to the identification of three OSA phenotypes based on pathophysiological traits, polysomnographic traits, and clinical/symptombased characteristics. In this review, we summarize recent progress and research trends in the phenotypic approach to OSA.