Evaluation of Obstructive Sleep Apnea Phenotypes Treatment Effectiveness

Abstract

Background and Objective: Obstructive sleep apnea (OSA) is a heterogeneous chronic sleep associated disorder. A common apnea-hypopnea index (AHI)-focused approach to OSA severity evaluation is not sufficient enough to capture the extent of OSA related risks, it limits our understanding of disease pathogenesis and may contribute to a modest response to conventional treatment. In order to resolve the heterogeneity issue, OSA patients can be divided into more homogenous therapeutically and prognostically significant groups–phenotypes. An improved understanding of OSA phenotype relationship to treatment effectiveness is required. Thus, in this study several clinical OSA phenotypes are identified and compared by their treatment effectiveness. Methods and materials: Retrospective data analysis of 233 adult patients with OSA treated with continuous positive airway pressure (CPAP) was performed. Statistical analysis of data relating to demographic and anthropometric characteristics, symptoms, arterial blood gas test results, polysomnografic and respiratory polygraphic tests and treatment, treatment results was performed. Results: 3 phenotypes have been identified: “Position dependent (supine) OSA” (Positional OSA), “Severe OSA in obese patients” (Severe OSA) and “OSA and periodic limb movements (PLM)” (OSA and PLM). The highest count of responders to treatment with CPAP was in the OSA and PLM phenotype, followed by the Positional OSA phenotype. Treatment with CPAP, despite the highest mean pressure administered was the least effective among Severe OSA phenotype. Conclusions: Different OSA phenotypes vary significantly and lead to differences in response to treatment. Thus, treatment effectiveness depends on OSA phenotypes and treatment techniques other than CPAP may be needed. This emphasizes the importance of a more individualized approach when treating OSA.

The Resolution of Obstructive Sleep Apnea in a Patient with Goiter after Total Thyroidectomy: A Case Report

“…The clinical and polygraphic data, in this case, reflect certain characteristics of OSA associated with a large and compressive multinodular goiter. These characteristics may be of major interest when studying phenotypes of OSA [18]. Firstly, diurnal and nocturnal symptoms of OSA were identified during the preoperative anesthesia assessment, but they had not previously prompted the patient to seek medical attention.…”

“…OSA phenotypes vary significantly when comparing certain anthropometric, clinical and polysomnographic findings [18]. Considering that OSA was primarily related to obesity and advanced age in this case, it was anticipated that the patient would continue to be followed up for OSA and CPAP therapy after total thyroidectomy.…”

Chronic intermittent hypoxia‐induced oxidative stress activates TRB3 and phosphorylated JNK to mediate insulin resistance and cell apoptosis in the pancreas

“…Obstructive sleep apnoea (OSA) is a common sleep disorder that affects from 3% to 38% of the general population 1–3 . It causes chronic intermittent hypoxia (CIH) and sleep fragmentation 4 .…”

“…Obstructive sleep apnoea (OSA) is a common sleep disorder that affects from 3% to 38% of the general population. [1][2][3] It causes chronic intermittent hypoxia (CIH) and sleep fragmentation. 4 OSA is an independent risk factor for hypertension, 5 dyslipidaemia, 6 stroke, 7 and type 2 diabetes mellitus (T2DM).…”

Exploring the Impact of Positional Sleep Apnea in a Turkish Population: Unveiling the Untold Story

“…Obstructive sleep apnea (OSA) is a common but often underdiagnosed sleep disorder, which leads to a significant health burden when left untreated through its associations with cardiometabolic diseases and impaired quality of life [ 1 – 4 ].…”