Amity Institute of Biotechnology, Amity University Uttar Pradesh, Noida, India.
Amity Institute of Molecular Medicine and Stem Cell Research, Amity University Uttar Pradesh, Noida, India.
Expert Rev Mol Diagn. 2021 Dec;21(12):1287-1301. doi: 10.1080/14737159.2021.2002686. Epub 2021 Nov 24.
Obstructive sleep apnea (OSA) is a common sleep disorder with multiple comorbidities including hypertension, diabetes, and cardiovascular disorders. Detected based on an overnight sleep study is called polysomnography (PSG); OSA still remains undiagnosed in majority of the population mainly attributed to lack of awareness. To overcome the limitations posed by PSG such as patient discomfort and overnight hospitalization, newer technologies are being explored. In addition, challenges associated with current management of OSA using continuous positive airway pressure (CPAP), etc. presents several pitfalls.
Conventional and modern detection/management techniques including PSG, CPAP, smart wearable/pillows, bio-motion sensors, have both pros and cons. To fulfill the limitations in OSA diagnostics, there is an imperative need for new technology for screening of symptomatic and more importantly asymptomatic OSA patients to reduce the risk of several associated life-threatening comorbidities. In this line, molecular marker-based diagnostics have shown great promises.
A detailed overview is presented on the OSA management and diagnostic approaches and recent advances in the molecular screening methods. The potentials of biomarker-based detection and its limitations are also portrayed and a comparison between the standard, current modern approaches, and promising futuristic technologies for OSA diagnostics and management is set forth. AHI: Apnea hypopnea index; AI: artificial intelligence; CAM: Cell adhesion molecules; CPAP: Continuous Positive Airway Pressure; COVID-19: Coronavirus Disease 2019; CVD: Cardiovascular disease; ELISA: Enzyme linked immunosorbent assay; HSAT: Home sleep apnea testing; IR-UWB: Impulse radio-ultra wideband; MMA: maxillomandibular advancement; PSG: Polysomnography; OSA: Obstructive sleep apnea; SOD: Superoxide dismutase; QD: Quantum dot.
阻塞性睡眠呼吸暂停(OSA)是一种常见的睡眠障碍,伴有多种合并症,包括高血压、糖尿病和心血管疾病。通过一夜睡眠研究检测到的称为多导睡眠图(PSG);由于缺乏意识,大多数人群中的 OSA 仍然未被诊断。为了克服 PSG 带来的限制,例如患者不适和过夜住院,正在探索新技术。此外,使用持续气道正压通气(CPAP)等方法治疗 OSA 所面临的挑战存在诸多缺陷。
包括 PSG、CPAP、智能可穿戴设备/枕头、生物运动传感器在内的传统和现代检测/管理技术都有其优缺点。为了克服 OSA 诊断的局限性,迫切需要新技术来筛查有症状和更重要的无症状 OSA 患者,以降低与多种相关致命合并症相关的风险。在这方面,基于分子标志物的诊断已显示出巨大的潜力。
本文对 OSA 的管理和诊断方法以及分子筛选方法的最新进展进行了详细的概述。还描绘了基于生物标志物检测的潜力及其局限性,并对 OSA 诊断和管理的标准、当前现代方法和有前途的未来技术进行了比较。AHI:呼吸暂停低通气指数;AI:人工智能;CAM:细胞黏附分子;CPAP:持续气道正压通气;COVID-19:2019 年冠状病毒病;CVD:心血管疾病;ELISA:酶联免疫吸附测定;HSAT:家庭睡眠呼吸暂停测试;IR-UWB:脉冲无线电超宽带;MMA:下颌前伸;PSG:多导睡眠图;OSA:阻塞性睡眠呼吸暂停;SOD:超氧化物歧化酶;QD:量子点。