Division of Pulmonary, Critical Care, and Sleep Medicine, University of California, San Diego, La Jolla, CA, USA.
Section of Sleep Medicine, Veterans Affairs (VA) San Diego Healthcare System, La Jolla, CA, USA.
Expert Rev Respir Med. 2022 Aug;16(8):917-929. doi: 10.1080/17476348.2022.2112669. Epub 2022 Aug 18.
The recent continuous positive airway pressure (CPAP) crisis has highlighted the need for alternative obstructive sleep apnea (OSA) therapies. This article serves to review OSA pathophysiology and how sleep apnea mechanisms may be utilized to individualize alternative treatment options.
The research highlighted below focuses on 1) mechanisms of OSA pathogenesis and 2) CPAP alternative therapies based on mechanism of disease. We reviewed PubMed from inception to July 2022 for relevant articles pertaining to OSA pathogenesis, sleep apnea surgery, as well as sleep apnea alternative therapies.
Although the field of individualized OSA treatment is still in its infancy, much has been learned about OSA traits and how they may be targeted based on a patient's physiology and preferences. While CPAP remains the gold-standard for OSA management, several novel alternatives are emerging. CPAP is a universal treatment approach for all severities of OSA. We believe that a personalized approach to OSA treatment beyond CPAP lies ahead. Additional research is needed with respect to implementation and combination of therapies longitudinally, but we are enthusiastic about the future of OSA treatment based on the data presented here.
最近持续气道正压通气（CPAP）危机凸显了需要替代阻塞性睡眠呼吸暂停（OSA）疗法的必要性。本文旨在回顾 OSA 的病理生理学，以及如何利用睡眠呼吸暂停机制来个性化选择替代治疗方案。
下面突出显示的研究重点关注 1）OSA 发病机制的机制和 2）基于疾病机制的 CPAP 替代疗法。我们检索了从成立到 2022 年 7 月的 PubMed 数据库，以获取有关 OSA 发病机制、睡眠呼吸暂停手术以及睡眠呼吸暂停替代疗法的相关文章。
尽管个体化 OSA 治疗领域仍处于起步阶段，但我们已经了解了很多关于 OSA 特征以及如何根据患者的生理状况和偏好来靶向这些特征的知识。虽然 CPAP 仍然是 OSA 管理的金标准，但几种新型替代方法正在出现。CPAP 是治疗所有严重程度 OSA 的通用方法。我们相信，超越 CPAP 的 OSA 治疗个性化方法即将到来。需要对长期实施和联合治疗进行更多的研究，但根据这里提供的数据，我们对 OSA 治疗的未来充满热情。
