Liu Yu, Abdul Ghafoor Ali, Hajipour Mohammadreza, Ayas Najib
Department of Pharmacology, Shanxi Medical University, Taiyuan, Shanxi, China.
Department of Medicine, University of British Columbia Faculty of Medicine, Vancouver, BC, Canada.
BMJ Med. 2023 Jan 5;2(1):e000218. doi: 10.1136/bmjmed-2022-000218. eCollection 2023.
Obstructive sleep apnoea is a substantial clinical and public health problem because it contributes to harmful effects on quality of life, daytime symptoms, road traffic incidents, and cardiometabolic disease. Increasingly, obstructive sleep apnoea is recognised as a heterogeneous disease, and patients have varied susceptibility to long term complications and different responses to treatment. This narrative review summarises the current knowledge of precision medicine in obstructive sleep apnoea, particularly the role of symptom clusters, polysomnogram phenotypes, physiological endotypes, and circulating biomarkers in defining subtypes. In the near future, the prognostic accuracy of these measures in predicting long term complications in obstructive sleep apnoea will likely be improved, together with better matching of treatments to disease subtypes.
阻塞性睡眠呼吸暂停是一个严重的临床和公共卫生问题,因为它会对生活质量、日间症状、道路交通事故和心脏代谢疾病产生有害影响。越来越多的人认识到阻塞性睡眠呼吸暂停是一种异质性疾病,患者对长期并发症的易感性各不相同,对治疗的反应也不同。这篇叙述性综述总结了阻塞性睡眠呼吸暂停精准医学的当前知识,特别是症状簇、多导睡眠图表型、生理内型和循环生物标志物在定义亚型中的作用。在不久的将来,这些措施在预测阻塞性睡眠呼吸暂停长期并发症方面的预后准确性可能会提高,同时治疗与疾病亚型的匹配也会更好。