Oxford Centre for Respiratory Medicine, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
Nuffield Department of Medicine, University of Oxford, Oxford, UK.
Thorax. 2023 Jul;78(7):726-732. doi: 10.1136/thorax-2023-220037. Epub 2023 May 22.
Obstructive sleep apnoea (OSA) was traditionally thought to be mainly caused by obesity and upper airway crowding, and hence OSA management was not personalised according to particular characteristics, with most symptomatic patients receiving continuous positive airway pressure therapy. Recent advances in our understanding have identified additional potential and distinct causes of OSA (endotypes), and subgroups of patients (phenotypes) with increased risk of cardiovascular complications. In this review, we discuss the evidence to date as to whether there are distinct clinically useful endotypes and phenotypes of OSA, and the challenges to the field in moving towards delivering personalised therapy in OSA.
阻塞性睡眠呼吸暂停（OSA）传统上被认为主要是由肥胖和上呼吸道拥挤引起的，因此 OSA 的管理并没有根据特定的特征进行个性化，大多数有症状的患者都接受持续气道正压通气治疗。我们对 OSA 的认识的最新进展已经确定了其他潜在的和不同的原因（表型），以及具有心血管并发症风险增加的患者亚组（表型）。在这篇综述中，我们讨论了迄今为止是否存在明确的、有临床应用价值的 OSA 表型和表型，以及在 OSA 中朝着提供个性化治疗方向发展所面临的挑战。
