Stewart G M, Tong B K, Cistulli P A
Charles Perkins Centre and Sydney Medical School, University of Sydney, Camperdown, Sydney, Australia.
Department of Respiratory and Sleep Medicine, Royal North Shore Hospital, St Leonards, Sydney, Australia.
Aust Dent J. 2024 Jun;69 Suppl 1(Suppl 1):S21-S30. doi: 10.1111/adj.13039. Epub 2024 Oct 1.
Obstructive Sleep Apnoea (OSA) is a common heterogenous sleep disorder that is associated with a wide range of comorbidities and consequences, including the development of neurocognitive and cardiometabolic disorders. The heterogeneity of OSA necessitates a precision medicine approach to accurately diagnose this condition and to effectively manage patients. One of the primary models of precision medicine is described by the P4 approach of predicting those who are susceptible to disease, preventing the occurrence of disease, personalizing treatment, and encouraging patients to participate in their individual healthcare journey. Recent advances in oral appliance therapy and OSA monitoring techniques have fostered an exciting opportunity for enhanced collaboration between dentists and sleep physicians to optimize OSA precision medicine care. This review aims to discuss the sources of heterogeneity among OSA patients, provide an overview of the growing applications of oral appliance therapy and tailored monitoring programs for OSA that are shifting treatment to a more personalized and participatory model of care, and outline the pivotal role of dentists in managing patients with OSA.
阻塞性睡眠呼吸暂停(OSA)是一种常见的异质性睡眠障碍,与多种合并症和后果相关,包括神经认知和心脏代谢疾病的发展。OSA的异质性需要采用精准医学方法来准确诊断这种疾病并有效管理患者。精准医学的主要模式之一由预测易患疾病者、预防疾病发生、个性化治疗以及鼓励患者参与其个人医疗保健过程的P4方法描述。口腔矫治器疗法和OSA监测技术的最新进展为牙医和睡眠医生加强合作以优化OSA精准医疗护理带来了令人兴奋的机会。本综述旨在讨论OSA患者之间异质性的来源,概述口腔矫治器疗法和针对OSA的定制监测计划日益增长的应用,这些应用正在将治疗转向更个性化和参与性的护理模式,并概述牙医在管理OSA患者中的关键作用。