Phenotypic approach to pharmacotherapy in the management of obstructive sleep apnoea

Atqiya Aishah, Danny J. Eckert

Research output: Contribution to journalArticlepeer-review

Abstract

Purpose of reviewTo provide a concise synthesis of the current knowledge of obstructive sleep apnoea (OSA) phenotyping concepts and how this information is being used to develop and direct targeted pharmacotherapy for OSA.Recent findingsThe causes of OSA vary between patients and therefore so too does the optimal therapy or therapies. Key phenotypic causes include impaired upper airway anatomy and non-anatomical contributors such as ineffective pharyngeal dilator muscles during sleep, waking up too easily to minor airway narrowing (low arousal threshold) and unstable respiratory control (high loop gain). Traditionally, heterogeneity of OSA pathophysiology was not considered in pharmacotherapy approaches for OSA. However, recent study has focussed on targeted pharmacotherapies directed towards specific OSA phenotypes. This, combined with advances in knowledge of the neurobiology of pharyngeal muscle control from animal studies that have recently been translated to human proof-of-concept studies by repurposing existing drugs that target the desired mechanisms, have opened up exciting new lines of investigation for OSA pharmacotherapy.SummaryThere have been major recent advances in the development of new targeted approaches to pharmacotherapy for OSA. This study shows considerable promise for a viable and much needed pathway to drug therapy for this common chronic health condition.

Original languageEnglish
Pages (from-to)594-601
Number of pages8
JournalCurrent Opinion in Pulmonary Medicine
Volume25
Issue number6
DOIs
Publication statusPublished - 1 Nov 2019

Keywords

  • precision medicine
  • sleep apnoea pathogenesis
  • sleep-disordered breathing
  • targeted therapy
  • upper airway

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