The Challenges of Precision Medicine in Obstructive Sleep Apnea

Gileles‐Hillel, Alex; Gozal, David

doi:10.1016/j.jsmc.2016.01.003

Cited by 33 publications

(20 citation statements)

References 142 publications

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“…Research on "-omics" (figure 1) continues, and may ultimately provide clinically useful biomarkers for adult [97] and paediatric [29,98,99] OSA. Examples are studies in adults and children with OSA using proteomics [29,100], studies on miRNA in patients with OSA and resistant hypertension [101], the application of system biology to genetic studies of OSA [102] and studies on visceral fat transcriptome to assess the molecular basis of the interaction between OSA and obesity [103,104]. A roadmap for a personalised approach to OSA has been proposed according to P4 medicine, ( personalisation, prediction, prevention and patient participation in healthcare) [27,28].…”

Section: Discussionmentioning

confidence: 99%

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Personalised medicine in sleep respiratory disorders: focus on obstructive sleep apnoea diagnosis and treatment

et al. 2017

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In all fields of medicine, major efforts are currently dedicated to improve the clinical, physiological and therapeutic understanding of disease, and obstructive sleep apnoea (OSA) is no exception. The personalised medicine approach is relevant for OSA, given its complex pathophysiology and variable clinical presentation, the interactions with comorbid conditions and its possible contribution to poor outcomes. Treatment with continuous positive airway pressure (CPAP) is effective, but CPAP is poorly tolerated or not accepted in a considerable proportion of OSA patients. This review summarises the available studies on the physiological phenotypes of upper airway response to obstruction during sleep, and the clinical presentations of OSA ( phenotypes and clusters) with a special focus on our changing attitudes towards approaches to treatment. Such major efforts are likely to change and expand treatment options for OSA beyond the most common current choices (i.e. CPAP, mandibular advancement devices, positional treatment, lifestyle changes or upper airway surgery). More importantly, treatment for OSA may become more effective, being tailored to each patient's need.

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Section: Discussionmentioning

confidence: 99%

“…Readers are referred to other recent reviews for updated information on personalised medicine in OSA, including biomarkers and "omic" approaches [26][27][28][29][30][31].…”

Section: Introductionmentioning

confidence: 99%

Personalised medicine in sleep respiratory disorders: focus on obstructive sleep apnoea diagnosis and treatment

et al. 2017

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“…This finding might also applicable in non‐dialysis CKD patient. On the contrary, previous studies have demonstrated that SA is an independent risk factor for CKD in both direct and indirect effects . SA can accelerate the deterioration of kidney function directly by activating renin‐angiotensin‐aldosterone system, sympathetic nervous system and nocturnal hypoxia .…”

Section: Discussionmentioning

confidence: 90%

“…It has been reported to affect 8–16% of global people . Except for typical risk factors, sleep apnoea (SA) is a new independent risk factor and has been underestimated and underdiagnosed, which can also contribute to other risk factors for CKD, such as, hypertension and atherosclerotic vascular disease …”

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confidence: 99%

Prevalence of sleep apnoea in non‐dialysis chronic kidney disease patients: A systematic review and meta‐analysis

et al. 2019

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This is a meta-analysis evaluating the prevalence of sleep apnoea (SA) in patients with chronic kidney disease (CKD). The authors found that SA is commonly seen in both early and advanced nondialysis CKD patients, and the prevalence of SA increases in advanced CKD. And male patients are more likely to be affected by SA than female patients. ABSTRACT:Aim: The prevalence of sleep apnoea (SA) in chronic kidney disease (CKD) varies greatly across preceding studies. The aim of our study was to provide a summary of the prevalence of SA among non-dialysis CKD patients. Method: Medline, Embase, Web of Science, China Knowledge ResourceIntegrated Database, VIP Chinese scientific journal database (VIP) and Wanfang Digital Periodical Full-text database were searched up to September 2018 to identify publications related to the prevalence of SA in non-dialysis CKD patients assessed by sleep questionnaires or sleep respiration monitoring. Random-effects meta-analysis was used to estimate pooled prevalence of SA. And subgroup analysis and meta-regression were conducted as well.Results: The pooled prevalence of SA in the included 26 studies was 38% (95% confidence interval [CI], 21-70%). In subgroup analyses, the pooled prevalence of SA varied using different diagnostic tools. The pooled prevalence of questionnaire-based SA for CKD was 10% (95% CI, 3-27%), while the prevalence of sleep monitoring-based SA was 56% (95% CI, 49-66%). Also, advanced CKD patients had a greater chance to suffer from moderate-to-severe SA than early stage CKD patients. Male patients were more likely to be affected by moderate-to-severe SA than female patients (47% vs 30%, P = 0.018).

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“…Além da avaliação clínica que incluiu dados demográficos e antropométricos, avaliação da composição corporal por bioimpedância e medida da pressão arterial, avaliamos o perfil dos miRNAs em sangue total periférico em duas etapas: 1) microarray em uma subamostra de 3 indivíduos de cada grupo (com o objetivo de verificar de forma ampla o perfil e a diferença de expressão dos miRNAs entre os grupos); 2) validação dos achados na 1ª etapa com seleção de vários miRNAs que participam da regulação de vias de sinalização relacionadas à fisiopatologia da AOS por meio da reação em cadeia da polimerase em tempo real (RT-qPCR). Os participantes apresentaram idade mediana de 35 (31)(32)(33)(34)(35)(36)(37)(38)(39)(40)(41) anos e IMC médio de 30,7+3,6 kg/m². Não foram observadas diferenças entre os grupos quanto aos parâmetros antropométricos, medidas de composição corporal e pressão arterial.…”

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Avaliação dos MicroRNAs na apneia obstrutiva do sono: implicações para a criação de biomarcadores e para o risco cardiovascular

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The Challenges of Precision Medicine in Obstructive Sleep Apnea

Cited by 33 publications

References 142 publications

Personalised medicine in sleep respiratory disorders: focus on obstructive sleep apnoea diagnosis and treatment

Personalised medicine in sleep respiratory disorders: focus on obstructive sleep apnoea diagnosis and treatment

Prevalence of sleep apnoea in non‐dialysis chronic kidney disease patients: A systematic review and meta‐analysis

Avaliação dos MicroRNAs na apneia obstrutiva do sono: implicações para a criação de biomarcadores e para o risco cardiovascular

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