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European Archives of Oto-Rhino-Laryngology

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01-03-2017 | Review Article

The importance of obstructive sleep apnoea and hypopnea pathophysiology for customized therapy

Authors: Marcello Bosi, Andrea De Vito, Riccardo Gobbi, Venerino Poletti, Claudio Vicini

Published in: European Archives of Oto-Rhino-Laryngology | Issue 3/2017

Abstract

The objective of this study is to highlight the importance of anatomical and not-anatomical factors’ identification for customized therapy in OSAHS patients. The data sources are: MEDLINE, The Cochrane Library and EMBASE. A systematic review was performed to identify studies that analyze the role of multiple interacting factors involved in the OSAHS pathophysiology. 85 out of 1242 abstracts were selected for full-text review. A variable combinations pathophysiological factors contribute to realize differentiated OSAHS phenotypes: a small pharyngeal airway with a low resistance to collapse (increased critical closing pressure), an inadequate responses of pharyngeal dilator muscles (wakefulness drive to breathe), an unstable ventilator responsiveness to hypercapnia (high loop gain), and an increased propensity to wake related to upper airway obstruction (low arousal threshold). Identifying if the anatomical or not-anatomical factors are predominant in each OSAHS patient represents the current challenge in clinical practice, moreover for the treatment decision-making. In the future, if a reliable and accurate pathophysiological pattern for each OSAHS patient can be identified, a customized therapy will be feasible, with a significant improvement of surgical success in sleep surgery and a better understanding of surgical failure.

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Title: The importance of obstructive sleep apnoea and hypopnea pathophysiology for customized therapy
Authors: Marcello Bosi
Andrea De Vito
Riccardo Gobbi
Venerino Poletti
Claudio Vicini
Publication date: 01-03-2017
Publisher: Springer Berlin Heidelberg
Published in: European Archives of Oto-Rhino-Laryngology / Issue 3/2017
Print ISSN: 0937-4477
Electronic ISSN: 1434-4726
DOI: https://doi.org/10.1007/s00405-016-4223-y

At a glance: The STEP trials

Springer Medicine

The importance of obstructive sleep apnoea and hypopnea pathophysiology for customized therapy

Abstract

At a glance: The STEP trials

Springer Medicine

Abstract

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