MODERN DIAGNOSTIC AND THERAPEUTIC APPROACHES IN OBSTRUCTIVE SLEEP APNEA: FROM PHENOTYPING TO PRECISION MEDICINE
DOI:
https://doi.org/10.31435/ijitss.2(50).2026.5715Keywords:
Obstructive Sleep Apnea, Precision Medicine, Phenotyping, Drug-induced Sleep Endoscopy, Artificial Intelligence, Personalized TherapyAbstract
Objectives: The aim of this paper is to present current approaches to the diagnosis and management of obstructive sleep apnea (OSA), with particular emphasis on precision medicine, phenotyping, and the use of modern diagnostic tools. The study seeks to identify key challenges in optimizing treatment effectiveness and adherence, as well as to highlight the role of individualized therapeutic strategies.
Methods: A narrative review of the literature was conducted, focusing on contemporary diagnostic and therapeutic methods in OSA. Particular attention was given to phenotyping approaches, drug-induced sleep endoscopy (DISE), and the application of artificial intelligence (AI) in clinical decision making. Relevant studies were selected through targeted database searches and analyzed to identify trends and gaps in current practice.
Key findings: OSA is a heterogeneous disorder with significant variability in clinical presentation, pathophysiology, and treatment response. Traditional diagnostic and therapeutic approaches are often insufficient to address this complexity. Emerging strategies, including patient phenotyping, DISE, and AI-supported tools, enable more precise identification of disease mechanisms and support personalized treatment selection. These approaches show promise in improving diagnostic accuracy, treatment outcomes, and patient adherence.
Conclusions: Effective management of OSA requires a shift toward individualized, data-driven approaches. Advances in precision medicine and AI have the potential to significantly enhance diagnostic processes and therapeutic outcomes. Further research is needed to validate these methods and integrate them into routine clinical practice to improve quality of life in patients with OSA.
References
Aaronson, J. A., Van Bennekom, C. A. M., Hofman, W. F., Van Bezeij, T., Van Den Aardweg, J. G., Groet, E., Kylstra, W. A., & Schmand, B. (2015). Obstructive sleep apnea is related to impaired cognitive and functional status after stroke. Sleep, 38(9), 1431–1437B. https://doi.org/10.5665/SLEEP.4984
Abad, V. C. (2021). Profile of solriamfetol in the management of excessive daytime sleepiness associated with narcolepsy or obstructive sleep apnea: Focus on patient selection and perspectives. Nature and Science of Sleep, 13, 75–91. https://doi.org/10.2147/NSS.S245020
Abd El-Aziz, A., Abd El-Fattah, A., El-Habashy, M., Omar, H., & Abd El_Wahab, S. (2018). Effectiveness of septoplasty with or without inferior turbinate reduction in patients with obstructive sleep apnea. The Egyptian Journal of Chest Diseases and Tuberculosis, 67(3), 295. https://doi.org/10.4103/EJCDT.EJCDT_5_18
Al-Abri, M. A., Al-Harmeli, A., Al-Habsi, M., & Jaju, D. (2020). Acceptance and compliance of continuous positive airway pressure in patients with obstructive sleep apnea: Local population survey. Oman Medical Journal, 35(6), 1–6. https://doi.org/10.5001/OMJ.2020.94
Alrubasy, W. A., Abuawwad, M. T., Taha, M. J. J., Khurais, M., Sayed, M. S., Dahik, A. M., Keshk, N., Abdelhadi, S., & Serhan, H. A. (2024). Hypoglossal nerve stimulation for obstructive sleep apnea in adults: An updated systematic review and meta-analysis. Respiratory Medicine, 234. https://doi.org/10.1016/j.rmed.2024.107826
Amali, A., Motiee-Langroudi, M., Saedi, B., Rahavi-Ezabadi, S., Karimian, A., & Amirzargar, B. (2017). A comparison of uvulopalatopharyngoplasty and modified radiofrequency tissue ablation in mild to moderate obstructive sleep apnea: A randomized clinical trial. Journal of Clinical Sleep Medicine, 13(9), 1089–1096. https://doi.org/10.5664/JCSM.6730
André, S., Andreozzi, F., Van Overstraeten, C., Ben Youssef, S., Bold, I., Carlier, S., Gruwez, A., Bruyneel, A. V., & Bruyneel, M. (2020). Cardiometabolic comorbidities in obstructive sleep apnea patients are related to disease severity, nocturnal hypoxemia, and decreased sleep quality. Respiratory Research, 21(1). https://doi.org/10.1186/S12931-020-1284-7
Antonaglia, C. (2022). Obstructive sleep apnea syndrome (OSAS) and asthma: A simple association: A new syndrome or a cluster? Journal of Biomedical Research & Environmental Sciences, 3(8), 944–952. https://doi.org/10.37871/jbres1537
Asarkar, A. A., Bui, R., Calligas, J., Gillespie, M. B., & Nathan, C. A. O. (2024). Where does hypoglossal nerve stimulator implant fit in the surgical management algorithm of obstructive sleep apnea? The Laryngoscope, 134(10), 4165–4166. https://doi.org/10.1002/LARY.31486
Aurora, R. N., Casey, K. R., Kristo, D., Auerbach, S., Bista, S. R., Chowdhuri, S., Karippot, A., Lamm, C., Ramar, K., Zak, R., Morgenthaler, T. I., & Tracy, S. L. (2010). Practice parameters for the surgical modifications of the upper airway for obstructive sleep apnea in adults. Sleep, 33(10), 1408–1413. https://doi.org/10.1093/SLEEP/33.10.1408
Avatef Fazeli, M., Hedayati, A., Dehghani, A., Hedayati, M., & Zaremehrjardi, F. (2022). The effects of nasal septoplasty on the severity of obstructive sleep apnea syndrome: A quasi-experimental study. Hospital Practices and Research, 7(3), 105–108. https://doi.org/10.34172/HPR.2022.21
Baptista, P. M., Zufiaurre, N. D., Garaycochea, O., Navarrete, J. M. A., Moffa, A., Giorgi, L., Casale, M., O’Connor-Reina, C., & Plaza, G. (2022). TORS as part of multilevel surgery in OSA: The importance of careful patient selection and outcomes. Journal of Clinical Medicine, 11(4). https://doi.org/10.3390/JCM11040990
Baradaranfar, M. H., Edalatkhah, M., Dadgarnia, M. H., Atighechi, S., Behniafard, N., Mirvakili, A., Halvani, A., Baradaranfar, A., & Emami Meybodi, T. (2015). The effect of uvulopalatopharyngoplasty with tonsillectomy in patients with obstructive sleep apnea. Indian Journal of Otolaryngology and Head and Neck Surgery, 67(Suppl 1), 29–33. https://doi.org/10.1007/S12070-014-0735-1
Baratta, F., Pastori, D., Bucci, T., Fabiani, M., Fabiani, V., Brunori, M., Loffredo, L., Lillo, R., Pannitteri, G., Angelico, F., & Del Ben, M. (2018). Long-term prediction of adherence to continuous positive air pressure therapy for the treatment of moderate/severe obstructive sleep apnea syndrome. Sleep Medicine, 43, 66–70. https://doi.org/10.1016/J.SLEEP.2017.09.032
Benke, S., Okorie, C. U. A., & Tablizo, M. A. (2021). The use of auto-titrating continuous positive airway pressure (AutoCPAP) for obstructive sleep apnea syndrome in children with obesity. Children, 8(12). https://doi.org/10.3390/CHILDREN8121204
Berg, L. M., Ankjell, T. K. S., Sun, Y.-Q., Trovik, T. A., Sjögren, A., Rikardsen, O. G., Moen, K., Hellem, S., & Bugten, V. (2020). Friedman score in relation to compliance and treatment response in nonsevere obstructive sleep apnea. International Journal of Otolaryngology, 2020, 1–8. https://doi.org/10.1155/2020/6459276
Bikov, A., Frent, S., Pleava, R., Kunos, L., Bokhari, S., Meszaros, M., & Mihaicuta, S. (2020). The burden of associated comorbidities in patients with obstructive sleep apnea—Regional differences in two Central-Eastern European sleep centers. Journal of Clinical Medicine, 9(11). https://doi.org/10.3390/JCM9113583
Bitners, A. C., & Arens, R. (2020). Evaluation and management of children with obstructive sleep apnea syndrome. Lung, 198(2), 257–270. https://doi.org/10.1007/S00408-020-00342-5
Boudewyns, A., Verhulst, S., Maris, M., Saldien, V., & Van de Heyning, P. (2014). Drug-induced sedation endoscopy in pediatric obstructive sleep apnea syndrome. Sleep Medicine, 15(12), 1526–1531. https://doi.org/10.1016/J.SLEEP.2014.06.016
Bradley, T. D., & Floras, J. S. (2003). Sleep apnea and heart failure: Part II: Central sleep apnea. Circulation, 107(13), 1822–1826. https://doi.org/10.1161/01.CIR.0000061758.05044.64
Brander, P. E., Soirinsuo, M., & Lohela, P. (1999). Nasopharyngeal symptoms in patients with obstructive sleep apnea syndrome: Effect of nasal CPAP treatment. Respiration; International Review of Thoracic Diseases, 66(2), 128–135. https://doi.org/10.1159/000029354
Bravata, D. M., Concato, J., Fried, T., Ranjbar, N., Sadarangani, T., McClain, V., Struve, F., Zygmunt, L., Knight, H. J., Lo, A., Richerson, G. B., Gorman, M., Williams, L. S., Brass, L. M., Agostini, J., Mohsenin, V., Roux, F., & Yaggi, H. K. (2010). Auto-titrating continuous positive airway pressure for patients with acute transient ischemic attack: A randomized feasibility trial. Stroke, 41(7), 1464–1470. https://doi.org/10.1161/STROKEAHA.109.566745
Camañes-Gonzalvo, S., Bellot-Arcís, C., Marco-Pitarch, R., Montiel-Company, J. M., García-Selva, M., Agustín-Panadero, R., Paredes-Gallardo, V., & Puertas-Cuesta, F. J. (2022). Comparison of the phenotypic characteristics between responders and non-responders to obstructive sleep apnea treatment using mandibular advancement devices in adult patients: Systematic review and meta-analysis. Sleep Medicine Reviews, 64. https://doi.org/10.1016/j.smrv.2022.101644
Cao, X., Zhou, Y., Zhang, J., Yin, G., & Ye, J. (2023). Application of drug-induced sleep endoscopy in predicting the outcomes of velopharyngeal surgery in adult patients with Friedman stage II and III obstructive sleep apnea syndrome. Frontiers in Neurology, 13. https://doi.org/10.3389/FNEUR.2022.1049425
Carneiro-Barrera, A., Amaro-Gahete, F. J., Guillén-Riquelme, A., Jurado-Fasoli, L., Sáez-Roca, G., Martín-Carrasco, C., Buela-Casal, G., & Ruiz, J. R. (2022). Effect of an interdisciplinary weight loss and lifestyle intervention on obstructive sleep apnea severity: The INTERAPNEA randomized clinical trial. JAMA Network Open, 5(4), e228212. https://doi.org/10.1001/JAMANETWORKOPEN.2022.8212
Chang, H. P., Chen, Y. F., & Du, J. K. (2020). Obstructive sleep apnea treatment in adults. The Kaohsiung Journal of Medical Sciences, 36(1), 7–12. https://doi.org/10.1002/KJM2.12130
Chang, J. L., Goldberg, A. N., Alt, J. A., Mohammed, A., Ashbrook, L., Auckley, D., Ayappa, I., Bakhtiar, H., Barrera, J. E., Bartley, B. L., Billings, M. E., Boon, M. S., Bosschieter, P., Braverman, I., Brodie, K., Cabrera-Muffly, C., Caesar, R., Cahali, M. B., Cai, Y., … Rosen, I. M. (2023). International consensus statement on obstructive sleep apnea. International Forum of Allergy & Rhinology, 13(7), 1061–1482. https://doi.org/10.1002/ALR.23079
Chung, F., Abdullah, H. R., & Liao, P. (2016). STOP-Bang questionnaire: A practical approach to screen for obstructive sleep apnea. Chest, 149(3), 631–638. https://doi.org/10.1378/CHEST.15-0903
Czerwaty, K., Dżaman, K., Sobczyk, K. M., & Sikorska, K. I. (2022). The overlap syndrome of obstructive sleep apnea and chronic obstructive pulmonary disease: A systematic review. Biomedicines, 11(1). https://doi.org/10.3390/BIOMEDICINES11010016
da Cunha Viana, A., Mendes, D. L., de Andrade Lemes, L. N., Thuler, L. C. S., Neves, D. D., & de Araújo-Melo, M. H. (2017). Drug-induced sleep endoscopy in the obstructive sleep apnea: Comparison between NOHL and VOTE classifications. European Archives of Oto-Rhino-Laryngology, 274(2), 627–635. https://doi.org/10.1007/S00405-016-4081-7
Dai, R., Yang, K., Zhuang, J., Yao, L., Hu, Y., Chen, Q., Zheng, H., Zhu, X., Ke, J., Zeng, Y., Fan, C., Chen, X., Fan, J., & Zhang, Y. (2024). Enhanced machine learning approaches for OSA patient screening: Model development and validation study. Scientific Reports, 14(1). https://doi.org/10.1038/S41598-024-70647-5
De Vito, A., Woodson, B. T., Koka, V., Cammaroto, G., Iannella, G., Bosi, M., Pelucchi, S., Filograna-Pignatelli, G. R., Chater, P. El, & Vicini, C. (2021). OSA upper airways surgery: A targeted approach. Medicina, 57(7). https://doi.org/10.3390/MEDICINA57070690
Dutta, R., Tong, B. K., & Eckert, D. J. (2022). Development of a physiological-based model that uses standard polysomnography and clinical data to predict oral appliance treatment outcomes in obstructive sleep apnea. Journal of Clinical Sleep Medicine, 18(3), 861–870. https://doi.org/10.5664/JCSM.9742
Eguchi, K., Yabuuchi, T., Nambu, M., Takeyama, H., Azuma, S., Chin, K., & Kuroda, T. (2022). Investigation on factors related to poor CPAP adherence using machine learning: A pilot study. Scientific Reports, 12(1). https://doi.org/10.1038/S41598-022-21932-8
Ferreira-Santos, D., Amorim, P., Martins, T. S., Monteiro-Soares, M., & Rodrigues, P. P. (2022). Enabling early obstructive sleep apnea diagnosis with machine learning: Systematic review. Journal of Medical Internet Research, 24(9). https://doi.org/10.2196/39452
Friedman, M., Salapatas, A. M., & Bonzelaar, L. B. (2017). Updated Friedman staging system for obstructive sleep apnea. Advances in Oto-Rhino-Laryngology, 80, 41–48. https://doi.org/10.1159/000470859
Fuhrman, C., Fleury, B., Nguyên, X. L., & Delmas, M. C. (2012). Symptoms of sleep apnea syndrome: High prevalence and underdiagnosis in the French population. Sleep Medicine, 13(7), 852–858. https://doi.org/10.1016/J.SLEEP.2012.04.005
Gabryelska, A., Sochal, M., Wasik, B., Szczepanowski, P., & Białasiewicz, P. (2021). Factors affecting long-term compliance of CPAP treatment—A single centre experience. Journal of Clinical Medicine, 11(1). https://doi.org/10.3390/JCM11010139
Georgakopoulou, V., Pantazis, N., Tsiafaki, X., Nena, E., Amfilochiou, A., & Steiropoulos, P. (2023). Validation of NoSAS score for the screening of obstructive sleep apnea. Medicine International, 3(2). https://doi.org/10.3892/MI.2023.74
Georgoulis, M., Yiannakouris, N., Kechribari, I., Lamprou, K., Perraki, E., Vagiakis, E., & Kontogianni, M. D. (2021). The effectiveness of a weight-loss Mediterranean diet/lifestyle intervention in the management of obstructive sleep apnea: Results of the “MIMOSA” randomized clinical trial. Clinical Nutrition, 40(3), 850–859. https://doi.org/10.1016/J.CLNU.2020.08
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Copyright (c) 2026 Julia Rydzek, Marta Zawadzka, Adrian Muzyka, Zuzanna Krupa, Joanna Wrona, Dr. Karolina Dorobisz
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