Les multiples enjeux de la sémiologie du syndrome d’apnées obstructives du sommeil chez l’adulte

Abstract

Semiology, through the study of clinical manifestations (symptoms and signs) of diseases, is a fundamental step for diagnostic evaluation, prognosis, and therapeutic decision-making. This article aims to explore the challenges of semiology in Obstructive Sleep Apnea Syndrome (OSAS) within the major domains of semiology application in medicine: defining diagnostic criteria (using symptoms as indicators, i.e., signs of a specific disease), screening (using symptoms as risk indicators for a disease), phenotyping (using symptoms as indicators of a specific phenotypic profile of a disease), and Patient-Reported Outcome Measures (PROMs) (using symptoms as indicators of a subject's disease experience). To date, no strong interrelation of semiological issues across these different domains has been established for OSAS. Facilitating a semiological translation across various research domains is therefore essential for unification and advancement of concepts on OSAS, as well as for clinicians' engagement to establish a beneficial loop between research and clinical practice. Two semiological perspectives for personalized medicine of OSAS are discussed. The first perspective aims to better understand the link between pathophysiological mechanisms, the presence and severity of clinical manifestations of OSAS, and their impact on functioning, quality of life, and perceived health. The second perspective aims to make the choice of clinical manifestations of OSAS more explicit and standardized to define therapeutic goals and the effectiveness of management.