Precision Prevention in Obstructive Sleep Apnea

Abstract

Sleep-related breathing disorders, encompassing snoring and obstructive sleep apnea, are highly prevalent worldwide and there have been important advances on recent years regarding the understanding of the underlying pathophysiology mechanisms, diagnosis, and improvement in the therapeutic options. There is still great debate on answering several basic questions: What, how, and when should patients be tested? What metrics and parameters should be used to characterize and define at-risk populations for developing consequences and predict the response an individual patient may have to different treatment options? The precision medicine and person-centered approaches are based on that every individual is unique and that a myriad of elements influence the likelihood of developing the disease, the signs and symptoms expressed, the response to different treatment modalities, and the susceptibility to complications. Thus, health and disease are the result of phenotypic outcomes resulting from interactions between biological factors, environment, and lifestyle. Customizing prevention and management strategies through this paradigm promotes an evidence-based shared decision approach to implement individualized strategies aiming to achieve continuity of care, disease alleviation and quality of life improvement in a cost-effective manner. This paradigm shift incorporates positive sleep health promotion and preservation across individuals and populations instead of concentrating mainly on disease treatment.