SLEEP 2026 | Toward personalized medicine in OSA care: optimal therapy based on individual characteristics

In this new era of personalized medicine and patient-centric medicine, it’s imperative that we do a better job of matching the patients up with their optimal therapy. There’s a number of different considerations that go into this. The first of which is consideration in regards to whether patients will respond to a certain kind of therapy, specifically therapies that are not CPAP or PAP related. And so one of the ways of being able to do this, and this has very much been pioneered by Dr Scott Sands over at Harvard, is by identifying OSA endotypes. And so depending on the type of physiologic or pathophysiologic component that leads to the patient’s airway collapse and sleep apnea and so forth, that really very well may guide us in regards to what therapies the patient is a candidate for. The other consideration would be related to more behavioral phenotyping as it relates to whether a person is a good candidate for CPAP therapy. As we know, CPAP therapy is fully efficacious, but the problem with CPAP is that it’s not fully effective and that adherence to CPAP, especially long-term, is a major barrier to optimizing outcomes. In which case, being able to utilize different data and to be able to behaviorally phenotype patients, perhaps even through electronic health record data and so forth, can help us predict if a person is going to be adherent to CPAP long term or not. And so there’s a few different considerations in regards to trying to optimize therapy. But our goal very much is to use data to really help us guide what kind of therapies a patient is a candidate for, whether it’s CPAP therapy or whether it’s an alternative therapy.

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