Future of sleep apnea therapy using a mechanistic approach

Obstructive sleep apnea(OSA) has multiple underlying mechanisms which vary across patients. In afflicted patients, the degree of abnormality in pharyngeal anatomy, dilator muscle function, ventilatory control instability etc is highly variable. In patients with anatomical compromise at the velopharynx, robust responses to palatal surgery would be predicted, whereas other patients may have no major improvement if the primary abnormality were elsewhere. Similarly, measures to influence ventilatory control such as oxygen or acetazolamide may yield major improvements, but only for patients with unstable ventilatory control. Further research into treatment of OSA based on underlying mechanism is required.