| Title: |
The Great Controversy of Obstructive Sleep Apnea Treatment for Cardiovascular Risk Benefit: Advancing the Science through Expert Consensus: An Official American Thoracic Society Workshop Report |
| Authors: |
Cohen, Oren; Cohen, Oren; Kundel, Vaishnavi; Barbé, Ferran; Peker, Yüksel; McEvoy, Doug; Sánchez-de-la-Torre, Manuel; Gottlieb, Daniel J; Bradley, T Douglas; Suárez-Fariñas, Mayte; Zinchuk, Andrey; Azarbarzin, Ali; Malhotra, Atul; Schotland, Helena; Gozal, David; Jelic, Sanja; Ramos, Alberto R; Martin, Jennifer L; Pamidi, Sushmita; Johnson, Dayna A; Mehra, Reena; Somers, Virend K; Hoyos, Camilla M; Jackson, Chandra L; Alcantara, Carmela; Billings, Martha E; Bhatt, Deepak L; Patel, Sanjay R; Redline, Susan; Yaggi, Henry K; Shah, Neomi A |
| Source: |
Annals of the American Thoracic Society; vol 22, iss 1, 1-22; 2329-6933 |
| Publisher Information: |
eScholarship, University of California 2025-01-01 |
| Document Type: |
Electronic Resource |
| Abstract: |
The prevalence of obstructive sleep apnea (OSA) is on the rise, driven by various factors including more sensitive diagnostic criteria, increased awareness, enhanced technology through at-home testing enabling easy and cost-effective diagnosis, and a growing incidence of comorbid conditions such as obesity. Treating symptomatic patients with OSA syndrome to enhance quality of life remains a cornerstone approach. However, there is a lack of consensus regarding treatment to improve cardiovascular disease (CVD) outcomes, particularly in light of overall negative results from several randomized controlled trials (RCT) indicating no benefit of positive airway pressure (PAP) therapy on primary and secondary CVD events. These RCTs were limited by suboptimal PAP adherence, use of composite CVD outcomes, and limited diversity and generalizability to Sleep Clinic patients. As such, this workshop assembled clinical experts, as well as researchers in basic and translational science, epidemiology, clinical trials, and population health to discuss the current state, and future research directions to guide personalized therapeutic strategies and future research directions in OSA. There was overall consensus among workshop participants that OSA represents a heterogeneous disease with variable endotypes and phenotypes, and heterogeneous responses to treatment. Future research should prioritize employing multi-modal therapeutic approaches within innovative and adaptive trial designs, focusing on specific subgroups of OSA patients hypothesized to benefit from a CVD perspective. Future work should also be inclusive of diverse populations and consider the life-course of OSA to better comprehend treatment strategies that can address the disproportionate impact of OSA on racially minoritized groups. Further, a more holistic approach to sleep must be adopted to include broader assessments of symptoms, sleep duration, and comorbid sleep and circadian disorders. Finally, it is imperative to |
| Index Terms: |
Biomedical and Clinical Sciences; Cardiovascular Medicine and Haematology; Behavioral and Social Science; Lung; Clinical Trials and Supportive Activities; Sleep Research; Prevention; Cardiovascular; Clinical Research; Women's Health; Good Health and Well Being; Cardiovascular medicine and haematology; Clinical sciences; article |
| URL: |
https://escholarship.org/uc/item/6gh842bj; https://escholarship.org/content/qt6gh842bj/qt6gh842bj.pdf |
| Availability: |
Open access content. Open access content; public |
| Note: |
application/pdf; Annals of the American Thoracic Society vol 22, iss 1, 1-22 2329-6933 |
| Other Numbers: |
CDLER oai:escholarship.org:ark:/13030/qt6gh842bj; qt6gh842bj; https://escholarship.org/uc/item/6gh842bj; https://escholarship.org/content/qt6gh842bj/qt6gh842bj.pdf; info:doi/10.1513/annalsats.202409-981st; https://escholarship.org/; 1490367671 |
| Contributing Source: |
UC MASS DIGITIZATION; From OAIster®, provided by the OCLC Cooperative. |
| Accession Number: |
edsoai.on1490367671 |
| Database: |
OAIster |