Future of Sleep-Disordered Breathing Therapy Using a Mechanistic Approach
Overview
Affiliations
Sleep disordered breathing (SDB) is highly prevalent among patients with cardiovascular disease (CVD), and the relationship between SDB and CVD may be bidirectional. However, SDB remains underdiagnosed and undertreated. One of the major barriers identified by cardiologists is lack of satisfaction with SDB therapy. This situation could be the result of the discordance between treatment and the pathophysiological characteristics of SDB. This condition is caused by multiple pathophysiological mechanisms, which could be classified into upper airway anatomic compromise, pharyngeal dilator muscle dysfunction, and ventilatory control instability. However, the effective treatment of SDB remains limited, and positive airway pressure therapy is still the mainstay of the treatment. Therefore, we review the pathophysiological characteristics of SDB in this article, and we propose to provide individualized treatment of SDB based on the underlying mechanism. This approach requires further study but could potentially improve adherence and success of therapy.
Tackling obstructive sleep apnea with pharmacotherapeutics: expert guidance.
Harding C, Fuentes A, Malhotra A Expert Opin Pharmacother. 2024; 25(8):1019-1026.
PMID: 38913403 PMC: 11227253. DOI: 10.1080/14656566.2024.2365329.
Malhotra A, Bednarik J, Chakladar S, Dunn J, Weaver T, Grunstein R Contemp Clin Trials. 2024; 141:107516.
PMID: 38547961 PMC: 11168245. DOI: 10.1016/j.cct.2024.107516.
Sleep Apnea, Obesity, and Diabetes - an Intertwined Trio.
Kurnool S, McCowen K, Bernstein N, Malhotra A Curr Diab Rep. 2023; 23(7):165-171.
PMID: 37148488 PMC: 10239381. DOI: 10.1007/s11892-023-01510-6.
Sleep apnea, metabolic disease, and the cutting edge of therapy.
Light M, McCowen K, Malhotra A, Mesarwi O Metabolism. 2017; 84:94-98.
PMID: 28966076 PMC: 5874161. DOI: 10.1016/j.metabol.2017.09.004.