PT  - JOURNAL ARTICLE
AU  - Winfried Randerath
AU  - Claudio L. Bassetti
AU  - Maria R. Bonsignore
AU  - Ramon Farre
AU  - Luigi Ferini-Strambi
AU  - Ludger Grote
AU  - Jan Hedner
AU  - Malcolm Kohler
AU  - Miguel-Angel Martinez-Garcia
AU  - Stefan Mihaicuta
AU  - Josep Montserrat
AU  - Jean-Louis Pepin
AU  - Dirk Pevernagie
AU  - Fabio Pizza
AU  - Olli Polo
AU  - Renata Riha
AU  - Silke Ryan
AU  - Johan Verbraecken
AU  - Walter T. McNicholas
TI  - Challenges and perspectives in obstructive sleep apnoea
AID  - 10.1183/13993003.02616-2017
DP  - 2018 Sep 01
TA  - European Respiratory Journal
PG  - 1702616
VI  - 52
IP  - 3
4099  - http://erj.ersjournals.com/content/52/3/1702616.short
4100  - http://erj.ersjournals.com/content/52/3/1702616.full
SO  - Eur Respir J2018 Sep 01; 52
AB  - Obstructive sleep apnoea (OSA) is a major challenge for physicians and healthcare systems throughout the world. The high prevalence and the impact on daily life of OSA oblige clinicians to offer effective and acceptable treatment options. However, recent evidence has raised questions about the benefits of positive airway pressure therapy in ameliorating comorbidities.An international expert group considered the current state of knowledge based on the most relevant publications in the previous 5 years, discussed the current challenges in the field, and proposed topics for future research on epidemiology, phenotyping, underlying mechanisms, prognostic implications and optimal treatment of patients with OSA.The group concluded that a revision to the diagnostic criteria for OSA is required to include factors that reflect different clinical and pathophysiological phenotypes and relevant comorbidities (e.g. nondipping nocturnal blood pressure). Furthermore, current severity thresholds require revision to reflect factors such as the disparity in the apnoea–hypopnoea index (AHI) between polysomnography and sleep studies that do not include sleep stage measurements, in addition to the poor correlation between AHI and daytime symptoms such as sleepiness. Management decisions should be linked to the underlying phenotype and consider outcomes beyond AHI.Clinical and pathophysiological phenotyping and personalised diagnostic and therapeutic procedures remain challenges in obstructive sleep apnoea management http://ow.ly/OhNU30jOCr3