Sleep apnoea and its consequences: from animal models to precision medicine

Abstract

A European Respiratory Society research seminar entitled "Sleep Apnoea and Its Consequences: From Animal Models to Precision Medicine" was held in January 2024 in Lisbon, Portugal. It provided an in-depth analysis of the current landscape and future directions in OSA research, integrating recent findings from metabolomics, animal models, clinical predictors of cardiometabolic consequences of OSA, artificial intelligence (AI), and advances in diagnostic algorithms. This article presents a narrative review of the seminar's key discussions and conclusions. The limitations of current randomized controlled trials (RCTs) in assessing OSA treatment, such as low adherence and patient selection bias (e.g., absence of sleepiness or severe hypoxemia), were critically discussed. The expert panel recommended the use of real-world data, including patients commonly seen in clinical practice, and the use of digital tools for real-time monitoring of adherence and side effects. The concept of platform "disease-focused" trials was discussed as a more efficient and adaptable research design that could allow clinical trials to be more representative of the general OSA population and to compare CPAP with emerging treatments such as new drugs, devices and lifestyle interventions to gain a broader understanding of effective management strategies. The seminar concluded that a multifaceted approach to OSA research that leverages the strengths of animal models, advanced AI, metabolomics, and improved diagnostic algorithms is needed to gain deeper insights into the mechanisms of OSA and its treatment response. This new approach, coupled with new "platform" clinical trial designs, could contribute to improved outcomes in patients with OSA