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

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 indicating no benefit of positive airway pressure therapy on primary and secondary CVD events. These randomized controlled trials were limited by suboptimal positive airway pressure 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 using multimodal therapeutic approaches within innovative and adaptive trial designs, focusing on specific subgroups of patients with OSA 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. Furthermore, 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 establish a sleep research consortium dedicated to collecting raw data and biospecimens categorized by OSA subtypes. This will facilitate mechanistic determinations, foster collaborative research, and help bolster the pipeline of early-career researchers.

Authors

Institutions

Publication Details

Journal
Annals of the American Thoracic Society
Published
2024-11-08
DOI
https://doi.org/10.1513/annalsats.202409-981st
Citations
18
Primary Topic
Obstructive Sleep Apnea Research
Type
article
Field-Weighted Citation Impact
5.88

Funders

Controls
|||
ALL TIME
JAN
FEB
MAR
APR
MAY
JUN
JUL
AUG
SEP
OCT
article

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

Dayna A. Johnson, R. Doug McEvoy, Virend K. Somers, Helena Schotland et al.
18 citations
Annals of the American Thoracic Society
Obstructive Sleep Apnea Research
5.88
article

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

Dayna A. Johnson, R. Doug McEvoy, Virend K. Somers, Helena Schotland, H. Klar Yaggi, T. Douglas Bradley, Daniel J. Gottlieb, David Gozal, Andrey Zinchuk, Ferrán Barbé, Sanja Jelić, Susan Redline, Neomi Shah, Chandra L. Jackson, Vaishnavi Kundel, Alberto R. Ramos, Jennifer L. Martin, Martha E. Billings, Mayte Suárez‐Fariñas, Oren Cohen, Sushmita Pamidi, Ali Azarbarzin, Manuel Sánchez‐de‐la‐Torre, Yüksel Peker, Carmela Alcántara, Camilla M. Hoyos, Sanjay R. Patel, Reena Mehra, Atul Malhotra, Deepak L Bhatt
article en
18 citations

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 indicating no benefit of positive airway pressure therapy on primary and secondary CVD events. These randomized controlled trials were limited by suboptimal positive airway pressure 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 using multimodal therapeutic approaches within innovative and adaptive trial designs, focusing on specific subgroups of patients with OSA 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. Furthermore, 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 establish a sleep research consortium dedicated to collecting raw data and biospecimens categorized by OSA subtypes. This will facilitate mechanistic determinations, foster collaborative research, and help bolster the pipeline of early-career researchers.

Annals of the American Thoracic SocietyVol. 22(1)
Brigham and Women's Hospital (US), National Institutes of Health (US), University Health Network (CA), Mayo Clinic (US), Koç University (TR), Harvard University (US), University of Miami (US), Emory University (US), University of California, Los Angeles (US), Flinders University (AU), University of Pittsburgh (US), University of Washington (US), Columbia University Irving Medical Center (US), Toronto Rehabilitation Institute (CA), Woolcock Institute of Medical Research (AU), Government of Western Australia Department of Health (AU), Instituto de Salud Carlos III (ES), VA Boston Healthcare System (US), McGill University Health Centre (CA), Toronto General Hospital (CA), Hospital Universitari Arnau de Vilanova (ES), University of California System (US), Yale University (US), University of California San Diego (US), National Institute of Environmental Health Sciences (US), Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (ES), Mount Sinai Hospital (US), Geriatric Research Education and Clinical Center (US), Adelaide Institute for Sleep Health (AU), Instituto de Investigación Biomédica de Lleida (ES), Circadian (United States) (US), Comunidad de Madrid (ES), Hospital Nacional de Parapléjicos (ES), VA Greater Los Angeles Healthcare System (US), National Health and Medical Research Council (AU), Columbia University (US), University of Castilla-La Mancha (ES), Marshall University (US), Icahn School of Medicine at Mount Sinai (US), Macquarie University (AU)
U.S. Department of Veterans Affairs, American Heart Association, American Thoracic Society, Amgen, Bristol-Myers Squibb, Eli Lilly and Company, Pfizer, AstraZeneca, GlaxoSmithKline, Sanofi, American College of Cardiology Foundation, Alnylam Pharmaceuticals, University of Miami, Cleveland Clinic, University of Pittsburgh, CSL Behring, Boston Scientific Corporation, Boston VA Research Institute, Regeneron Pharmaceuticals, American Academy of Sleep Medicine, Ironwood Pharmaceuticals, Incorporated, Jazz Pharmaceuticals, LivaNova, Amarin Corporation, Medicines Company, MyoKardia, ResMed, Regado Biosciences, Belvoir Media Group, Moderna, Australasian Sleep Association, Cerebra, Eisai, Novo Nordisk, Assistance publique-Hôpitaux de Paris, Idorsia Pharmaceuticals, HLS Therapeutics, National Institutes of Health, Agency for Healthcare Research and Quality, Respicardia, Canadian Institutes of Health Research, Instituto de Salud Carlos III, National Heart, Lung, and Blood Institute, Duke Clinical Research Institute
Good health and well-being
Openalex Percentile: Top 3%
Obstructive Sleep Apnea Research
5.88
DOIOpen Access PDFOpenAlex
AI Navigator

Ask Laika to Summarize, Analyze, and Connect papers live on the map.

Summarize Papers & Methodologies

Extract key findings, datasets, and comparative methods across publications.

Benchmark Rankings & Visual Analytics

Rank top research institutions, authors, funders, topics, and journals by Field-Weighted Citation Impact (FWCI) and paper volume with instant charts.

Connect Distant Disciplines

Bridge topological clusters on the map to find hidden collaborative intersections.