Endotyping in Patients with Obstructive Sleep Apnea and Hypoglossal Nerve Stimulation. The Golden Goal to a Successful Treatment?

Heiser discusses the study by Op de Beeck and colleagues different endotypes in patients with obstructive sleep apnea (OSA) and which of these factors have influence on outcomes for hypoglossal nerve stimulation (HGNS). The authors' work will help future patient selection to be more precise regarding various treatment options. HGNS for patients who are noncompliant with the standard treatment of continuous positive airway pressure therapy has rapidly emerged in the foundational clinical routine in Western industrialized countries. Nonetheless, approximately one-third of the patients are incomplete responders, fueling the need for more discerning selection criteria. Op de Beeck and colleagues used polysomnographic data from the STAR trial to assess the pathophysiological mechanisms, namely, arousal threshold, loop gain, collapsibility, and muscle compensation.