Endotypes and phenotypes in obstructive sleep apnea-current developments

The apnea-hypopnea index is now outdated as a single parameter for severity classification and treatment management in obstructive sleep apnea (OSA) due to various limitations. In this review article, current findings regarding endotypes and phenotypes in OSA are highlighted, providing insights into pathophysiological mechanisms and clinical manifestations. In addition to anatomical aspects, pathophysiological factors also include functional aspects, the knowledge and identification of which opens up personalized treatment options. New polysomnographic parameters are able to identify risk collectives with regard to cardiovascular and overall mortality as well as neurocognitive outcome. Clinical parameters such as symptoms are also of particular importance in patients with OSA. Biomarkers such as micro-RNA are potentially helpful for the identification and characterization of certain risk collectives.