David White

Presenters of a Monday afternoon scientific symposium will discuss the state of the art of personalized medicine for obstructive sleep apnea (OSA).

“Currently, the vast majority of patients with OSA are treated with nasal continuous positive airway pressure (CPAP), which, although effective, is poorly tolerated by most patients and is unacceptable to many,” says David White, MD, a professor of sleep medicine at Harvard Medical School and a senior physician in the Division of Sleep Medicine at Brigham and Women’s Hospital, Boston.

“Although there are other potential therapies, most only work in a sub-segment of OSA patients with no real way, other than trial and error, to determine in whom these therapies might be effective. Thus many patients remain untreated,” Dr. White adds.

Dr. White and Allan Richard Schwartz, MD, professor of medicine at Johns Hopkins University, Baltimore, are co-chairs of “Personalized Medicine for Sleep Apnea: State of the Art” from 2:15 to 4:15 p.m. in Mile High Ballroom 2B/3B (Lower Level) Colorado Convention Center.

Speakers will discuss novel ways to determine why a given patient has OSA, with four traits dictating those with and without OSA:

• Pharyngeal anatomy and site of collapse
• Upper airway muscle control asleep
• Respiratory arousal threshold
• Loop gain (ventilator control instability)

“With this knowledge, therapies can be targeted at the individual pathology with reasonable expectations for success,” says Dr. White, adding that such therapies can include devices, surgery, and drugs, which can be used alone or in combination to achieve optimal results.

Symposium speakers will address sophisticated pharmaceutical approaches to OSA therapy, as well as more standard ones, such as surgery and oral appliances.

“This is a fundamental change in the approach to OSA therapy, which to date has been ‘one size fits all,’ plus ‘trial and error.’ It also will allow the introduction of new therapies, which previously would not have been considered reasonable options,” Dr. White says.

For additional programming concentrating on sleep-disordered breathing in personalized medicine, plan to attend today’s abstract-based mini symposium “Picking Winners. Predicting Response to Treatment of Sleep-Disordered Breathing in an Era of Personalized Medicine” and Wednesday’s symposium “Impact of Sleep-Disordered Breathing on Maternal and Fetal Outcomes of Pregnancy.” Both will be from 9:30 to 11:30 a.m. in Mile High Ballroom 2B/3B (Lower Level) Colorado Convention Center.