Obstructive Sleep Apnea Phenotypes: First Decade of Exploration and Beyond

A special issue of Pathophysiology (ISSN 1873-149X).

Deadline for manuscript submissions: 31 December 2025 | Viewed by 1074

Special Issue Editors


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Guest Editor
Department of Molecular and Cellular Physiology, LSU Health Shreveport, Shreveport, LA 71103, USA
Interests: neurophysiology; neurodegeneration; cellular neuroscience; neurobiology; stroke therapy; kidney and liver transplantation; 3D tissue engineering
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Guest Editor
Sleep Medicine Division, Department of Neurology, Louisiana State University Health Sciences Center, Shreveport, LA, USA
Interests: sleep medicine; neurology; vascular neurology; headache; creatome neurosciences; mobile sleep medicine; precision sleep medicine

Special Issue Information

Dear Colleagues,

We would like to invite you to contribute to this Special Issue of Pathophysiology entitled “Obstructive Sleep Apnea Phenotypes: First Decade of Exploration and Beyond”.

Obstructive sleep apnea (OSA) is a common sleep disorder with a significant heterogeneity in presentation and substantial cardio-cerebrovascular morbidity and mortality. Current practice uses the Apnea–Hypopnea index (AHI) as the main tool for classification and stratification of OSA; however, this index does not consider the heterogeneity of the clinical presentation of OSA, as patients with the identical AHIs may express different symptoms, experience different responses to therapy, as well as have different comorbid associations. This gap in the current management of OSA has been a subject of research and discussion over the past 10 years. A proposed way to address this gap is to classify the disease through quantitative and qualitative clinical, demographic, pathophysiologic, polysomnographic, and neurophysiologic characteristics and generate homogeneous categories called “phenotypes”. It has been proposed that OSA phenotypes are “categories of patients with OSA distinguished from others by a single or combination of disease features in relation to clinically meaningful attributes (symptoms, response to therapy, health outcomes, quality of life)”. It is worth noticing that this definition differs from the status of “endotype”, which would require categorization through biological or genetic mechanisms; however, phenotypes allow for further disease stratification and possible therapy strategy generation reflected in the concept of precision sleep medicine.

This Special Issue intends to review and summarize the latest articles on OSA phenotypes and their significance on management, disease prognosis, and comorbid associations.

We welcome reviews, original studies, and case reports that contribute to the field of precision sleep medicine and improve our practical understanding of OSA diagnosis, prognosis, and management based on this novel clinical methodology.

We look forward to receiving your contributions.

Prof. Dr. Jonathan Steven Alexander
Prof. Dr. Oleg Chernyshev
Guest Editors

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Keywords

  • OSA phenotypes
  • OSA endotypes
  • precision sleep medicine
  • clinical polysomnographic OSA phenotypes
  • pathophysiologic OSA phenotypes
  • clinical neuro-physiologic OSA phenotypes
  • clinical symptom-based OSA phenotypes
  • quantitative
  • qualitative OSA phenotypes

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Published Papers (1 paper)

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Research

12 pages, 1226 KB  
Article
Three-Dimensional Airway Assessment as Diagnostic Aid in Obstructive Sleep Apnea
by Oscar Arturo Benítez-Cárdenas, Néstor Oliver Herrera-Salguero, Elhi Manuel Torres-Hernández, Miguel Angel Noyola-Frías, Ricardo Martínez-Rider and Marlen Vitales-Noyola
Pathophysiology 2025, 32(4), 50; https://doi.org/10.3390/pathophysiology32040050 - 26 Sep 2025
Viewed by 302
Abstract
Background: Obstructive Sleep Apnea Syndrome (OSAS) is a prevalent and underdiagnosed condition with significant systemic and quality-of-life impacts. While polysomnography remains the gold standard for diagnosis, cone-beam computed tomography (CBCT) presents a potential adjunctive imaging tool for anatomical airway evaluation. Objective: [...] Read more.
Background: Obstructive Sleep Apnea Syndrome (OSAS) is a prevalent and underdiagnosed condition with significant systemic and quality-of-life impacts. While polysomnography remains the gold standard for diagnosis, cone-beam computed tomography (CBCT) presents a potential adjunctive imaging tool for anatomical airway evaluation. Objective: We aimed to assess the effectiveness of three-dimensional airway evaluation via CBCT as a complementary diagnostic tool for OSAS. Methods: A diagnostic test study (experimental pilot study) was conducted using CBCT scans of 30 patients, divided into two groups: 15 scans from patients with a confirmed OSAS diagnosis through polysomnography and 15 scans from healthy controls. Five tomographic variables were analyzed: anteroposterior distance, lateral distance, minimum cross-sectional area, airway volume, and airway shape. Statistical analysis was performed comparing both groups. Results: The minimum cross-sectional area and airway volume showed statistically significant differences between the OSAS and control groups (p = 0.038 and p = 0.0055, respectively). Anteroposterior and lateral distances showed trends toward significance but were not statistically significant. Conclusions: CBCT-based airway analysis, particularly focusing on volumetric and cross-sectional area parameters, demonstrates strong potential as a complementary tool in the diagnosis of peripheral-type OSAS. However, it cannot replace polysomnography, especially for central OSAS diagnosis. Full article
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