Development of a predictive model for endotype-based patient selection for obstructive sleep apnea treatment. 01/10/2021 - 30/09/2024

Abstract

Obstructive sleep apnea (OSA) is a highly prevalent disease, associated with several cardiovascular and cerebrovascular comorbidities. Adequate treatment is thus crucial. Based on the current guidelines, continuous positive airway pressure (CPAP) is considered the standard OSA treatment. While CPAP efficacy is high, patient tolerance and acceptance is only moderate. In general, alternative non-CPAP treatments like mandibular advancement devices, hypoglossal nerve stimulation or pharmacotherapy are well-received, however, their efficacy is potent in some patients but incomplete in others. Efficacy of emerging therapies depends largely on the site of obstruction of the upper airway, key diagnostic information that is notoriously challenging to obtain. In current clinical practice this information is captured during drug-induced sleep endoscopy (DISE), assessing the upper airway during sedation. However, this DISE procedure still requires an additional step in the clinical path involving specialized personnel, time and equipment at the operating theatre. Therefore, I aim to 1) correlate the collapse patterns during DISE with parameters extracted from baseline clinical data in order to develop a prediction model to predict collapse patterns without the need of drug-induced sedation and 2) to apply this model to patients treated with a non-CPAP treatment. In this way, I aim to attain precision OSA medicine using endotype-driven instead of guideline-based OSA treatment.

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Correlations between upper airway endoscopy and physiological traits of obstructive sleep apnea. 04/01/2021 - 04/07/2021

Abstract

Site, pattern and degree of upper airway collapse is correlated with different obstructive sleep apnea (OSA) treatment outcomes. Currently, assessment requires additional, invasive endoscopy techniques. In the current research proposal I aim to non-invasively associate endoscopic outcomes with baseline overnight sleep study parameters using the technical and analytical skills from the group of Drs. Wellman and Sands at Harvard Medical School and the high quality clinical data of the Antwerp University Hospital. Combining the unique features of both groups into one research project will leverage sleep medicine in both the US and Belgium, paving the way to personalized OSA management.

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