Abstract：
Obstructive sleep apnea (OSA) affects nearly one billion of the global adult population. It is associated with substantial burden in terms of quality of life, cognitive function, and cardiovascular health. Positive airway pressure (PAP) therapy, commonly considered the first-line treatment, is limited by low compliance and lacking efficacy on long-term cardiovascular outcomes. A substantial body of research has been produced investigating (novel) non-PAP treatments. With increased understanding of OSA pathogenesis, promising therapeutic approaches are emerging. There is an imperative need of high-quality synthesis of evidence; however, current systematic reviews and meta-analyses (SR/MA) on the topic demonstrate important methodological limitations and are seldom based on research questions that fully reflect the complex intricacies of OSA management. Here, we discuss the current challenges in management of OSA, the need of treatable traits based OSA treatment, the methodological limitations of existing SR/MA in the field, potential remedies, as well as future perspectives.
摘要：
阻塞性睡眠呼吸暂停(OSA)影响全球近10亿成年人口。它与生活质量方面的沉重负担有关，认知功能,和心血管健康。气道正压通气（PAP）治疗，通常认为是一线治疗，受到依从性低和对长期心血管结局缺乏疗效的限制。已经产生了大量的研究来研究(新的)非PAP治疗。随着人们对OSA发病机制的进一步了解，有希望的治疗方法正在出现。迫切需要高质量的证据合成；然而，当前有关该主题的系统评价和荟萃分析（SR/MA）显示出重要的方法论局限性，并且很少基于充分反映OSA管理复杂复杂性的研究问题。这里,我们讨论了OSA管理的当前挑战，需要基于可治疗性状的OSA治疗，该领域现有SR/MA的方法学局限性，潜在的补救措施，以及未来的前景。
