Sleep studies have become an integral part of understanding various physiological processes in the body, and it is opening new doors to clinical practices. Dr. Reena Mehra, director and professor of medicine at the Sleep Disorders Center at the Cleveland Clinic, highlighted the vast potential for endophenotypes yielded by sleep studies in predicting clinical outcomes in an interview at the SLEEP 2023 conference. These endophenotypes can help in screening and predicting outcomes, ranging from conditions like atrial fibrillation to risk stratification populations and treatment responsiveness.
However, the treatment for sleep apnea has primarily been focused on managing patient symptoms. The field of endophenotyping, which is gaining significant attention, emphasizes the need to move beyond simplistic measures. Dr. Mehra stressed on integrating clinical symptom management with the objective data obtained from sleep studies.
Dr. Mehra and her team at Cleveland Clinic have received the Discovery Accelerator Award in collaboration with IBM to investigate how different facets of sleep apnea pathophysiology contribute to the development of atrial fibrillation. CPAP therapy remains the first-line treatment, but the optimal option depends on the individual. Advancements have led to additional treatment avenues like hypoglossal nerve stimulation and oral appliances. However, there is a need to determine which specific treatment strategy is best for each patient.
Dr. Mehra noted that there is an opportunity to look at patients’ symptoms and polysomnographic findings during cluster analyses and determine whether there are grouping of endophenotypes from the sleep studies. Combining all these factors would aid in figuring out who will derive the most significant benefit from a specific type of therapy.
Sleep studies have shown that they can provide a wealth of information to advance clinical practice. Beyond analyzing sleep disorders, sleep studies have the potential to help screen patients for other medical conditions. For instance, apnea-hypopnea events are strongly associated with cardiovascular diseases like atrial fibrillation, and identifying the endophenotypes of sleep apnea can help in developing strategies for cardiovascular risk assessment.
It is worth noting that initial screening for cardiovascular diseases typically relies on risk scores like the Framingham Risk Score. These scores can be a good starting point, but they are not sensitive enough to pick up on subtle changes in an individual’s health. Picking up on these changes can lead to early intervention and better disease management.
Sleep studies can provide more sensitive measures to detect subclinical changes in the body that are not detectable during routine check-ups. Sleep studies can identify subclinical cardiac dysfunction and can point out the predictors of developing cardiovascular disease. Also, sleep deprivation can have significant implications for cardiovascular health. Thus, understanding sleep cycles through sleep studies can aid in the management of cardiovascular disease.
It is evident that sleep studies have enormous potential to help identify endophenotypes of various conditions and manage patient symptoms effectively. A more significant emphasis on using sleep studies to predict clinical outcomes opens many doors to early intervention and better disease management.
